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La Sakka, La Sakka. "PENGGUNAAN OBAT GASTRITIS GOLONGAN PROTON PUMP INHIBITOR PADA PASIEN RAWAT JALAN DI RUMAH SAKIT LABUANG BAJI MAKASSAR 2021." Journal of Pharmaceutical Science and Herbal Technology 6, no. 1 (2021): 29–33. http://dx.doi.org/10.35892/jpsht.v6i1.642.
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Penelitian ini bertujuan untuk mengetahui pola penggunaan obat golongan proton pump inhibitor pada pada pasien rawat jalan di RSUD Labuang Baji provinsi Sulawesi selatan. Jenis penelitian ini adalah penelitian deskriptif dengan pendekatan studi kasus yang bertujuan untuk memperoleh gambaran mengenai obat gastritis golongan proton pump inhibitor. Sampel penelitian adalah semua resep di apotek rawat jalan yang mengandung obat golongan proton pump inhibitor (PPI) dan dihitung jumlah obat yang diberikan pada pasien rawat jalan pada bulan Maret-Mei 2021. Hasil penelitian yaitu obat golongan Proton Pump Inhibitor (PPI) yang paling banyak digunakan adalah Omeprazol 64.88% dan Lanzoprazol 35.12% sedangkan Pantoprazol, Rabeprazol dan Esomeprazol sama sekali tidak digunakan. Peresepan obat golongan proton pump inhibitor terbanyak dari poliklinik yaitu poli interna dan kardiologi penyakit dalam dengan persentase 42.06% dan 28.56% sedangkan poli anak sama sekali tidak meresepkan obat golongan proton pump inhibitor (PPI). Hal ini dikarenakan poli interna adalah spesialis medis yang berhubungan dengan berbagai penyakit dan masalah kesehatan yang mempengaruhi organ-organ bagian dalam salah satunya lambung.
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Bytautienė, Ramunė, Ilona Trečiokaitė, and Jonas Valantinas. "Protonų siurblio inhibitorių vaidmuo klinikinėje praktikoje." Lietuvos chirurgija 4, no. 1 (2006): 0. http://dx.doi.org/10.15388/lietchirur.2006.1.2277.
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Protonų siurblio inhibitorių vaidmuo klinikinėje praktikoje Ramunė Bytautienė, Ilona Trečiokaitė, Jonas ValantinasVilniaus universiteto ligoninės Santariškių klinikųHepatologijos, gastroenterologijos ir dietologijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: jonas.valantinas@santa.lt Protonų siurblio inhibitoriai (PSI) yra pirmo pasirinkimo vaistai gydant gastroezofaginio refliukso ligą, jos komplikacijas, skrandžio ir dvylikapirštės žarnos opaligę. Jie efektyviai naikina Helicobacter pylori sergant peptinėmis opomis. Tai saugūs ir gerai toleruojami vaistai. PSI nepakeičiami gydant nesteroidinių vaistų nuo uždegimo (NVNU) sukeltą opaligę, jos profilaktikai, ypač jei NVNU turi būti vartojami ir toliau. Reikšminiai žodžiai: Protonų siurblio inhibitoriai The role of proton pump inhibitors in the clinical practice Ramunė Bytautienė, Ilona Trečiokaitė, Jonas ValantinasCenter of Hepatology, Gastroenterology and Dietology,Vilnius University Hospital "Santariškių klinikos",Vilnius, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: jonas.valantinas@santa.lt Acid-related disorders of the upper gastrointestinal tract are the most important indications for treatment with a proton pump inhibitor (PPI). PSIs have become the gold standard for gastroesophageal reflux disease and peptic ulcer treatment. They are effective for Helicobacter pylori eradication in patients with peptic ulcers. PPI are irreplaceable in achieving healing in ulcers related to non-steroid anti-inflammatory drugs, even during their continued, long-term use, and prevention of such lesions. PPI are safe and well tolerated medicines. Key words: proton pump inhibitor
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Ghosh, Abhishek, and Shankar Dey. "Inappropriate use of proton pump inhibitors in non-critical indoor patients in a tertiary care teaching hospital in Eastern India." International Journal of Research in Medical Sciences 8, no. 1 (2019): 230. http://dx.doi.org/10.18203/2320-6012.ijrms20195913.
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Background: Proton pump inhibitors are one of the most commonly used drugs worldwide. Often they are used for inappropriate indications too, imposing economic burden to patients and governments. Many studies have showed equipotent efficacy of oral and intravenous proton pump inhibitor therapy. Despite that, most of the hospitalized patients receive intravenous proton pump inhibitor without appropriate indications. This study aimed to assess use of proton pump inhibitors in government hospital.Methods: It was an observational cross-sectional study done in the general medicine department of a tertiary care teaching hospital in Eastern India, including 800 noncritical patients. Objective was to assess the use of proton pump inhibitors (indications, route of administration, dosing frequency).Results: 100% patient received intravenous proton pump inhibitor irrespective of diagnosis. 80% of them received it twice daily and 18% received it once daily. Majority of the patients received intravenous proton pump inhibitor despite taking other drugs by oral route.Conclusions: Most of the PPI administration was done without appropriate indication. All patients received Intravenous proton pump inhibitors, which may impose economic burden on a government hospital. Majority of the patients received proton pump inhibitors twice daily. These approaches are not cost effective and need to be rectified.
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Prahastutik, Rizkia Hani, Muhammad Perdana Airlangga, Yudith Annisa Ayu Rezkitha, and Detti Nur Irawati. "Dilema Penggunaan Aspirin dan Proton Pump Inhibitor (PPI) Pada Pasien Gastroesophageal Reflux Disease Dengan Coronary Artery Disease (CAD)." Journal of Islamic Medicine 5, no. 1 (2021): 33–40. http://dx.doi.org/10.18860/jim.v5i1.11572.
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Latar belakang: Gastroesofageal Reflux Disease (GERD) ini sering terjadi pada penderita Coronary Artery Disease (CAD) dengan keluhan nyeri dada. Oleh karena itu obat antiplatelet digabungkan dengan Proton Pump Inhibitor (PPI) untuk pencegahan dari efek samping aspirin dan pengobatan GERD itu sendiri. Karena efek samping pendarahan gastrointestinal yang disebabkan oleh aspirin, Proton Pump Inhibitors (PPI) juga bisa berpengaruh mengurangi ketersediaan hayati aspirin, sehingga mengurangi kerja aspirin. Tujuan : untuk menganalisis munculnya dilema pengobatan pada pasien Gastroesophageal Reflux Disease (GERD) dengan Coronary Artery Disease (CAD). Metode: Artikel-artikel ilmiah terpublikasi tentang Gastroesophageal Refluks Disease (GERD) dengan Coronary Artery Disease (CAD) dicari menggunakan kata kunci Gastroesophageal Reflux Disease, Coronary Artery Disease, Antiplatelet, Proton Pump Inhibitors. dengan mendapatkan jumlah artikel sebanyak 1144877 dan telah melalui skrining sesuai dengan kriteria inlusi menjadi 7 jurnal Hasil : Pada pasien kunci Gastroesophageal Reflux Disease (GERD) dengan Coronary Artery Disease (CAD) Proton Pump Inhibitors (PPIs) sering dikombinasikan dengan antiplatelet yang telah terbukti secara efektif mengurangi resiko komplikasi pada gastrointestinal pada pasien. Namun, pada beberapa penelitian pemberian PPI akan mengurangi efek kemanjuran dari antiplatelet aspirin Kesimpulan: Penggunaan PPI pada GERD dianjurkan untuk digunakan dalam jangka pendek,karena penggunaan jangka panjang pada PPI meningkatkan resiko infark miokard, gagal ginjal, dan demensia. Pertimbangan pada resiko dan manfaat dengan mengkaji faktor resiko dari ganstrointestinal perlu diperhatikanKata kunci : Antiplatelet, Coronary Artery Disease, Gastroesophageal Proton Pump Inhibitors Reflux Disease,
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Dr., Kasi Subbiah Dr. Siva Sivappriyan. "LONG TERM PPI USE: NOT SO BENIGN AFTER ALL." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 06, no. 01 (2019): 1228–30. https://doi.org/10.5281/zenodo.2542785.
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<em>Proton pump inhibitors (PPIs) potently inhibit gastric acid secretion and are widely used for treatment of acid-related diseases including gastroesophageal reflux disease and secondary prevention of aspirin/NSAID-induced ulcers. In the following case report, we present a 53-year-old male patient with convulsions caused by severe hypomagnesemia as an adverse effect of proton pump inhibitor (PPI) treatment. He also had hypocalcemia, hypokalemia, borderline vitamin D insufficiency, vitamin B12 deficiency & vertigo as a side effect of long-term PPI use.</em> <strong>Key Words:</strong><em> Proton Pump Inhibitors (PPIs), Hypomagnesemia, Hypocalcemia, Hypokalemia, Vitamin B12 Deficiency</em>
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Riha, Heidi M., Rachel Wilkinson, Jennifer Twilla, et al. "Octreotide Added to a Proton Pump Inhibitor Versus a Proton Pump Inhibitor Alone in Nonvariceal Upper-Gastrointestinal Bleeds." Annals of Pharmacotherapy 53, no. 8 (2019): 794–800. http://dx.doi.org/10.1177/1060028019833696.
