scholarly journals Critical Hypomagnesemia and Seizure Induced by Chronic Use of Proton Pump Inhibitors (PPIs)

2019 ◽  
Vol 6 ◽  
pp. 3-4
Author(s):  
Gheith Yousif
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Side Effect ◽  
Seizure Activity ◽  
Magnesium Level ◽  
Low Magnesium ◽  
Rare Side Effect ◽  
History Of ◽  
Alternative Medications ◽  
Chronic Use

Background: Chronic use of proton pump inhibitors (PPIs) may lead to severe hypomagnesemia, although it is a rare side effect. Hypomagnesemia related to PPIs use less reported compared to other side effects. Critically low magnesium level may lead to fatal seizure activity, which could lead to death if went undiagnosed. Case presentation: This is a report of a 49 yearold female with a history of gastroesophageal reflux disease (GERD) presented to our emergency department with a seizure activity and critically low magnesium level (< 0.5 mg/dL). Initially the patient was hemodynamically unstable, required intubation, and admitted to the medical intensive care unit (MICU). After further management in MICU, patient stabilized and transferred to the inpatient regular medical floor. Most of the potential common causes of her low magnesium level were thoroughly investigated and ruled out except for PPIs use (as she was a chronic user). The patient was advised to discontinue her PPIs and to use alternative medications because of lifethreatening side effect "hypomagnesemia"and based on the riskbenefit balance (as the risk overweight the benefits in this situation). No further hypomagnesemic episodes reported after the second admission to the ICU unit when PPIs were discontinued completely. Conclusion: Although PPIs use is beneficial for patients with GERD especially those with gastritis, but may lead to lifethreatening hypomagnesemia in rare occasions. Physicians should be aware of this side effect in all patients with chronic PPIs use. In addition, we recommend that patients who developed this rare side effec need to use alternative medications to prevent recurrence an fatal consequences. Further research is needed to determine the incidence and the association between the development of hypomagnesemia and the use of different types of gastric acid suppressants.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

Dermal Discoloration Secondary to Triamcinolone Acetonide Injection Observed in Patients with Autoimmune Disorders

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
James A. Wright ◽  
Jessica A. Wenz ◽  
Gabrielle Jackson Madrigal
Keyword(s):  
Psoriatic Arthritis ◽  
Side Effects ◽  
Autoimmune Disease ◽  
Triamcinolone Acetonide ◽  
Current Literature ◽  
Side Effect ◽  
Inflammatory Conditions ◽  
Rare Side Effect ◽  
History Of ◽  
Synthetic Glucocorticoid

Triamcinolone acetonide is a synthetic glucocorticoid used to treat numerous acute and chronic inflammatory conditions. The various side effects of this drug from parenteral administration are well documented in the literature. In this study, three patients present with a rare side effect of violaceous dermal pigmentation. To the best of the authors' knowledge, this finding is rarely presented in the current literature. The purpose of this study is to provide awareness of a less-documented, delayed side effect from triamcinolone acetonide administration. Although all patients presenting in this study had a known history of autoimmune disease (eg, lupus, psoriatic arthritis) further research is needed to suggest a possible association between dermal violaceous change and the use of triamcinolone.

scholarly journals Chronic use of proton pump inhibitors, adverse events and potential biological mechanisms: A translational analysis

Therapies ◽  
2018 ◽  
Vol 73 (3) ◽  
pp. 273-281 ◽  
Author(s):  
Farid Kheloufi ◽  
Diane Frankel ◽  
Elise Kaspi ◽  
Marion Lepelley ◽  
Michel Mallaret ◽  
...  
Keyword(s):  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Biological Mechanisms ◽  
Chronic Use

Small-bowel bacterial overgrowth

2010 ◽  
pp. 2330-2334
Author(s):  
Richard A. Schatz ◽  
Phillip P. Toskes
Keyword(s):  
Small Bowel ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Case History ◽  
Diagnostic Tool ◽  
Bacterial Overgrowth ◽  
Breath Tests ◽  
Small Bowel Bacterial Overgrowth ◽  
History Of

Case History—A 78 yr old woman presenting with a five-year history of diarrhoea. Updates Pathogenesis—discussion of the possible role of proton pump inhibitors. Diagnosis—comparison of lactulose hydrogen, glucose hydrogen, and 14C D-xylose breath tests; preliminary studies of circulating CdtB antibodies as a diagnostic tool....

scholarly journals The Burden of Potentially Inappropriate Medications in Chronic Polypharmacy

2020 ◽  
Vol 9 (11) ◽  
pp. 3728
Author(s):  
Jordan Guillot ◽  
Sandy Maumus-Robert ◽  
Alexandre Marceron ◽  
Pernelle Noize ◽  
Antoine Pariente ◽  
...  
Keyword(s):  
Older Adults ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Middle Aged ◽  
Cross Sectional ◽  
Long Acting ◽  
Chronic Use ◽  
Inappropriate Medications

