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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). 👉 Access tables for this episode at https://www.thisiswhy.health/topics/p... 👉 Get more with a free membership at https://www.thisiswhy.health/ Access free downloads from our videos Access deep dive content from Dr. Busti Organize content via playlists & collections Join live Q&A Receive member newsletters Coupons & discounts for exam prep resources 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 👍 If this helped you, please like, subscribe, and share it with a classmate or colleague. That will help this new channel continue producing free, high-yield medical education content. 🔔 Don’t forget to turn on notifications so you don’t miss upcoming lectures on diuretics, antihypertensives, antibiotics, and more! #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.