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Background: Literature indicating clinically relevant benefits of an adjunctive somatostatin analog to standard therapies in nonvariceal upper-gastrointestinal bleeding (NVUGIB) is lacking. Objective: The primary objective of this study was to find the association between outcomes in patients with NVUGIB treated with octreotide and a proton pump inhibitor (PPI; combination group) compared with those treated with a PPI alone. Methods: We conducted a retrospective cohort study of adults admitted within a 5-hospital health care system with a NVUGIB treated with a PPI continuous infusion with or without an octreotide infusion. Notable exclusion criteria included varices, history of cirrhosis without endoscopy, or active gastrointestinal cancer. The primary outcome was association of combination treatment versus PPI alone with hospital length of stay (LOS). Results: A total of 180 patients were included (combination group: n = 90; PPI: n = 90). In univariate analyses, the median hospital and intensive care unit (ICU) LOS in the combination group versus PPI was 6.1 versus 4.9 days ( P = 0.25) and 2.3 versus 1.9 days ( P = 0.24), and rebleeding and mortality occurred in 9% versus 12% ( P = 0.63) and 6.7% versus 5.6% ( P = 1.00) of patients. Median units of packed red blood cells in the combination therapy versus PPI group was 3 vs 2 units ( P = 0.43). After propensity score adjustment in multivariable analyses, hospital and ICU LOS, rebleeding, and mortality all remained nonsignificant. Conclusion and Relevance: Our study observed no difference in clinical end points. This suggests that octreotide provides no additional major clinical benefit in NVUGIB, and PPI therapy alone may be sufficient.
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Ashok, Agrawal. "Rabeprazole: The Unique PPIs." Clinical Endocrinology and Metabolism 2, no. 1 (2023): 01–04. https://doi.org/10.31579/2834-8761/014.
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Rabeprazole is a proton pump inhibitor (PPI). Rabeprazole is a rapid and potent inhibitor of H+, K+-ATPase. Rabeprazole has many advantages over the other currently available proton pump inhibitors in terms of chemical activation rate, onset of action, degree of inhibition of gastric acid secretion, metabolism, and gastric mucus and mucin production. Current review article is undertaken to discuss these unique features.
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Tri Nur Agustin, Riska Junianti, Puji Islamiah Hafitah, Khoti’ah Azzahra, Siti Noerwanti, and Aisyahtun Nurhikmah. "PENGARUH PENGGUNAAN JANGKA PANJANG PROTON PUMP INHIBITOR (PPI) TERHADAP IMUNITAS SALURAN GASTROINTESTINAL." Medimuh : Jurnal Kesehatan Muhammadiyah 4, no. 2 (2023): 101–12. http://dx.doi.org/10.37874/mh.v4i2.647.
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ABSTRAK Inhibitor pompa proton (PPI) adalah sekelompok obat yang digunakan untuk menurunkan kadar asam lambung dan meredakan gejala yang disebabkan oleh asam lambung tinggi yang tidak normal. Dengan penggunaan PPI jangka panjang, sejumlah potensi efek samping dapat terjadi, dikhawatirkan efek samping tersebut dapat mempengaruhi sistem kekebalan tubuh. Penelitian ini bertujuan untuk mengetahui pengaruh penggunaan PPI jangka panjang terhadap imunitas saluran cerna, khususnya sel epitel, keasaman, kualitas mukus, mikrobiota saluran cerna dan pengaruhnya terhadap neutrofil. Penelitian tentang efek jangka panjang penghambat pompa proton ( PPI) pada sistem kekebalan dan homeostasis saluran pencernaan, yang dicari melalui database Google Scholar , Pubmed Central dan sciencedirect dengan memasukkan kata kunci " proton pump inhibitors "" imun disfungsi "" kerugian "" Efek samping "" Mikroflora " dan " Infeksi saluran cerna " . Jurnal dipilih berdasarkan kriteria inklusi, yaitu artikel jurnal asli dengan rentang publikasi dari 2010 hingga 2020 dan teks lengkap yang dapat diakses. Sebanyak 13 jurnal dipilih berdasarkan kriteria inklusi. Terdapat 3 jurnal tidak valid dan 10 jurnal valid jurnal membahas mengenai keasaman, lendir, mikrobiota, dan neutrofil. Sebagian besar jurnal yang diperoleh membahas efek PPI pada keasaman dan mikrobiota gastrointestinal. Penggunaan proton pump inhibitor (PPIs) jangka panjang dapat mempengaruhi imunitas gastrointestinal, terutama keasaman dan mikrobiota GIT. Kata kunci: Inhibitor pompa proton, kekebalan, saluran pencernaan
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Russo, Michele, Kryssia Isabel Rodriguez-Castro, Marilisa Franceschi, et al. "Appropriateness of Proton Pump Inhibitor Prescription Evaluated by Using Serological Markers." International Journal of Molecular Sciences 24, no. 3 (2023): 2378. http://dx.doi.org/10.3390/ijms24032378.
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Inappropriate prescription of proton pump inhibitors (PPI) has been widely reported, often lacking initial exclusion of Helicobacter pylori (HP) infection and evaluation of gastric functional status. The aim of this study was to evaluate the utility of gastric functional tests to define the acid output, as well as HP status, in order to better direct PPI therapy prescription. Dyspeptic patients without alarm symptoms from a primary care population were evaluated. For each patient, serum Pepsinogen I (PGI) and II (PGII), gastrin 17 (G17) and anti-HP IgG antibodies (Biohit, Oyj, Finland) were determined. For each subject, data were collected regarding symptoms, past medical history of HP infection, and PPI use. Therapeutic response to PPIs was determined according to PGI and G17 values, where G17 > 7 in the presence of elevated PGI and absence of chronic atrophic gastritis (CAG) was considered an adequate response. Among 2583 dyspeptic patients, 1015/2583 (39.3%) were on PPI therapy for at least 3 months before serum sampling, and were therefore included in the study. Active HP infection and CAG were diagnosed in 206 (20.2%) and 37 (3.6%) patients, respectively. Overall, an adequate therapeutic response to PPIs was observed in 34.9%, reaching 66.7% at the highest dose. However, 41.1% and 20.4% of patients showed low (G17 1-7) or absent (G17 < 1) response to PPI, regardless of the dosage used. According to gastric functional response, most patients currently on PPI maintenance therapy lack a proper indication for continuing this medication, either because acid output is absent (as in CAG) or because gastrin levels fail to rise, indicating absence of gastric acid negative feedback. Lastly, HP eradication is warranted in all patients, and gastric function testing ensures this pathogen is sought for and adequately treated prior to initiating long-term PPI therapy.
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Dewi, Ni Made Amelia Ratnata. "Interaksi Obat Antara Klopidogrel dan Proton Pump Inhibitor (PPI)." Sasambo Journal of Pharmacy 1, no. 1 (2020): 1–5. http://dx.doi.org/10.29303/sjp.v1i1.12.
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Abstrak: Pemberian Proton Pump Inhibitor (PPI) dapat menurunkan terjadinya kejadian perdarahan gastrointestinal berulang pada pasien yang mendapatkan dual therapy antiplatelet yaitu klopidogrel dan aspirin. Klopidogrel diaktivasi melalui proses metabolisme oleh enzim CYP2C19 sedangkan obat golongan PPI dimetabolisme dan menghambat enzim CYP2C19. Studi farmakodinamik menunjukkan adanya efek PPI terutama omeprazole terhadap metabolisme klopidogrel yang dapat mengakibatkan penurunan efek dari inhibisi platelet. Beberapa studi klinik mendapatkan bahwa tidak terdapat kejadian yang dapat menyebabkan permasalahan pada jantung (cardiovascular event) jika kedua obat diberikan secara bersamaan. Kemaknaan klinis dari interaksi obat dari klopidogrel dan PPI belum diketahui secara jelas sehingga untuk keamanan direkomendasikan untuk membatasi penggunaan PPI terutama omeprazole. Pilihan lain adalah dengan mengganti PPI dengan H2 blocker ataupun menggunakan golongan PPI yang tidak banyak dimetabolisme oleh enzim CYP2C19 seperti pantoprazole.
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Atepela, Josephine Herwita. "Proton Pump Inhibitor (PPI) sebagai Farmakoterapi GERD pada Lansia." Cermin Dunia Kedokteran 50, no. 7 (2023): 379–82. http://dx.doi.org/10.55175/cdk.v50i7.635.
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Gastroesophageal reflux disease (GERD) merupakan salah satu penyakit gastrointestinal (GI) paling umum pada lanjut usia (lansia). Gejala GERD pada lansia umumnya atipikal dan tidak terlalu parah, namun lebih berisiko terjadi kelainan mukosa dan komplikasi. Proton pump inhibitor (PPI) masih menjadi sarana farmakoterapi terapi lini pertama pasien GERD lansia. Namun, penggunaan PPI pada lansia dikaitkan dengan beberapa efek samping. Hingga saat ini, belum ada konsensus mengenai durasi optimal penggunaan PPI pada lansia. Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal (GI) diseases in the elderly. GERD symptoms in the elderly are generally atypical and less severe, but with a higher risk of mucosal abnormalities and complications. Proton pump inhibitor (PPI) therapy is still the first line pharmacotherapy for elderly GERD patients. However, PPI use in elderly are associated with several side effects. To date, there is no consensus yet on the optimal duration of PPI use in the elderly.
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Colmenares, Evan W., and Ashley L. Pappas. "Proton Pump Inhibitors." Annals of Pharmacotherapy 51, no. 1 (2016): 66–71. http://dx.doi.org/10.1177/1060028016665641.
