scholarly journals Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage?

2015 ◽  
Vol 9 (3) ◽  
pp. 217 ◽  
Author(s):  
Mario Visconti
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Bone Fractures ◽  
Health Care Expenditure ◽  
Significant Proportion ◽  
Acute Interstitial Nephritis ◽  
Nutritional Deficiencies ◽  
Gastric Neoplasms ◽  
Ulcer Disease ◽  
Iatrogenic Damage

Proton pump inhibitors (PPIs) are the most potent drugs for reducing gastric acid secretion; so, since their release in the late 1980s, they have been recommended as the first therapeutic choice for many gastroesophageal diseases, risk reduction in or healing of non-steroidal anti-inflammatory drugs-associated ulcer disease and stress ulcer prophylaxis in intensive care unit patients. Thus PPIs account for a significant proportion of pharmaceutical health-care expenditure. Much of this high expenditure results from overuse of PPIs in account of inappropriate indications or prolongation of therapies for excessive time compared to real need. PPIs overutilization occurs in all medical care settings: in the majority of hospitalized patients with low risks for gastrointestinal bleeding, in patients healed at discharge from hospital, in outpatients in ambulatory practice. However potential adverse effects associated with PPIs therapy have been described, including enteric (especially by <em>Clostridium</em> <em>difficile</em> in elderly patients) and pneumonia infections, nutritional deficiencies, rebound acid hypersecretion, acute interstitial nephritis, gastric neoplasms, bone fractures. Caution is required for some coprescription, particularly with clopidogrel.

scholarly journals Adverse Effects of Proton Pump Inhibitors on Platelet Count: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Subhajit Mukherjee ◽  
Tanima Jana ◽  
Jen-Jung Pan
Keyword(s):  
Case Report ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Case Reports ◽  
Strong Association ◽  
Acute Interstitial Nephritis ◽  
Ulcer Disease ◽  
New Onset

Proton pump inhibitors (PPIs) are the most effective and preferred class of drugs used to treat peptic ulcer disease, gastroesophageal reflux disease, and other diseases associated with increased production of gastric acid. PPIs in general have an excellent long-term safety profile and are well-tolerated. However, studies have shown some adverse reactions (e.g., osteoporosis, Clostridium difficile-associated diarrhea, Vitamin B12 and iron deficiency, and acute interstitial nephritis) on long-term PPI use. Thrombocytopenia attributed to use of PPIs has been described in a few case reports and a retrospective study. In this case report, we describe a case of PPI-induced thrombocytopenia. In our patient, thrombocytopenia immediately developed after the initiation of PPI on two separate occasions and resolved after its discontinuation. The strong association found in our case implies the potential role of PPI in causing this rare but serious adverse reaction. Based on this case report and the observation from other studies, a PPI-induced adverse event should be considered as a possible etiology for new-onset idiopathic thrombocytopenia.

scholarly journals Proton Pump Inhibition is a Feasible Primary Alternative to Surgery and Balloon Dilatation in Adult Peptic Pyloric Stenosis (APS): Report of Six Consecutive Cases

2006 ◽  
Vol 88 (2) ◽  
pp. 174-175 ◽  
Author(s):  
J Shabbir ◽  
S Durrani ◽  
PF Ridgway ◽  
K Mealy
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Pyloric Stenosis ◽  
Median Duration ◽  
Oral Treatment ◽  
Duration Of Symptoms ◽  
Ulcer Disease ◽  
Proton Pump Inhibition

INTRODUCTION Surgery has been the gold standard in the treatment of adult pyloric stenosis (APS). The introduction of proton pump inhibitors (PPIs) in 1989 revolutionised the treatment of peptic ulcer disease and its complications. PATIENTS AND METHODS We carried out a prospective study to evaluate the effectiveness of PPIs as an alternative to surgery for treatment of APS. Six consecutive patients admitted with a diagnosis of adult peptic pyloric stenosis between November 1999 and August 2002 were studied. The diagnosis was confirmed with endoscopy. All patients were commenced on a twice-daily dose of intravenous PPI. This was changed to oral treatment after 2 days. Main outcome measures evaluated were resolution of symptoms on PPIs and failure of medical therapy. RESULTS There were five females and one male. Median age at diagnosis was 72 years (range, 30–90 years). Median duration of symptoms was 2 weeks (range, 1–5 weeks). Of the patients, five had a history of peptic ulcer disease. Complete resolution was achieved in 5 patients (83%). Median duration for resolution of symptoms was 9 days (range, 5–14 days). All patients were changed to oral PPIs after 2 days. One patient did not respond to oral therapy and required surgical intervention (pyloroplasty). Median follow-up was 26 months (range, 6–48 months). There was no recurrence of symptoms. All patients were discharged on low-dose PPI. CONCLUSIONS This study supports the view that proton pump inhibitors are a safe and feasible alternative to surgery in adult pyloric stenosis secondary to peptic ulcer disease.

