This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
Proton pump inhibitors are most effective when they are given - 
Select and explain. 
A. After meals, B. Sholy before meals, C. Along with H2 blockers, D. During prolonged fasting periods
B: Sholy before meals
Answer: B: Sholy before meals 
Explanation: Ans. is 'b' i.e., Sholy before meals o Bioavailibility of all PPIs is reduced by food; they should be taken in empty stomach, followed 1 hour later by a meal to activate 1-1+ ATPase and make it more susceptible to the PPI. o PPIs should be administered approximately 1 hour before a meal (usually breakfast) so that the peak serum concentration coincides with the maximal activity of proton pump secretion.