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Objective: The purpose of this article is to describe the relationship between proton pump inhibitors (PPIs) and symptoms of myopathy based on case reports. Data Sources: A literature search was conducted in PubMed (1946 to June 2016) using MeSH terms proton pump inhibitors, omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, pantoprazole, and muscular diseases. Additionally, a search was conducted in ToxNet and EMBASE using similar search criteria. Study Selection and Data Abstraction: The resulting articles were scanned to assess relevance to the review. Bibliographies of all relevant articles were evaluated for additional sources; 26 articles resulted from the search of PubMed, ToxNet, and EMBASE; articles that involved medications typically considered to have myalgia-like side effects (eg, statins), or included patients who presented with a confounding disease state (eg, Guillain-Barré) were excluded. Data Synthesis: In total, 11 case reports as well as a review of an adverse event reporting database that included 292 cases were evaluated. Association of PPI use and myopathy symptoms does not have a clear etiology. Overall, the available published data do not show a high risk of myopathy with PPI use but should be considered if a patient presents with myopathy symptoms and concurrent PPI use. Conclusion: A limited body of published data suggests that PPI use has been associated with myopathy-like symptoms without long-term effects following discontinuation. Although myopathy is a rare adverse effect observed with PPIs, it can be a serious side effect to be considered when starting a patient on acid suppression therapy.
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Pradeep, Roshini, Afsheen Moshtaghi, Hamza Khan, Ann K. Walenga, Neychelle Rocca, and Andrzej Piotr Kudelka. "Role of proton pump inhibitors in immune checkpoint inhibitor colitis." Journal of Clinical Oncology 42, no. 3_suppl (2024): 743. http://dx.doi.org/10.1200/jco.2024.42.3_suppl.743.
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743 Background: Proton pump inhibitors (PPIs) are known to be beneficial in symptomatic control of gastroesophageal reflux disease and gastritis which can be a common complication of various cancers specifically gastrointestinal (GI) cancers. Microscopic colitis development has been studied to be associated with PPI use. Immune checkpoint Inhibitor (ICI) colitis is a known adverse effect of Inhibitors of Programmed cell death 1 (PD-1) and its ligand (PD-L1). Previous studies have also shown use of PPIs and NSAIDs are common risk factors which can exacerbate ICI Colitis caused by Inhibitors of PD-1 and PD-L1. This study is designed to observe association of certain drugs especially PPIs in ICI colitis. Methods: This is a single center, retrospective, and observational study that investigated patients treated with PD-1 and PD-L1 Inhibitors for management of any type of cancer between January 2022- September 2023. A list of patients treated with PD-1 and PD-L1 inhibitors was obtained from Inpatient pharmacy records followed by retrospective chart review to look for symptoms of colitis and other medications used by each patient. Primary outcome was to observe the role of PPIs in ICI colitis. Secondary outcomes were to observe the number of patients with GI cancers on PPIs who developed colitis. We also observed the effect of NSAIDs use as a potential risk factor in the population with ICI colitis. Results: The data consisted of 93 patients of which 17 (18.3%) developed colitis. Among this population 13 (76.5%) was ICI colitis, 2 (11.7%) was diverticular colitis and 2 (11.7%) was Infectious colitis. PPI use was seen in 3 out of 13 patients (23%) with ICI colitis. Patients with any type of GI cancer who developed colitis was 5 (25%) and PPI use in ICI colitis was seen in 2 out of these 5 patients. NSAIDs use was seen in 3 (23%) patients with ICI colitis. Conclusions: We did not observe significant association between PPI use and ICI colitis. ICI use becoming increasingly common in oncologic population, larger studies may be needed to further evaluate risk factors associated with ICI colitis in this population.
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Tsukanov, V. V., A. V. Vasyutin, and Yu L. Tonkikh. "Current management of proton pump inhibitor-refractory gastroesophageal reflux disease." Fundamental and Clinical Medicine 5, no. 2 (2020): 93–100. http://dx.doi.org/10.23946/2500-0764-2020-5-1-93-100.
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Here we review current concepts in diagnosis and treatment of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (PPIGERD) which includes an insufficient response to daily PPI 8-week therapy in combination with pathological gastroesophageal reflux. Patients with PPI-GERD frequently suffer from non-acidic and asymptomatic gastroesophageal reflux. In developed countries, PPI-GERD accounts for 30-40% of all patients receiving PPIs. Diagnosis of PPIGERD is performed by means of clinical anamnesis, esophagogastroscopy and impedance-pH monitoring. PPI-GERD needs to be differentiated with functional heartburn, reflux hypersensitivity and nonerosive reflux disease. Functional heartburn is characterised by reference time with a esophageal pH < 4 and the absence of a link between reflux episodes and GERD symptoms. Reflux hypersensitivity is diagnosed with normal esophageal acid exposure and association of reflux episodes with symptoms of GERD. Nonerosive reflux disease can be diagnosed solely by evaluating pathological acid exposure (pH < 4 for > 6% of the time). Treatment of PPI-GERD includes diet and lifestyle modification to reduce weight in obese patients, optimization of PPI use, and administration of alginate, prokinetics, baclofen and other drugs. Surgical treatment is also widely used and provide good results.
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Gasiorowska, Anita, and Ronnie Fass. "The Proton Pump Inhibitor (PPI) Test in GERD." Journal of Clinical Gastroenterology 42, no. 8 (2008): 867–74. http://dx.doi.org/10.1097/mcg.0b013e31816c47ed.
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Bhandari, Jeetendra, and Narendra Bhandari. "Appropriate Use of Proton Pump Inhibitors in General Out Patient Department of a Tertiary Care Center of Kathmandu Valley: An Observational Study." Journal of Nepal Medical Association 63, no. 283 (2025): 149–53. https://doi.org/10.31729/jnma.8913.
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Introduction: Proton Pump Inhibitors (PPIs) are widely used medications that suppress gastric acid secretion worldwide. However, they have been linked to an increased risk of chronic kidney disease, hypomagnesemia, and bacterial infections, including C. difficile and acid hypersecretion. This study aimed to identify the appropriateness of PPI prescriptions in general clinics. Methods: An observational cross-section study was conducted in General out patient department of a tertiary care center of Nepal . Purposive sampling was done. The study included 355 clinical notes from the clinic’s out patient department with at least one proton pumb inhibitor prescription. Data was collected, and the proportion of different parameters was calculated.Results: Appropriate use of proton pumb inhibitor was 255 (57.74%). Among the total study population, 186 (51.22%) were male. The appropriate use of proton pump inhibitor use by faculties was 83 (61.02%) and 68 (33.68%) reported that it was given to prevent Non-steroidal Anti-Inflammatory Drug-related complications. Pantoprazol was prescribed in 256 (74.62%) cases.Conclusions: This study suggests that PPIs were appropriate more than 50 percent of the time, but a high number of patients have been prescribed PPIs without a clear indication.
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Illueca, Marta, Berhanu Alemayehu, Nze Shoetan, and Huiying Yang. "Proton Pump Inhibitor Prescribing Patterns in Newborns and Infants." Journal of Pediatric Pharmacology and Therapeutics 19, no. 4 (2014): 283–87. http://dx.doi.org/10.5863/1551-6776-19.4.283.
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OBJECTIVES: In 2011, the Food and Drug Administration (FDA) approved intravenous esomeprazole 0.5 mg/day for children aged &gt;1 month and oral esomeprazole for infants aged 1 month to &lt;1 year at doses of 2.5, 5, and 10 mg based on weight. Prior to 2011, proton pump inhibitors (PPIs) were not approved for use in infants aged &lt;1 year. This study determined PPI usage rates prior to the FDA approval among newborns and infants in both the inpatient and outpatient settings and compared PPI and histamine-2 receptor antagonist (H2RA) usage in the inpatient setting. METHODS: We conducted a retrospective analysis of PPI prescribing patterns for newborns and infants from 2003 to 2008 using data from the Premier Perspective Inpatient Hospital Database and the PharMetrics Patient-Centric Database for inpatient and outpatient data, respectively. PPI use and diagnoses were determined from clinical and charge records from more than 500 hospitals. Descriptive statistics were used to summarize the findings. RESULTS: Our analysis showed that PPIs were prescribed for approximately 5000 newborns (0.13%) and 15,000 infants (2.65%) each year in the hospital setting and 1.6% of newborns and infants, as a group, in the outpatient setting. Newborns and infants receiving PPIs most often had diagnoses of gastroesophageal reflux disease (GERD) and were generally prescribed an adult PPI dose, although the actual dose administered could not be substantiated. CONCLUSIONS: Although no PPI was approved by the FDA for patients aged &lt;1 year at the time of this study, results of this analysis indicate that PPIs were commonly prescribed for newborns and infants, mostly in hospital, but also in outpatient settings. Most PPIs were prescribed for infants with a diagnosis of GERD.
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Syafhan, Nadia Farhanah, Maulidya Augustine, Uci Ramadhani, and Yetti Hersunaryati. "PROTON-PUMP INHIBITOR USE AND POTENTIAL DRUG INTERACTIONS IN OUTPATIENTS." International Journal of Applied Pharmaceutics 10, no. 1 (2018): 358. http://dx.doi.org/10.22159/ijap.2018.v10s1.79.
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Objective: This study aimed to evaluate the use and potential drug interactions of proton-pump inhibitor (PPI) in outpatients.Methods: This study is a retrospective descriptive analysis of prescriptions and medical records from outpatients in Gatot Soebroto Army Hospitalselected by purposive sampling who received PPI with one or more other drugs from July to December 2015. The analysis was conducted on 400prescriptions from 192 patients.Results: Data showed that 100% of the PPI therapy utilized was appropriate for the patients’ condition, 79.00% was appropriate for the indication,79.00% was appropriate for the dosage, 79.00% had an appropriate administration duration, and 83.75% was given the appropriate drug. Thepotential of PPI interactions with other drugs was found in 324 prescriptions (81.00%) from 475 cases. Of all the cases, 42 were considered majorinteractions, 138 were moderate interactions, and 295 cases had minor interactions. There were 14 drugs that could potentially interact with PPI, suchas mycophenolate mofetil, clopidogrel, cilostazol, warfarin, iron, levothyroxine, propranolol, cyclosporine, simvastatin, atorvastatin, cyanocobalamin,sucralfate, theophylline, and antacids.Conclusion: PPI use in outpatients at the Gatot Soebroto Army Hospital was not entirely appropriate and had a large number of potential druginteractions with concurrent drugs.