1226 Under-Utilization of Proton Pump Inhibitors in the Prevention of NSAID-Related Peptic Ulcer Disease in the Elderly

2019 ◽  
Vol 114 (1) ◽  
pp. S684-S684
Author(s):  
Ahmad M. Al-Taee ◽  
Elie Ghoulam ◽  
Preston Lee ◽  
Robert Sbertoli ◽  
Christine Hachem
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
The Elderly ◽  
Ulcer Disease

scholarly journals Increased Risk of Bone Fractures in Hemodialysis Patients Treated with Proton Pump Inhibitors in Real World: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

2019 ◽  
Vol 34 (12) ◽  
pp. 2238-2245 ◽  
Author(s):  
Maria Fusaro ◽  
Graziella D'Arrigo ◽  
Annalisa Pitino ◽  
Giorgio Iervasi ◽  
Francesca Tentori ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Real World ◽  
Practice Patterns ◽  
Bone Fractures ◽  
Hemodialysis Patients ◽  
Increased Risk ◽  
Dialysis Outcomes

Acute interstitial nephritis caused by two different proton pump inhibitors

2016 ◽  
Vol 77 (1) ◽  
pp. 50-51 ◽  
Author(s):  
Frederick JA Torlot ◽  
Duncan J Whitehead
Keyword(s):  
Interstitial Nephritis ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Acute Interstitial Nephritis

Proton-pump inhibitors in peptic ulcer disease

The Lancet ◽  
2008 ◽  
Vol 372 (9645) ◽  
pp. 1198-1200 ◽  
Author(s):  
Francis KL Chan
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ulcer Disease

Proton Pump Inhibitors and Acute Interstitial Nephritis

2006 ◽  
Vol 4 (5) ◽  
pp. 597-604 ◽  
Author(s):  
Nimeshan Geevasinga ◽  
Patrick L. Coleman ◽  
Angela C. Webster ◽  
Simon D. Roger
Keyword(s):  
Interstitial Nephritis ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Acute Interstitial Nephritis

scholarly journals Long Term Use of Proton Pump Inhibitors: Where to Draw the Line

2018 ◽  
Vol 1 (1) ◽  
pp. 20-35
Author(s):  
M. Manzurul Haque
Keyword(s):  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Community Acquired Pneumonia ◽  
Ulcer Disease ◽  
Increased Risk ◽  
Prospective Trials ◽  
Evidence Based Therapy ◽  
Clostridium Difficile Associated Diarrhea

Proton pump inhibitors are the leading evidence-based therapy for acid related upper gastrointestinal disorders including dyspepsia, GERD and peptic ulcer disease. These are among the most frequently prescribed drugs globally. However, PPIs have been subjected to studies and have been associated with increased risk of adverse effects like Clostridium difficile-associated diarrhea, community-acquired pneumonia, bone fracture, reduced intestinal absorption of vitamins and minerals, and more recently kidney damage and dementia etc. In this review the recent literature regarding these adverse effects and their association with long-term proton pump inhibitor treatment is discussed. The objective of this review is to analyse the potential adverse effects of long-term PPI use and summarize the clinical implications. We documented a considerable increase in the use of PPIs over the last decade. This increase is due to over-prescription and use of PPIs for inappropriate indications. On the other hand, some patients may have had PPI therapy discontinued abruptly or inappropriately due to safety concerns. However the patients with a proven indication for a PPI should continue to receive it in the lowest effective dose for a shortest possible time. Finally, in most cases and based on the available evidence, PPIs benefits seem to outweigh potential adverse effects. Large randomized prospective trials are required to more firmly establish direct cause and effect relationships between PPIs and adverse events.

Sign in / Sign up

Export Citation Format

Share Document