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NBME 21 Answers
A 53-year-old woman with gastroesophageal reflux ...
Famotidine is an H2 blocker which really only stops acid secretion via the stimulation of H+/K+ ATPase by histamine, but it still has vagus and gastrin stimulation.
If you use Omeprazole, you get irreversible inhibition of the pump itself which stops the secretion of acid even if there is histamine, gastrin, vagus stimulation.
what about the healing of her mucosa. Is that not the action of prostaglandin?. That threw me off cos according to FA, misoprostol increases secretion of the gastric mucosa
I guess because misoprostol is more associated with treatment of NSAID related ulcers and PPIs are 1st line DOC for GERD?