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Sasaki, Takamitsu, Shiori Mori, Shingo Kishi, et al. "Effect of Proton Pump Inhibitors on Colorectal Cancer." International Journal of Molecular Sciences 21, no. 11 (2020): 3877. http://dx.doi.org/10.3390/ijms21113877.
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Proton pump inhibitors (PPIs) are administered commonly to aged people; however, their effect on colorectal cancer (CRC) has still not been fully elucidated. Here, we examined the effect of PPIs and consequent alkalization on CRC cells. PPI administration alkalized the fecal pH and increased serum gastrin concentration. PPI and pH8 treatment (alkalization) of CMT93 mouse colon cancer cells inhibited cell growth and invasion, increased oxidative stress and apoptosis, and decreased mitochondrial volume and protein levels of cyclin D1 and phosphorylated extracellular signal-regulated kinase (pERK) 1/2. In contrast, gastrin treatment enhanced growth and invasion, decreased oxidative stress and apoptosis, and increased mitochondrial volume and cyclin D1 and pERK1/2 levels. Concurrent treatment with a PPI, pH8, and gastrin increased aldehyde dehydrogenase activity and also enhanced liver metastasis in the BALB/c strain of mice. PPI administration was associated with Clostridium perfringens enterotoxin (CPE) in CRC lesions. CPE treatment activated yes-associated protein (YAP) signals to enhance proliferation and stemness. The orthotopic colon cancer model of CMT93 cells with long-term PPI administration showed enhanced tumor growth and liver metastasis due to gastrin and YAP activation, as indicated by gastrin receptor knockdown and treatment with a YAP inhibitor. These findings suggest that PPI promotes CRC growth and metastasis by increasing gastrin concentration and YAP activation, resulting in gut flora alteration and fecal alkalization. These findings suggest that PPI use in colorectal cancer patients might create a risk of cancer promotion.
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Quinn, Rachel, Karen M. Park, and Rita Bodine. "Pharmacist-Driven Step-Down of Long-Term Proton-Pump Inhibitor Therapy." Senior Care Pharmacist 34, no. 8 (2019): 520–28. http://dx.doi.org/10.4140/tcp.n.2019.520.
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OBJECTIVE: To evaluate the appropriateness of proton-pump inhibitor (PPI) prescribing and reduce the number of outpatients on long-term PPI therapy, defined as greater than or equal to one year.<br/> DESIGN: Phase I was retrospective and evaluated the appropriateness of PPI prescribing. Phase II was prospective and involved implementation of a pharmacist-driven PPI step-down protocol.<br/> SETTING: This study was conducted in an outpatient setting at Veterans Affairs Hudson Valley Health Care System.<br/> PATIENTS, PARTICIPANTS: Patients were limited to a single primary care provider and were required to fill an outpatient PPI prescription between August 15, 2015, and August 15, 2016.<br/> INTERVENTIONS: After patients were identified in Phase I as having an inappropriate indication for long-term PPI therapy, they were contacted by a pharmacist to complete the step-down protocol. The patients then received a call two weeks after completing each step.<br/> MAIN OUTCOME MEASURE(S): To determine the number of patients without an indication for long-term PPI therapy that could successfully complete the PPI step-down protocol.<br/> RESULTS: Phase I identified that long-term PPI therapy was not indicated in 68.4% of patients. Phase II implementation demonstrated that 71.4% of patients were able to successfully step-down from PPI therapy in an average of 13 weeks with the use of alternative acid-suppression therapy.<br/> CONCLUSION: This study concluded that a majority of PPI prescriptions were not indicated for a duration of greater than or equal to 1 year. With the implementation of a pharmacist-driven PPI step-down protocol, a majority of patients were able to tolerate the PPI step-down with the use of alternative acidsuppression therapy.
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Szemes, Kata, Nelli Farkas, Zoltan Sipos, et al. "Co-Administration of Proton Pump Inhibitors May Negatively Affect the Outcome in Inflammatory Bowel Disease Treated with Vedolizumab." Biomedicines 12, no. 1 (2024): 158. http://dx.doi.org/10.3390/biomedicines12010158.
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Concomitant medications may alter the effect of biological therapy in inflammatory bowel disease. The aim was to investigate the effect of proton pump inhibitors on remission rates in patients with inflammatory bowel disease treated with the gut-selective vedolizumab. Patients from the Hungarian nationwide, multicenter vedolizumab cohort were selected for post hoc analysis. Primary outcomes were the assessment of clinical response and endoscopic and clinical remission at weeks 14 and 54. Secondary outcomes were the evaluation of the combined effect of concomitant steroid therapy and other factors, such as smoking, on remission. A total of 108 patients were identified with proton pump inhibitor data from 240 patients in the original cohort. Patients on steroids without proton pump inhibitors were more likely to have a clinical response at week 14 than patients on concomitant PPI (95% vs. 67%, p = 0.005). Non-smokers with IBD treated with VDZ were more likely to develop a clinical response at week 14 than smokers, particularly those not receiving PPI compared with patients on co-administered PPI therapy (81% vs. 53%, p = 0.041, and 92% vs. 74%, p = 0.029, respectively). We found that the use of PPIs in patients treated with VDZ may impair the achievement of response in certain subgroups. Unnecessary PPI prescriptions should be avoided.
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Arsita, Elli, and Achmad Fauzi. "Role of Proton Pump Inhibitor in the Management of Acid-Related Disorders." Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy 15, no. 1 (2014): 31–7. http://dx.doi.org/10.24871/151201431-7.
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Proton pump inhibitor (PPI) is the strongest inhibitor to gastric acid secretion. PPI is effective in all gastricacid disorders, such as: peptic ulcer, gastroesofageal reflux disease, non steroid anti inflammatory drugs (NSAIDs)gastropathy, and Zollinger-Ellison syndrome. Several studies comparing one PPI to another. Although somedifferences have been reported, there are small differences with unclear clinical importance.PPI has side effects that may be related to diarrhea due to Clostridium difficile, pneumonia, hip fracture, vitamin B12 deficiency, and IgE mediated allergic reaction. Several studies revealed strong association but havelimitation in design and sampel size. PPI therapy should be according to indication, dose, and appropriate period.Keywords: proton pump inhibitor, gastric acid disorder, indication, dose, period ABSTRAKPenghambat pompa proton (PPP) adalah inhibitor paling kuat terhadap sekresi asam lambung. PPPefektif untuk terapi semua gangguan asam lambung termasuk ulkus peptikum, penyakit gastroesofageal reflux,gastropati karena obat anti inflamasi non steroid (OAINS), dan sindrom Zollinger-Ellison. Beberapa penelitianmembandingkan beragam PPP satu dengan yang lainnya. Walaupun dilaporkan ada beberapa perbedaan,namun besaran perbedaannya kecil dan tidak jelas kepentingan klinisnya.PPP kemungkinan berkaitan dengan efek samping diare karena Clostridium difficile, pneumonia, frakturpanggul, defisiensi vitamin B12, dan reaksi alergi yang dimediasi IgE. Beberapa penelitian menunjukkanhubungan yang kuat namun memiliki keterbatasan desain dan besaran sampel. Terapi PPP harus sesuai denganindikasi, dosis, dan jangka waktu yang tepat.Kata kunci: penghambat pompa proton, gangguan asam lambung, indikasi, dosis, jangka waktu
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Ng, Andrew Kei-Yan, Pauline Yeung Ng, April Ip, Ka-Shing Cheung, and Chung-Wah Siu. "Association between proton pump inhibitors after percutaneous coronary intervention and risk of gastric cancer." BMJ Open Gastroenterology 8, no. 1 (2021): e000719. http://dx.doi.org/10.1136/bmjgast-2021-000719.
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BackgroundPrevious studies showing an association between chronic use of proton pump inhibitor (PPI) and gastric cancer are limited by confounding by indication. This relationship has not been studied in patients receiving PPI for prophylaxis, such as those undergoing percutaneous coronary intervention (PCI).MethodThis was a retrospective cohort study including 14 hospitals under the Hospital Authority of Hong Kong between 1 January 2004 and 31 December 2017. Participants were patients who underwent first-ever PCI, were not on PPI prescription within 30 days before admission for PCI, had no known malignancy and survived for 365 days after PCI. Propensity score matching was used to balance baseline characteristics and other prescription patterns. The primary outcome was diagnosis of gastric cancer made >365 days after PCI as a time-to-first-event analysis. The secondary outcome was death from gastric cancer.ResultsAmong the 13 476 patients (6738 pairs) matched by propensity score, gastric cancer developed in 17 (0.25%) PPI users and 7 (0.10%) PPI non-users after a median follow-up of 7.1 years. PPI users had a higher risk of gastric cancer (HR 3.55; 95% CI 1.46 to 8.66, p=0.005) and death from gastric cancer (HR 4.18; 95% CI 1.09 to 16.08, p=0.037), compared with non-users. The association was duration-dependent and patients who took PPI for ≥365 days were at increased risk.ConclusionsChronic use of PPI was significantly associated with increased risk of gastric cancer and death from gastric cancer in patients for whom it was prescribed as prophylaxis. Physicians should judiciously assess the relevant risks and benefits of chronic PPI use before prescription.
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Turco, Thomas F. "A Pharmacy-Managed Intravenous to Enteral Proton-Pump Inhibitor Conversion Program." Hospital Pharmacy 38, no. 8 (2003): 753–57. http://dx.doi.org/10.1177/001857870303800813.
