Using proton-pump inhibitors among hemodialysis patients - single academic dialysis center’s preliminary experience

2017 ◽  
Vol 7 (1) ◽  
pp. 39-43
Author(s):  
M. Rakowska ◽  
S. Brzósko ◽  
E. Dąbrowska ◽  
E. Jabłońska ◽  
J. Szczykowska ◽  
...  
Keyword(s):  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Mechanism Of Action ◽  
Acid Production ◽  
Hemodialysis Patients ◽  
Dialysis Unit ◽  
Common Purpose ◽  
Drugs Prescription ◽  
Medical Indications

Introduction: Proton-pump inhibitors (PPIs) are a class of drugs which decrease gastric acid production, their overuse is becoming increasingly common. Purpose: The aim of this study was to evaluate medical indications for PPIs in a cohort of prevalent hemodialysis (HD) patients and their awareness about the medical effects of these drugs. Materials and methods: The study was performed in 78 HD patients enrolled in a chronic dialysis program in a single academic dialysis unit. The study was based on medical history obtained from the patients (survey about drugs they take with intention of revealing PPIs, indications for the treatment, their awareness of the mechanism of action of these drugs).Results: 46 patients (59%) took or have been taking PPIs. Almost half (49%; n=22) had no clear medical indications for the drugs. Prescription of PPIs without medical indications was more common among nephrologists (27%), when compared with gastroenterologists (5%; p<0.05). Only 29% (n=13) of patients taking PPIs were aware of the mechanism of action of the drugs. Conclusions: Results of this study reveal the problem of PPI overuse among HD patients. Gastroenterologists usually prescribed PPIs according to medical indications. Lack of patients’ knowledge about the indications for PPI therapy is overwhelming.

Risk of Clostridium difficile-Associated Disease Among Patients Receiving Proton-Pump Inhibitors in a Quebec Medical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1305-1307 ◽  
Author(s):  
Mathieu Beaulieu ◽  
David Williamson ◽  
Gilbert Pichette ◽  
Jean Lachaine
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Medical Intensive Care Unit ◽  
Antibiotic Use ◽  
Medical Intensive Care

Our study was conducted to determine whether use of gastric acid-suppressive agents increased the risk of Clostridium difficile-associated disease (CDAD) in a medical intensive care unit of one of the first hospitals to be threatened by the current CDAD epidemic in Quebec, Canada. Our findings suggest that efforts to determine risk factors for CDAD should focus on other areas, such as older age and antibiotic use.

Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors

1998 ◽  
Vol 93 (5) ◽  
pp. 763-767 ◽  
Author(s):  
PaoloL. Peghini ◽  
PhilipO. Katz ◽  
NicoleA. Bracy ◽  
DonaldO. Castell
Keyword(s):  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump

PREDICTING EFFICACY OF PROTON PUMP INHIBITORS IN REGULATING GASTRIC ACID SECRETION

2004 ◽  
Vol 12 (01) ◽  
pp. 1-34 ◽  
Author(s):  
DHRUV SUD ◽  
IAN M. P. JOSEPH ◽  
DENISE KIRSCHNER
Keyword(s):  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Acid Reflux ◽  
Published Data ◽  
Turnover Rates ◽  
Long Term Effects ◽  
Dosing Regimens

Developing drugs to treat gastric acid related illnesses such as ulcers and acid reflux disease is the leading focus of pharmaceutical companies. In fact, expenditure for treating these disorders is highest among all illnesses in the US. Over the last few decades, a class of drugs known as a proton pump inhibitors (PPIs) appeared on the market and are highly effective at abating gastric illnesses by raising stomach pH (reducing gastric acid levels). While much is known about the action of PPIs , there are still open questions regarding their efficacy, dosing and long-term effects. Here we extend a previous gastric acid secretion model developed by our group to incorporate a pharmacodynamic/pharmacokinetic model to study proton pump inhibitor (PPI) action. Model-relevant parameters for specific drugs such as omeprazole (OPZ) , lansoprazole (LPZ) and pantoprazole (PPZ) were used from published data, and we conducted simulations to study various aspects of PPI treatment. Clinical data suggests that duration of acid suppression is dependent on proton pump turnover rates and this is supported by our model. We found the order of efficacy of the different PPIs to be OPZ>PPZ>LPZ for clinically recommended dose values, and OPZ>PPZ=LPZ for equal doses. Our results indicate that a breakfast dose for once-daily dosing regimens and a breakfast-lunch dose for twice-daily dosing regimens is recommended. Simulation of other gastric disorders using our model provides atypical applications for the study of drug treatment on homeostatic systems and identification of potential side-effects.