We aimed to describe the burden represented by potentially inappropriate medications (PIMs) in chronic polypharmacy in France. We conducted a nationwide cross-sectional study using data from the French National Insurance databases. The study period was from 1 January 2016 to 31 December 2016. Chronic drug use was defined as uninterrupted daily use lasting ≥6 months. Chronic polypharmacy was defined as the chronic use of ≥5 medications, and chronic hyperpolypharmacy as the chronic use of ≥10 medications. For individuals aged ≥65 (older adults), PIMs were defined according to the Beers and Laroche lists, and for individuals aged 45–64 years (middle-aged) PIMs were defined according to the PROMPT (Prescribing Optimally in Middle-aged People’s Treatments) list. Among individuals with chronic polypharmacy, 4009 (46.2%) middle-aged and 18,036 (64.8%) older adults had at least one chronic PIM. Among individuals with chronic hyperpolypharmacy, these figures were, respectively, 570 (75.0%) and 2544 (88.7%). The most frequent chronic PIM were proton pump inhibitors (43.4% of older adults with chronic polypharmacy), short-acting benzodiazepines (older adults: 13.7%; middle-aged: 16.1%), hypnotics (6.1%; 7.4%), and long-acting sulfonylureas (3.9%; 12.3%). The burden of chronic PIM appeared to be very high in our study, concerning almost half of middle-aged adults and two-thirds of older adults with chronic polypharmacy. Deprescribing interventions in polypharmacy should primarily target proton pump inhibitors and hypnotics.

The deleterious association between proton pump inhibitors and prostate cancer specific death.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 309-309
Author(s):  
Hanan Goldberg ◽  
Faizan Moshin ◽  
Refik Saskin ◽  
Girish S. Kulkarni ◽  
Alejandro Berlin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cox Regression ◽  
Population Based ◽  
Study Data ◽  
History Of ◽  
Time Dependent Covariates

309 Background: Proton pump inhibitors (PPIs) are a commonly prescribed class of medications. Although in-vitro and in-vivo data have shown PPIs to have anti-tumor effects, more recent studies suggest an increased cancer risk in several solid organs. Pantoprazole, a commonly prescribed PPI, has been shown to harbor a protective effect in human prostate cancer (PCa) cells. We aimed to investigate the effect of pantoprazole and other PPIs on PCa-specific death and additional PCa outcomes. Methods: In this retrospective, population-based cohort study, data were incorporated from the Institute for Clinical and Evaluative Sciences to identify all men aged 66 and above with a history of a single negative prostate biopsy between 1994 and 2016. We used multivariable Cox regression models with time-dependent covariates, to assess the effect of PPIs on PCa diagnosis, androgen deprivation therapy (ADT) use, and PCa-specific death. All models included other medications with a putative effect on PCa. All models were adjusted for age, rurality, comorbidity, and year of patient study inclusion. Results: Overall, 21,512 men were included, with a mean follow-up time of 8.06 years (SD 5.44 years). A total of 10,999 patients (51.1%) used a PPI. A total of 5,187 patients (24.1%) were diagnosed with PCa, 2,043 patients (9.5%) were treated with ADT, and 805 patients (3.7%) died from PCa. Pantoprazole was associated with a 3.0% (95% CI 0.3%-6,0%) increased rate of being treated with ADT for every six months of cumulative use, while any use of all other PPIs was associated with a 39.0% (95% CI 18.0%-64.0%) increased PCa-specific mortality. No significant association was found with PCa diagnosis. Conclusions: Upon validation of the potentially negative association of PPIs with PCa outcomes, the expansive use of PPIs may need to be reassessed, especially in PCa patients.

scholarly journals Erectile Dysfunction as Rare Side Effect in the Simultaneous Intrathecal Application of Morphine and Clonidine

2012 ◽  
Vol 4;15 (4;8) ◽  
pp. E523-E526
Author(s):  
Gershom Koman
Keyword(s):  
Erectile Dysfunction ◽  
Pain Relief ◽  
Side Effect ◽  
Life Quality ◽  
Chronic Neuropathic Pain ◽  
Combined Application ◽  
Rare Side Effect ◽  
Provide Pain Relief ◽  
History Of ◽  
Systemic Application