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This article describes a pharmacy-managed, intravenous (IV) to enteral proton-pump inhibitor (PPI) program at a 377-bed tertiary care, teaching community hospital. IV pantoprazole was not restricted by indication, service, or patient location. Pharmacy converted any eligible patient prescribed an IV PPI to either pantoprazole tablets or lansoprazole capsules, packets, or enteral suspension according to protocol. Over a four-month evaluation period, 113 patients (mean age of 66 years) were prescribed IV PPIs for primarily suspected or documented GI bleeding. Gastroenterology specialists initiated 85% of IV PPI therapy. The most common dosage of IV PPI was 40 mg, once or twice daily with a median duration of 3 to 4 days. Continuous infusion IV PPI therapy was used for only two patients, both with GI bleeding. IV pantoprazole was converted to an enteral PPI in 73 of 113 patients in dosages of pantoprazole 40 mg or lansoprazole 30 or 60 mg administered once (32%) or twice (68%) daily. Pharmacists initiated 34% of the conversions. The total PPI expenditure was $6200 during the evaluation period. Daily acquisition cost savings, based on nominal pricing, ranged from approximately $5 to $25. Initial evaluation of the conversion program resulted in protocol revision and education of the medical staff, in an effort to minimize days of IV PPI use and encourage transition to enteral therapy. The protocol conversion dosage of lansoprazole 60 mg twice daily was changed to 30 mg twice daily and enteral pantoprazole tablets were deleted from the protocol (all IV PPI is converted to lansoprazole, 30 mg twice daily). Although IV pantoprazole remained on the hospital formulary, the medical staff were educated about the relative effectiveness of IV and enteral PPI therapy and the use of histamine-2 receptor antagonists for various indications. Prescribers of IV pantoprazole are now required to document the rationale for use. The Pharmacy and Therapeutics Committee will continue to explore the role IV PPI therapy, based on efficacy, safety, and cost.
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Hameed, Tahir. "THE PHYSIOLOGICAL ASPECTS OF EFFECTIVE AND SAFE PROTON PUMP INHIBITOR THERAPY FOR ACID SUPPRESSION IN QUETTA." Pak-Euro Journal of Medical and Life Sciences 2, no. 1 (2019): 12–14. http://dx.doi.org/10.31580/pjmls.v2i1.986.
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ABSTRACT
 
 The prescribing proton pump inhibitors for longtime is a rational practice now adays. In some cases patiants with peptic ulcers have to take them for whole life. The patient should have to use PPIs and there is evolved distress for the strong antagonistic effects as a result of its continuous therapy. The first discovered proton pump inhibitor is omeprazole and after some time of discovery of omeprazole , the French gastroenterologist Jean Paul Galmiche has anticipating that the unprecedented clinical effectiveness of this medicine would have lead (patients and physicians alike) to dependence, and indeed, this is the case. Once proton pump inhibitor PPI, used by large number of patients for long-term, the proton pump inhibitors, often , may result in bone weakness and sometimes cardiac distress. especially the mature women Even though PPIs being the ideal anti-secretory drugs and that innovative longer-acting compounds that developed prolonged acid suppression and they stay, no doubt, the PPIs are prescribing in all age group and give very effective result in all available medications
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Mustikarani, Dewi, Henrico Citrawijaya, and Saskia Aziza Nursyirwan. "Evidence-Based Case Report: Comparison of Potassium Competitive Acid Blocker and Proton Pump Inhibitor as First Line Therapy in Adult Patients with H. pylori Infection." Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy 25, no. 2 (2024): 170–75. https://doi.org/10.24871/2522024204.
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ABSTRACTBackground: Increased eradication of Helicobacter pylori decreases the incidence of gastric cancer. Vonoprazan is a potassium-competitive acid blocker (PCAB) with a stronger acid production suppression effect than proton pump inhibitors (PPI). Vonoprazan has been recognized as a therapy for gastric acid reflux disease since 2015 in Japan, but the comparison of the effectiveness of PCAB first-line therapy with PPI for adult patients with H. pylori infection is still controversial.Method: A literature search was carried out on three databases: Pubmed, Cochrane, and Scopus on March 30th 2023, using keywords vonoprazan, potassium competitive acid blocker (PCAB), proton pump inhibitor, and H. pylori. There were 7 studies on Pubmed, 26 studies on Cochrane, and 144 studies on Scopus. Critical screening was conducted using the Oxford Centre for Evidence-Based Medicine for systematic reviews and randomized controlled trials. Results: Based on screening of inclusion and exclusion criteria, one study met the criteria. The intention to treat analysis (ITT) showed eradication of H. pylori in the combination of three therapies with PCAB vs PPI of 91.81% vs 75.5% (1,18 [1.08−1.28], p0,0001), no heterogeneity found (I2 = 43%). Analysis per protocol showed PCAB versus PPI eradications of 92.99% vs 78.57% (1,13 [1,02−1,26], p = 0.02), heterogeneity obtained (I 2 = 75%). Conclusion: Generally, PCAB has better eradication than PPI as first-line therapy for adult patients with H. pylori infection Keywords: potassium competitive acid blocker, proton pump inhibitors, helicobacter pylori
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Kecskemeti, K. L., M. Borgaonkar, and J. McGrath. "A149 CHARACTERIZING INAPPROPRIATE PROTON-PUMP INHIBITOR DISCONTINUATION IN PATIENTS WITH ESOPHAGEAL STRICTURES." Journal of the Canadian Association of Gastroenterology 6, Supplement_1 (2023): 81–82. http://dx.doi.org/10.1093/jcag/gwac036.149.
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Abstract Background Recent recommendations to reduce proton pump inhibitor (PPI) usage may cause uncertainty for clinicians and patients. We have shown increased PPI discontinuation rates in patients with esophageal strictures in recent years. Purpose: We aim to determine the appropriateness of PPI discontinuation in patients undergoing esophageal dilation for symptomatic strictures. Purpose We aim to determine the appropriateness of PPI discontinuation in patients undergoing esophageal dilation for symptomatic strictures. Method All patients from two gastroenterology practices who received dilations to treat symptomatic esophageal strictures in 2015-2021, (group 1: 2015-17 and group 2: 2019-21) were identified using physician billing codes for this retrospective study. Patient demographics, medications, and previous GI diagnoses were collected using endoscopy reports, nursing reports and medication records from the local hospital database. We defined PPI discontinuation as either a 50% dose reduction, 50% frequency reduction or complete medication discontinuation at the time of endoscopic dilation compared to the established PPI therapy. Next, we defined inappropriate PPI discontinuation as a patient who discontinued their PPI medication with a past history of 1. esophageal stricture, 2. Barrett’s esophagus 3. grade C/D esophagitis, or 4. experienced symptom reoccurrence after PPI discontinuation. We selected these criteria as they are consistent with both Canadian and American Gastroenterology Society GERD management guidelines. This information was coded on a standard data sheet and entered into SPSS for analysis. Result(s) In total, 223 patients were identified with an average age of 58.7 and a sex ratio of (125:98, M:F). 26 patients discontinued their PPI medication prior to esophageal stricture dilation. The most frequent type of event was complete PPI discontinuation at 58% (15/26 cases). Followed by frequency reduction at 27% (7/26), dose reduction at 8% (2/26), and both dose and frequency reduction at 8% (2/26). The 26 patients with PPI discontinuations had an average length of 13 months between PPI discontinuation and esophageal stricture dilation. 57% (15/26 cases) of patients meet our criteria for inappropriate PPI discontinuation (table 2). The proportion of inappropriate PPI discontinuation are as follows: Group 1: 33% (3/9 cases) inappropriate PPI discontinuations and Group 2: 70% (12/17 cases) inappropriate PPI discontinuations, (P=0.06) upon Chi-squared analysis. Table 2- Inappropriate PPI discontinuations Previous Stricture: 10/26 Barrett’s Esophagus: 0/26 Grade C/D Esophagitis: 1/26 Symptom Reoccurrence: 4/26 Total inappropriate discontinuations: 15/26 = 57% Total appropriate discontinuations (no PMH): 11/26 = 43% Conclusion(s) Compete PPI discontinuation was the most common type of PPI discontinuation event. There was a trend toward more inappropriate PPI discontinuations in the second time period. Physicians should carefully consider indications for PPI use prior to discontinuation. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest K. Kecskemeti: None Declared, M. Borgaonkar Consultant of: $10K, Speakers bureau of: $20K, J. McGrath: None Declared
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Altman, Kenneth W., and James A. Radosevich. "Unexpected consequences of proton pump inhibitor use." Otolaryngology–Head and Neck Surgery 141, no. 5 (2009): 564–66. http://dx.doi.org/10.1016/j.otohns.2009.08.027.
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Proton pump inhibitors (PPIs) are among the most widely prescribed classes of medications for gastroesophageal and laryngopharyngeal reflux diseases. There is emerging evidence that the pathogenesis of disease in laryngeal mucosa is not just related to refluxed acid, but also the presence of pepsin and acidic microenvironments. The widespread use of PPIs is also calling into question potential complications of PPI use. This commentary expands upon these issues with other potential unexpected consequences, and considers the importance of determining a proper approach to patient management.
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Huang, Alina M., Christine M. Ho, John L. Reagan, and Eric Winer. "Proton Pump Inhibitor Use and the Ability to Replete Iron Stores." Blood 118, no. 21 (2011): 1039. http://dx.doi.org/10.1182/blood.v118.21.1039.1039.
