GI Medications for the NCLEX: PPIs, H2 Blockers, and Antiemetics

Proton Pump Inhibitors (PPIs)

• Suffix: -prazole (omeprazole, pantoprazole, esomeprazole)
• Action: Block H+/K+ ATPase pump - most potent acid suppression
• Take 30-60 minutes before meals
• Long-term risks: C. diff, bone fractures, B12/magnesium deficiency

H2 Receptor Blockers

• Suffix: -tidine (ranitidine*, famotidine, cimetidine)
• Action: Block histamine at H2 receptors - reduce acid production
• Cimetidine: many drug interactions (inhibits CYP450)

Antiemetics

• Ondansetron (Zofran): Serotonin antagonist - first-line for chemo-induced nausea
• Promethazine (Phenergan): Give deep IM (IV can cause tissue necrosis)
• Metoclopramide (Reglan): Prokinetic - risk of tardive dyskinesia

Laxatives

• Bulk-forming (psyllium): Take with full glass of water
• Osmotic (lactulose): Also used for hepatic encephalopathy (reduce ammonia)
• Stimulant (bisacodyl): Short-term use only

Study more at Drug Classifications cheat sheet and Pharmacology Fundamentals deep dive.