scholarly journals Clinical Significance of Changes in Gut Microbiome Associated with Use of Proton Pump Inhibitors

2020 ◽  
Vol 20 (3) ◽  
pp. 196-203
Author(s):  
Tae Jun Kim ◽  
Hyuk Lee
Keyword(s):  
Gastric Acid ◽  
Clinical Significance ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Gut Microbiome ◽  
Inflammatory Diseases ◽  
Oral Bacteria ◽  
Inflammatory Microenvironment ◽  
Microbiome Composition ◽  
Gut Dysbiosis

Proton pump inhibitors (PPIs) are commonly used for the treatment of gastric acid-related disorders, and are generally well tolerated. However, by reducing the secretion of gastric acid in the long term, PPI can increase the risk of inducing an imbalance in the gut microbiome composition. Moreover, gastric hypochlorhydria that is caused by PPIs favors the survival and migration of oral bacteria in the lower part of the gastrointestinal tract, with a possible induction of pro-inflammatory microenvironment. Therefore, gut dysbiosis that is associated with the use of PPI has been found to cause adverse infectious and inflammatory diseases. In this regard, adverse effects of the PPI-related gut dysbiosis have been reported in different observational studies, but their clinical relevance remains unclear. Therefore, the aim of this review was to explore the available data on the PPI-related gut dysbiosis in order to better understand its clinical significance.

Hypomagnesemia in hemodialysis patients taking proton pump inhibitors

2020 ◽  
Vol 14 (2) ◽  
pp. 55-58
Author(s):  
Abdul Malik ◽  
Syed Mohkumuddin ◽  
Humaira Rahim ◽  
Shamima Hanif
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Serum Magnesium ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Mean Value ◽  
Female Dominance ◽  
P Value ◽  
Cross Sectional ◽  
The Mean

Background: Proton pump inhibitors (PPIs) are in routine widely prescribed to hemodialysis patients. Recent studies have reported the association of PPIs use with hypomagnesemia in patients with long term hemodialysis. This study aims to determine the frequency of hypomagnesemia in patients of hemodialysis taking proton pump inhibitors. Patients and methods: This cross-sectional study was conducted in the Department of Nephrology of Sandman Provincial Hospital Quetta from 01-6-2019 till 01-9-2019. A total of 120 patients (52 PPI users and 68 non-PPI users) who were on HD for more than 06 months were included. Data regarding age, gender, duration of hemodialysis and taking PPIs were collected. Determination of serum magnesium was made by taking 3 different samples at 2 weeks’ interval and the mean value of serum magnesium was calculated. Serum Mg2+ levels <2.0 mg/dL was taken as hypomagnesemia. A Chi-square test was applied to determine the association of PPI use with hypomagnesemia. Results: Demographic variables such as age and gender were not significantly different between the groups. There was female dominance in both groups (73% in PPI groups and 66.1% in the non-PPI group (p-value 0.65). The mean duration of dialysis was 45.3±13.8 months in PPI users versus 48.9±12.9 months in non-PPI users (p-value 0.14). There was a significantly higher frequency of hypomagnesemia in PPI users; 36 (69.3%) versus 27 (39.7%) in non-PPI users (p-value 0.001). Conclusion: The use of PPI is associated with a significant reduction in serum magnesium levels. So serum magnesium levels should be advised as routine monitoring in patients of hemodialysis taking PPIs.

Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors

2001 ◽  
Vol 15 (9) ◽  
pp. 1351-1356 ◽  
Author(s):  
S. Xue ◽  
P. O. Katz ◽  
P. Banerjee ◽  
R. Tutuian ◽  
D. O. Castell
Keyword(s):  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
H2 Blockers ◽  
Acid Control
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