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Abstract Abstract 1039 Background: Oral iron absorption occurs in the duodenum and requires increased gastric acidity to allow iron to remain in the more soluble, ferrous form. Many patients with iron deficiency anemia who require oral iron repletion are on proton pump inhibitors (PPIs) for management of various conditions that require acid suppression for treatment. In vitro studies suggest that inhibition of gastric acid secretion decreases the bioavailability of iron. In patients with established iron deficiency anemia who are on PPIs, there is a paucity of data regarding the efficacy of iron replacement with concomitant PPI use. Sharma et al. published a case report on 2 patients who were iron deficient and on PPI therapy (Sharma et. al. Southern Medical Journal 2004). Their findings showed that discontinuation of the PPI resulted in improvement of iron deficiency anemia on the same dose of oral iron replacement. Additionally, Hutchinson et al. demonstrated that in individuals with hereditary hemachromatosis, those on PPIs had a significant reduction in phlebotomy requirements needed to keep serum ferritin ∼50μg (Hutchinson et. al. Gut 2007). We conducted a retrospective study to assess whether a difference exists in terms of iron repletion between patients on a PPI versus those not on a PPI. Methods: Patients were selected from the medical primary care clinic from charts dating January 2000 until January 2009. Included patients were adults older than 18 years of age, a diagnosis of iron deficiency based on ferritin < 30 with at least one follow up ferritin value, and recipients of oral iron replacement. Excluded patients were those with chronic active bleeding and anemia of chronic disease. Indices examined include iron (Fe), total iron binding capacity (TIBC), ferritin, transferrin saturation, hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume (MCV). The primary endpoint of interest is repletion of iron stores defined by ferritin > 30. Those who were able to replete their iron stores are termed “responders” and those who were not are termed “nonresponders”. Results: Forty-five patients have been identified who have met the above criteria. Of these patients, 14 were on a PPI and 31 were not on a PPI. Of the patients not on a PPI, 38.7% responded to oral iron. Of the patients on a PPI, 50.0% responded to oral iron. The average initial and final values of indices of interest were compared between the groups (Table 1). Discussion: Our data suggests that patients both on and off PPIs show the ability to replete their iron stores. Furthermore, it appears that a slightly greater percentage of patients on a PPI compared with those not on a PPI are able to replete their iron stores, though the numbers remain small. Most importantly, these findings challenge the commonly held belief that PPI use impairs oral iron absorption. A prospective study is warranted to further confirm these observational data. Disclosures: No relevant conflicts of interest to declare.
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Hashimoto, Atsushi, Takashi Sugawa, Narika Iwakura, et al. "The Predictive Factors of Responsiveness to Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis." Gastrointestinal Disorders 1, no. 1 (2019): 220–30. http://dx.doi.org/10.3390/gidisord1010017.
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Approximately half of patients with eosinophilic esophagitis (EoE) respond clinically and histologically to proton pump inhibitor (PPI) therapy. Although recent guidelines suggest that PPI-responders and non-responders were included in EoE, it is important to investigate the predictive factors of PPI- responsiveness. This study aimed to determine the rate of PPI- responders and compare the characteristics of PPI-responders and non-responders. Fifty-nine patients with esophageal eosinophilia received PPI therapy for eight weeks, and its efficacy was assessed. PPI- responsiveness was diagnosed based on the relief in symptoms and reduction of intraepithelial eosinophilic infiltration to <15 per high-power field (hpf) after PPI therapy. Multivariate analysis was performed to identify factors associated with PPI-responders. Of the 59 patients, 41 (69.5%) were diagnosed with PPI-responders. The rate of gastrointestinal (GI) screening in the indications for endoscopy was significantly higher in patients with PPI- responders than in those with non-responders. On multivariate analysis, GI screening and presence of reflux esophagitis was associated with an increased odds ratio (OR) of PPI-responders, but presence of rings with a decreased OR of PPI-responders. Presence of reflux esophagitis and absence of rings on endoscopy especially during GI screening might be significant predictive factors for PPI response in patients with EoE.
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Ohmure, H., K. Kanematsu-Hashimoto, K. Nagayama, et al. "Evaluation of a Proton Pump Inhibitor for Sleep Bruxism." Journal of Dental Research 95, no. 13 (2016): 1479–86. http://dx.doi.org/10.1177/0022034516662245.
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Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting of the mandible. Recent advances have clarified the relationship between gastroesophageal reflux and sleep bruxism (SB). However, the influence of pharmacological elimination of gastric acid secretion on SB has not been confirmed. The authors aimed to assess the efficacy of a proton pump inhibitor (PPI) on SB and to examine the gastrointestinal (GI) symptoms and endoscopic findings of the upper GI tract in SB patients. The authors performed a randomized double-blind placebo-controlled crossover study at Kagoshima University Hospital. Twelve patients with polysomnography (PSG)–diagnosed SB underwent an assessment of GI symptoms using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) and esophagogastroduodenoscopy. At baseline (i.e., before interventions), the mean frequencies of electromyography (EMG) bursts and rhythmic masticatory muscle activity (RMMA) episodes were 65.4 ± 49.0 bursts/h and 7.0 ± 4.8 episodes/h, respectively, and at least 1 RMMA episode with grinding noise was confirmed in all participants. The mean FSSG score was 8.4 ± 5.6, and 41.7% of patients were diagnosed with gastroesophageal reflux disease. Mild reflux esophagitis was confirmed in 6 patients. PSG, including EMG of the left masseter muscle and audio-video recording, was performed on days 4 and 5 of administration of 10 mg of the PPI (rabeprazole) or placebo. PPI administration yielded a significant reduction in the frequency of EMG bursts, RMMA episodes, and grinding noise. No significant differences were observed regarding the swallowing events and sleep variables. Since the clinical application of PPI for SB treatment should remain on hold at present, the results of this trial highlight the potential application of pharmacological gastroesophageal reflux disease treatment for SB patients. Larger scale studies are warranted to corroborate these findings. (UMIN Clinical Trials Registry: UMIN000004577).
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Schneider, HR. "Is a proton pump inhibitor (PPI) the GP's gastroscopy?" South African Family Practice 47, no. 2 (2005): 24–29. http://dx.doi.org/10.1080/20786204.2005.10873182.
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Losik, Ye A. "Safety of proton pump inhibitors." Russian Journal of Gastroenterology, Hepatology, Coloproctology 26, no. 3 (2016): 87–92. http://dx.doi.org/10.22416/1382-4376-2016-26-3-87-92.
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Aim of review. To present modern data on the possible mechanisms of development of side effects of the proton pump inhibitors (PPI). Summary. Proton pump inhibitors is the class of pharmaceuticals that block N+/K+-ATPase of gastric parietal cells. In this regard they are widely applied in acid-related diseases of upper gastro-intestinal tract. Short term intake of PPI is well tolerated by patients and can rarely cause side effects. The risk of development of iron deficiency, vitamin B12, magnesium is discussed. The interrelation between PPI intake and osteoporosis development is of special interest. Cases of the PPIassociated acute interstitial nephritis are presented. The risk of intestinal infections development, C. difficileassociated disease, and spontaneous bacterial peritonitis in liver cirrhosis patients are still under discussion. Conclusion. The majority of side effects develops in elderly patients have and concomitant diseases. Thus, PPIs can be considered only as supplementary risk factor, and before onset of the long-term treatment all pro et contra consideration should be evaluated.
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T, Husna, Manju CS, and Hasna Moideen. "Review on Concomitant Use of Proton Pump Inhibitors [PPI] with Antiplatelet Agents." International Journal of Research and Review 10, no. 4 (2023): 533–38. http://dx.doi.org/10.52403/ijrr.20230466.
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Clopidogrel and proton pump inhibitors (PPI) are the two drugs which are commonly used in clinical settings. clopidogrel is an anti-platelet drug used for cardiovascular and cerebrovascular disease. The main drawback of long-term use of antiplatelet therapy is gastrointestinal bleeding so that the patients with antiplatelet drug is prescribed with proton pump inhibitors as a prophylactic measure. Many studies suggest that proton pump inhibitors can reduce the antiplatelet effect of clopidogrel by inhibiting the enzyme CYP450.clopidogrel is a prodrug which is converted to active drug mainly by CYP2C19 in the liver. The same enzyme is responsible for the metabolism of proton pump inhibitors. Hence there is a possibility of interaction between clopidogrel and proton pump inhibitors. As a result, there is a chance of increasing cardiovascular events in patient taking proton pump inhibitors along with clopidogrel. Keywords: [proton pump inhibitors, clopidogrel, gastrointestinal bleeding, prodrug, CYP450 enzyme, interaction]
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Helgadottir, Holmfridur, and Einar S. Björnsson. "The Impact of Sex on the Response to Proton Pump Inhibitor Treatment." Pharmaceuticals 16, no. 12 (2023): 1722. http://dx.doi.org/10.3390/ph16121722.
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Proton pump inhibitor (PPI) treatment is responsible for substantial gastrin elevation secondary to reduced intragastric acidity. Due to the increasing global prevalence of PPI users, concerns have been raised about the clinical significance of continuous gastrin elevation and its potential long-term side effects. Hypergastrinemia secondary to PPIs has trophic effects on gastric mucosa, leading to enterochromaffin-like cell hyperplasia and gastric (fundic) polyp formation, and it is believed to provoke acid rebound following PPI withdrawal that induces PPI overutilization. Previous studies have found higher gastrin release following PPI therapy in females compared with males, and sex differences have also been demonstrated in pharmacokinetic parameters and dose requirements for acid reflux. It is conceivable that females might be at increased risk of PPI overuse, because they often receive higher milligram-per-kilogram doses. The prevalence of PPI use is more common among females, and the female sex is a risk factor for adverse drug reactions. This non-systematic review outlines the current knowledge of the impact of biological sex on the response to PPIs. The aim is to highlight the female sex as a potential risk factor that could be a step toward precision medicine and should be considered in future research on the response to PPI treatment.
