Potassium-Competitive Acid Blockers (P-CAB): Pharmacology Made Easy

In this This Is Why with Dr. Busti pharmacology review, we break down the newest entrant to the antacid category — the potassium-competitive acid blocker (P-CAB or PCAB), vonoprazan. You’ll see how P-CABs differ from H₂ blockers and PPIs, why their rapid onset, 24-hour+ acid suppression, and basal acid control make them a valuable option when PPIs fall short, and where they fit for GERD, erosive esophagitis, and H. pylori.

We connect mechanism to practice: relevant anatomy, parietal-cell signaling, PK/PD (onset, duration, metabolism), drug interactions (including pH-dependent meds and CYP pathways), adverse effects (mirroring PPI risks), monitoring, and concise patient counseling (including the chromogranin A caveat).

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Chapter Table of Contents
00:00 Introduction to PCABs: The New Acid-Suppressing Drug Class
00:37 Indications & Clinical Role: GERD, Erosive Esophagitis, H. pylori Regimens
01:23 Onset of Action & Why Rapid Acid Suppression Matters
03:48 Mechanism of Action: Potassium-Competitive Inhibition of H+/K+ ATPase
05:12 Acid-Related Disorders: GERD, Ulcers, Barrett’s & Bleeding Risk
10:22 Deep Dive: Parietal Cell Structure, Luminal vs Basolateral Membrane
12:48 Proton Pump Function vs PCAB Binding Characteristics
16:17 Dosing Considerations: Once-Daily Regimens & Patient-Specific Factors
17:20 Gene-Level & Cellular Effects: Receptor Biology and Longevity of Acid Blockade
22:40 Pharmacokinetics: CYP450 Pathways, Onset, Half-Life & Drug Interactions
24:22 Adverse Effects: Pneumonia, C. diff, SBP Risk & Altered Gastric Flora
25:36 Risk Factors for Adverse Events: Hospitalization, Travel Exposure, Antibiotic Use

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#PCAB #Vonoprazan #pharmacology #gipharmacology #medicaleducation

Disclaimer: This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard in this content.