We report on the case of a 52-year-old man who presented with a history of chronic neuropathic pain treated with intrathecal application of morphine for many years. In spite of significant dose escalation, considerable pain relief had not been achieved. Ziconotide had been tried but not only did it not provide pain relief, but it also caused severe side effects in this patient. A combination of morphine and clonidine was delivered by a programmable pump, slowly increasing the clonidine rate over several weeks. For ease of transition and minimization of hospitalization, which was a special concern to this patient, combining clonidine and morphine was chosen over monotherapy with hydromorphone, with both possibilities being described as equal alternatives in the literature. Considerable pain relief was achieved during week 2 at a clonidine dose of 0.040 mg/d, thereby decreasing the visual analog score (VAS) from 10 to 4. Yet, after developing erectile dysfunction and relative hypotension soon after beginning clonidine treatment, the patient decided not to continue with the combined application of morphine and clonidine. Treatment was therefore switched back to the former monotherapy with morphine. Thereafter, erectile dysfunction disappeared and blood pressure returned to habitual high levels. Although common in systemic application, erectile dysfunction caused by the intrathecal application of clonidine has not been described yet in the literature. In this patient, this rare side effect decisively impaired life quality, subjectively outweighing the considerable pain relief which could be achieved after formerly inefficacious treatment. Further and prospective investigation might be needed to estimate the connection of erectile dysfunction to intrathecal application of clonidine. Key words: intrathecal, erectile dysfunction, morphine, chronic pain, drug pump

scholarly journals Intervention by Post for Reducing the Chronic Use of High Doses of Proton Pump Inhibitors

2020 ◽  
pp. 03-08
Author(s):  
Elena Valverde Bilbao ◽  
Amaia Mendizabal Olaizola ◽  
Guillermo Delgado Alvarado ◽  
Itxaso Idoiaga Hoyos ◽  
Daniel Hernández Amunarriz
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
High Doses ◽  
Chronic Use

scholarly journals Gynecomastia in a Rheumatoid Arthritis patient: A rare side effect of Methotrexate therapy. (Preprint)

2016 ◽  
Author(s):  
Soorih Shaikh ◽  
Sarwan Shaikh
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Arthritis Patient ◽  
Male Patient ◽  
Side Effect ◽  
Methotrexate Therapy ◽  
Folate Supplementation ◽  
Rare Side Effect ◽  
History Of ◽  
Male Patients

UNSTRUCTURED A 51-year-old male patient with a 3-year history of Rheumatoid Arthritis developed gynecomastia 2-3 months after starting Methotrexate therapy, without folate supplementation. Two months after stopping MTX therapy and initiating folate supplementation, gynecomastia started resolving. Very few cases of gynecomastia due to MTX therapy have been reported worldwide. Although it is a rare yet a significant occurrence and should always be considered in male patients with Rheumatoid Arthritis.

scholarly journals Determining the Risk of Spontaneous Bacterial Peritonitisdue to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Bashir Ahmed Shaikh ◽  
Zahid Ali Shaikh ◽  
Aftab Hussain Shah ◽  
Aneel Kumar
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Polymorphonuclear Neutrophil ◽  
Retrospective Case ◽  
Medical College ◽  
Creative Commons ◽  
Bacterial Peritonitis ◽  
History Of ◽  
Cirrhotic Patients

Objectives: The current study aimed to determine the Spontaneous Bacterial Peritonitis (SBP) risk due to increased use of Proton Pump Inhibitors (PPIs) among cirrhotic patients with ascites. Methods: This retrospective case-control study was conducted at Chandka Medical College & Hospital, Larkana from March 2013 to February 2014, involving 215 cirrhotic patients with ascites. Paracentesis was performed to distinguish cirrhotic patients with SBP and Polymorphonuclear Neutrophil (PMN) count ≥ 250 neutrophils/mm3 (cases) and non-SBP with PMN count < 250 neutrophils/mm3 (controls). The demographic details, history of PPIs use before admission and duration of Chronic Liver Disease (CLD) were inquired and statistical analysis was carried through SPSS Version 23.0. Results: Increased pre-hospital PPI intake was observed among cirrhotic patients with SBP (69.8%) as compared to those without SBP (48.8%; p = 0.014). The mean duration of PPI use was 19.16 ± 4.772 days, and it was more significant among older cirrhotic patients (p < 0.05). Increased duration of CLD was observed among PPI users, i.e. 20.47 ± 6.305 months vs. 18.95 ± 5.527 months among non-PPI users (p < 0.05). Conclusions: Our results show that cirrhotic patients with ascites consuming PPIs are more likely to develop SBP as compared to non-PPI users. doi: https://doi.org/10.12669/pjms.37.4.3476 How to cite this:Shaikh BA, Shaikh ZA, Shah AH, Kumar A. Determining the Risk of Spontaneous Bacterial Peritonitis due to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites. Pak J Med Sci. 2021;37(4):---------.   doi: https://doi.org/10.12669/pjms.37.4.3476 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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