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BRITO, Hugo Leite de Farias, Cynthia BARROS, Marcelle Vieira FREIRE, Miraldo Nascimento da SILVA FILHO, and Tereza Virgínia NASCIMENTO. "GASTRIC FUNDIC GLAND POLYPS: CAN HISTOLOGY BE USEFUL TO PREDICT PROTON PUMP INHIBITORS USE?" Arquivos de Gastroenterologia 55, no. 4 (2018): 380–84. http://dx.doi.org/10.1590/s0004-2803.201800000-82.
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ABSTRACT BACKGROUND: Fundic gland polyps allegedly increased in frequency in recent decades, and had attracted great attention due to possible association with prolonged proton pump inhibitor therapy. Prolonged use of this drug could cause parietal cell hyperplasia, obstruction of glandular lumen and cystic dilation of the gland. OBJECTIVE: This study aims to analyze clinical and pathological features of fundic gland polyps in patients with and without proton pump inhibitor therapy in a selected population from Brazil. METHODS: It was selected a sample of 101 Brazilian patients (78 females and 23 males), from a five years retrospective search of the files from a private pathology laboratory. The patients had an average age of 57 years and we included patients with a histological diagnosis of fundic gland polyp. The clinical data were obtained from their files and all histological slides were reviewed and examined with hematoxylin and eosin (HE) and Giemsa. RESULTS: Information about the use or non-use of proton pump inhibitors (PPI) was obtained in 84 patient files. In 17 cases we could not determine if PPI were used or not. Among those in which the information was available, a positive history of anti-acid therapy was observed in 63 (75.0%) patients. Parietal cell hypertrophy/hyperplasia and parietal cell protrusions were detected in most slides. Histological findings were identical in PPI users and PPI negative patients. Helicobacter pylori infection was detected in just two samples. Epithelial dysplasia or adenocarcinoma were not observed in our cases. Histopathological analysis of fundic gland polyps could not distinguish between PPI and non-PPI related cases. Parietal cell cytoplasmic protrusions, an alleged marker of prolonged acid suppression therapy, was detected in both groups. CONCLUSION: Histological features could not discriminate anti-acid therapy related fundic glands polyps in our patients.
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Rida Manzoor, Fazal Ur Rehman, Javeria, et al. "Frequency of Interstitial Nephritis in Patients Taking Proton Pump Inhibitor." Indus Journal of Bioscience Research 3, no. 3 (2025): 259–64. https://doi.org/10.70749/ijbr.v3i3.863.
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Background: Acute interstitial nephritis (AIN), a major cause of drug-induced acute kidney injury (AKI) and possible chronic kidney disease (CKD) is linked to extended PPI use. Proton pump inhibitors (PPIs) are frequently recommended for acid-related gastrointestinal illnesses. At a tertiary care hospital in Quetta, Pakistan, this study examines the incidence and clinical consequences of PPI-induced interstitial nephritis in patients on long-term PPI therapy. Methods: One hundred individuals with a clinical and laboratory diagnosis of interstitial nephritis who had been using PPIs for at least six months were included in this qualitative analysis. Reviews of medical records, reports from kidney biopsies, and semi-structured interviews with patients and nephrologists were used to gather data. Laboratory parameters, histopathological results, demographics, and symptoms were all examined using descriptive statistics. Results: Of the participants, 80% had been taking PPIs for more than a year, and 40% had been taking them for more than three years. AKI (60%), decreased urine production (55%), and weariness (70%), were common symptoms. Laboratory results showed a lower estimated glomerular filtration rate (eGFR) (45 ± 12 mL/min/1.73m²) and an increased serum creatinine (2.1 ± 0.5 mg/dL). The diagnosis of AIN was supported by renal biopsies, which showed eosinophilic infiltration in 60% of cases and tubulointerstitial inflammation in 85% of cases. Fibrosis was observed in 30% of cases, indicating CKD progression risk. Conclusion: This study emphasizes the significance of routine renal function monitoring by demonstrating a substantial association between long-term PPI usage and interstitial nephritis. Renal outcomes can be improved and the risk of CKD decreased with early identification and prompt PPI discontinuation. Safer prescribing procedures should be used by medical professionals to lessen nephrotoxic consequences.
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Mangan, John J., Srikanth N. Divi, James C. McKenzie, et al. "Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes." Global Spine Journal 10, no. 1 (2019): 55–62. http://dx.doi.org/10.1177/2192568219853222.
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Study Design: Retrospective cohort review Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown. The purpose of this study was to determine if patients taking PPIs have higher rates of nonunion after ACDF. Methods: A retrospective cohort review was performed to compare patients who were taking PPIs preoperatively with those not taking PPIs prior to ACDF. Patients younger than 18 years of age, those with less than 1-year follow-up, and those undergoing surgery for trauma, tumor, infection, or revision were excluded. The rates of clinically diagnosed pseudarthrosis and radiographic pseudarthrosis were compared between PPI groups. Patient outcomes, pseudarthrosis rates, and revision rates were compared between PPI groups using either multiple linear or logistic regression analysis, controlling for demographic and operative variables. Results: Out of 264 patients, 58 patients were in the PPI group and 206 were in the non-PPI group. A total of 23 (8.71%) patients were clinically diagnosed with pseudarthrosis with a significant difference between PPI and non-PPI groups ( P = .009). Using multiple linear regression, PPI use was not found to significantly affect any patient-reported outcome measure. However, based on logistic regression, PPI use was found to increase the odds of clinically diagnosed pseudarthrosis (odds ratio 3.552, P = .014). Additionally, clinically diagnosed pseudarthrosis negatively influenced improvement in PCS-12 scores ( P = .022). Conclusions: PPI use was found to be a significant predictor of clinically diagnosed pseudarthrosis following ACDF surgery. Furthermore, clinically diagnosed pseudarthrosis negatively influenced improvement in PCS-12 scores.
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Sajjal Shadia, Mahnoor Javed Janjua, Abali Wandala, et al. "Impact of Proton Pump Inhibitor Use on Efficacy of Dual Antiplatelet Therapy in Post-PCI Patients: A Meta-Analysis of Randomized Controlled Trials." Indus Journal of Bioscience Research 3, no. 3 (2025): 106–11. https://doi.org/10.70749/ijbr.v3i3.926.
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Background: Dual antiplatelet therapy (DAPT) is a standard treatment following percutaneous coronary intervention (PCI), significantly reducing ischemic events but increasing gastrointestinal (GI) bleeding risk. Proton pump inhibitors (PPIs) are frequently co-prescribed to mitigate this risk, yet concerns persist regarding potential interactions with P2Y12 inhibitors—particularly clopidogrel—that may compromise cardiovascular outcomes. Objective: The objective of this meta-analysis is to assess the impact of proton pump inhibitor (PPI) use on the efficacy and safety of dual antiplatelet therapy (DAPT) in patients who have undergone percutaneous coronary intervention (PCI). By analyzing data from randomized controlled trials (RCTs), this study aims to determine whether concurrent PPI therapy alters cardiovascular outcomes or provides gastrointestinal protection without compromising antiplatelet effectiveness. Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science identified RCTs comparing DAPT with and without concurrent PPI use in PCI patients. Five RCTs met the inclusion criteria. Primary outcomes included major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and GI events. Data were synthesized using a random-effects model, and heterogeneity was assessed via the I² statistic. Results: PPI use was associated with a significantly increased risk of MACE (OR: 1.12; 95% CI: 1.04–1.21), MI (OR: 1.20; 95% CI: 1.10–1.31), and stroke (OR: 1.15; 95% CI: 1.02–1.29), while significantly reducing GI events (OR: 0.75; 95% CI: 0.68–0.83). Subgroup analyses indicated heightened cardiovascular risk in high-risk patients and those on prolonged DAPT or omeprazole. Heterogeneity was low to moderate across outcomes. Conclusion: While PPIs offer substantial GI protection in patients on DAPT post-PCI, their use may elevate cardiovascular risk, particularly with clopidogrel and long-term therapy. These findings support personalized risk-benefit assessment and the cautious selection of PPIs in this patient population.
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Nishizawa, Toshihiro, Kiyoto Mori, Shuntaro Yoshida, Hirotoshi Ebinuma, Osamu Toyoshima, and Hidekazu Suzuki. "Additional Mosapride to Proton Pump Inhibitor for Gastroesophageal Reflux Disease: A Meta-Analysis." Journal of Clinical Medicine 9, no. 9 (2020): 2705. http://dx.doi.org/10.3390/jcm9092705.
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Background and Aim: In gastroesophageal reflux disease (GERD), the additive effect of mosapride to a proton pump inhibitor (PPI) is still controversial. This meta-analysis integrated randomized controlled trials (RCTs) in which mosapride combined with a PPI was compared with a PPI alone in GERD treatment. Methods: RCTs were systematically searched with the PubMed, Cochrane library, Web of Science, and the Igaku-Chuo-Zasshi database. We combined the data from the RCTs with a random effects model, calculated the standardized mean difference (SMD) and pooled the risk difference (RD) with 95% confidence intervals (CIs). Results: We included nine RCTs in the present meta-analysis. In the mosapride combined with PPI group, the improvement of the symptom score was significantly greater than that in the PPI alone group without significant heterogeneity (SMD: −0.28, 95% CI: −0.45 to −0.12, p = 0.0007). In the mosapride combined with PPI group, the symptom score after treatment was significantly lower than that in the PPI alone group (SMD: −0.24, 95% CI: −0.42 to −0.06, p = 0.007). Conclusions: Mosapride combined with a PPI significantly improved the reflux symptom score compared with that of PPI alone.
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Saha, Shasanka Kumar, Madhusudan Saha, Bimal Chandra Shil, Md ANM Saifullah, Monirul Hasan, and Nahian Faruque Chowdhury. "Trends of Proton Pump Inhibitor Uses among Pharmaceutical Promotional Workers." Sir Salimullah Medical College Journal 31, no. 1 (2023): 41–46. http://dx.doi.org/10.3329/ssmcj.v31i1.69359.
