GI drugs: H2 blockers versus PPIs: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · GI drugs: H2 blockers versus PPIs

Sample item

How do H2 receptor blockers and proton pump inhibitors differ in their effect on gastric acid?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. PPIs block the final common step of acid secretion and suppress it more completely than H2 blockers

H2 blockers block only the histamine pathway on the parietal cell, whereas PPIs irreversibly inhibit the proton pump, the final step common to all stimuli. PPIs therefore achieve greater and longer suppression, particularly of meal-stimulated acid.

Option by option

  • A. PPIs act by blocking muscarinic M3 receptors on parietal cells

    PPIs are not muscarinic antagonists.

  • B. H2 blockers inhibit H+/K+ ATPase irreversibly

    H2 blockers are receptor antagonists and do not touch the pump.

  • C. H2 blockers suppress acid secretion more completely than PPIs

    The reverse is true; PPIs are more effective.

  • D. PPIs block the final common step of acid secretion and suppress it more completely than H2 blockers (correct)

    Correct. PPIs act at the final common step and are more efficacious.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, PPIs block the final common step of acid secretion and suppress it more completely than H2 blockers. H2 blockers block only the histamine pathway on the parietal cell, whereas PPIs irreversibly inhibit the proton pump, the final step common to all stimuli.

Why is "PPIs act by blocking muscarinic M3 receptors on parietal cells" not the answer?

PPIs are not muscarinic antagonists.

Why is "H2 blockers inhibit H+/K+ ATPase irreversibly" not the answer?

H2 blockers are receptor antagonists and do not touch the pump.

Why is "H2 blockers suppress acid secretion more completely than PPIs" not the answer?

The reverse is true; PPIs are more effective.

What concept does this question test?

It tests GI drugs: H2 blockers versus PPIs in Pharmacology. PPIs therefore achieve greater and longer suppression, particularly of meal-stimulated acid.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI drugs: H2 blockers versus PPIs?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.