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Background: Proton pump inhibitors (PPIs) are one of the most frequently used drugs in the world for the management of gastric- acid related diseases. The aim of this study was to assess the trend of PPIs uses among the pharmaceutical promotional workers in Bangladesh. Methods: A questionnaire-based survey was conducted on pharmaceutical promotional workers from different regions in Bangladesh. The study data were collected which includes demographics, PPIs uses in terms of duration, dose, generics, symptoms for which they took PPIs and effects of PPIs on symptoms. Drugs or diseases that influenced the intake of PPIs were also recorded. Results: Among six hundred surveys issued for the study, 581 valid questionnaires were returned. Among the respondents 520 individuals (89.5%) were male and 61 individuals (10.5%) were female. Common indications for taking PPIs were abdominal discomfort (51.5%), vomiting (34.1%) and abdominal pain (24.6%). Two hundred seventy (48.56%) respondents had satisfactory relief of symptoms, 125 (22.48%) had symptoms reappeared after stopping PPIs and 77 (13.85%) had complete cure of symptoms. Most of the participants (42.60%) were on PPIs therapy for up to one year. Most of the participants (64.49%) took PPI once daily. Most of the participants (60.75%) started PPI by themselves. Esomeprazole (40.1%) and rabeprazole (30.1%) were the most frequently used PPIs. Conclusion: PPI is found to be a frequently used medication among pharmaceutical promotional workers. Further well-designed study with adequate work up may be designed to see misuse and overuse of PPI among workers of pharmaceutical sector as well as general population. Sir Salimullah Med Coll J 2023; 31: 41-46
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Cho, H., H. Chun, B. Keum, et al. "Ethanol-induced DNA damage and the expression of repair-related molecules in human gastric carcinoma AGS cells with use of an acid pump antagonist and proton pump inhibitor." Journal of Clinical Oncology 29, no. 4_suppl (2011): 30. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.30.
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30 Background: Proton pump inhibitor (PPI) inhibits gastric acid secretion by strongly suppressing H + / K +- ATPase of parietal cells and is a major drug for peptic ulcers and gastroesophageal reflux. Recently it was reported that PPI has antioxidant and anti- inflammatory effects as well as a powerful acid inhibitory effect. To analyze the DNA repair capacity from the antioxidant effect of acid pump antagonist (Revanex-RN) and proton pump inhibitor (Omeprazole-OP), this study examined ethanol-induced DNA damage and the expression of repair related molecules in human gastric cancer AGS cells pretreated with an acid pump antagonist and a proton pump inhibitor. Methods: AGS, a human gastric cancer cell line was obtained from ATCC, was treated with ethanol (0, 2, 4, 6, 8, 10%) during 1hr. MTT and Comet assay were performed to evaluate ethanol-induced DNA damage. The optimum concentration of ethanol which caused DNA damage was established. And AGS cells were cultured in proper concentration of RN or OP overnight. Then, these cells were treated with 5% ethanol during 1hr. DNA damage and recovery were represented the value of Olive tail moment in comet assay. Western blot was also performed to detect expression of DNA polymerase beta, APE/ref-1, PCNA, and GADD45. Results: The DNA damage of AGS cell depended upon ethanol concentration distinctly. Damaged cells showed up recovered tendency in the group treated with low dose RN or OP. In addition, DNA repair enzymes including DNA polymerase beta and APE/ref-1 which were associated with mechanism of base excision repair (BER) were increased. A relevant protein such as GADD45 was also increased significantly. Conclusions: PPI has capacity to recover damaged DNA, which is associated with increased expression of GADD45 directly. Therefore, PPI offers cancer prevention by reducing the level of DNA damage in the gastric mucosa. GADD45 is also likely to suggest that it could be used a major factor on the injury mechanism and an indicator of mucosal damage in stomach. Moreover, RN, an acid pump antagonist is expected to have the higher safety compared to the existing PPIs and considered to be equal to PPIs in terms of anti-cancer effect. No significant financial relationships to disclose.
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Ziegler, Matthew J., Craig Freyer, Daniel Landsburg, et al. "Guideline implementation is effective at reducing proton pump inhibitor use in hematology-oncology units: A multidisciplinary intervention for reducing Clostridioides difficile risk." Infection Control & Hospital Epidemiology 40, no. 11 (2019): 1294–96. http://dx.doi.org/10.1017/ice.2019.238.
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AbstractWe implemented a guideline for appropriate acid suppressant use in hematology-oncology patients. This intervention resulted in a sustained reduction in proton pump inhibitor (PPI) use without an increase in rates of gastrointestinal bleeding. Practice guidelines are effective in reducing PPI use, which is associated with risk of Clostridioides difficile infection.
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Okoro, Roland Nnaemeka, Kasim Abdullahi, and Dauda Ayuba Dayar. "Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria." Medicine Access @ Point of Care 5 (January 2021): 239920262110627. http://dx.doi.org/10.1177/23992026211062729.
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Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients’ Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients’ medical records. Chi-square or Fisher’s exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.
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Miyazaki Umar, Fetri Lestari, and Bambang Tri Laksono. "Safety of Proton Pump Inhibitors in Patients with Cirrhosis: A Systematic Literature Review." Bandung Conference Series: Pharmacy 5, no. 1 (2025): 83–91. https://doi.org/10.29313/bcsp.v5i1.16925.
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Abstract. Drug safety is a very important concept in therapy, especially regarding the risk of Adverse Drug Reactions (ADRs). Proton Pump Inhibitors (PPIs) are one of the most widely prescribed drugs in the world with diverse indications such as gastritis, GERD, and peptic ulcers. However, the side effects of PPIs in cirrhosis are still a concern. This study aims to review the safety of PPI use in cirrhotic patients through a systematic literature review method. The results showed that the safety of PPI use in cirrhotic patients is associated with an increased risk of PPI side effects, worsening of the disease, and causing new diseases. However, further research is needed to evaluate mechanisms and strategies to prevent the risk of PPI side effects in cirrhotic patients. Abstrak. Kemanan obat merupakan konsep yang sangat penting dalam terapi, terutama terkait resiko Adverse Drug Reactions (ADRs). Proton Pump Inhibitor (PPI) merupakan salah satu obat yang paling banyak diresepkan di dunia dengan indikasi yang beragam seperti gastritis, GERD, dan tukak lambung. Namun, efek samping PPI pada sirosis masih menjadi perhatian. Penelitian ini bertujuan untuk meninjau keamanan penggunaan PPI pada pasien sirosis melalui metode kajian literatur sistematik. Hasil penelitian menunjukkan keamanan penggunaan PPI pada pasien sirosis berhubungan dengan peningkatan resiko efek samping PPI, perburukan penyakit, hingga menimbulkan penyakit baru. Namun, diperlukan penelitian lebih lanjut untuk mengevaluasi mekanisme dan strategi pencegahan resiko efek samping PPI pada pasien sirosis.
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TY, Bando, di Pace LS, Lapa M, and Chehter EZ. "Proton pump inhibitors: Are they safe?" Gastroenterology & Hepatology: Open Access 13, no. 2 (2022): 34–47. http://dx.doi.org/10.15406/ghoa.2022.13.00492.
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The number of Proton Pump Inhibitor (PPI) users has grown since the last decade. This greater use has come together with its inappropriate prescription, which is a result of its effectiveness and good tolerance. However, there is overuse and inappropriate use with excessive dose and duration. The literature reveals that long-term PPI use has side effects such as pneumonia, gastrointestinal cancer, dementia. These side effects need to be proved and have weak association. Further studies are necessary to elucidate them. This study will ascertain the relationship of PPIs and their long-term collateral effects. In this study, reviews from the last five years addressing the long-term use of PPIs and their possible side effects were sought in indexed databases (PubMed, SciELO and Lilacs). Fourteen articles and 21 relevant side effects were analyzed. The association with most of the reported side effects such as cancer, chronic kidney disease, dementia and community-acquired pneumonia (CAP) is denied. There was a positive association with gastric polyps, magnesium deficiency and acute interstitial nephritis. The side effects are widely spread and even if there is a positive association with some of them, the use of PPIs is likely safe, as the association was negative for more debilitating collateral effects.
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Ballinger, TJ, Z. Djuric, S. Sardesai, et al. "Proton Pump Inhibitor Use and Obesity-Associated Cancers in the Women's Health Initiative." Cancer Epidemiology, Biomarkers & Prevention 31, no. 7 (2022): 1511. http://dx.doi.org/10.1158/1055-9965.epi-22-0475.
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Purpose: Proton pump inhibitors (PPIs) inhibit fatty acid synthase (FAS), a critical enzyme in lipogenesis, energy balance, and cancer cell survival. We aimed to evaluate the association of PPI use with incidence of common obesity- related cancers in women: postmenopausal breast, colorectal, and endometrial cancers. Methods: Our study included 124,931 postmenopausal who were enrolled in the Women's Health Initiative (WHI) observational study and clinical trials, and had responded to a year 3 follow-up assessment. We examined prescription and over the counter use of PPI and/or histamine 2 receptor antagonists (H2RA) at baseline and year 3, to isolate potential effects of FAS inhibition by PPI rather than simply acid suppression. Incident cancer cases were physician-adjudicated. Cox proportional hazard regression models were used to estimate multivariable hazard ratios (HR) and 95% confidence intervals (CI) for associations between PPI and/or H2RA use and cancer incidence after year 3. Results: There were 7956 PPI ever users (with or without H2RA use) and 9398 H2RA only users. PPI or H2RA use was not associated with risk of breast cancer (n=9186 cases), compared to women who did not use either agent (HR 1.01, 95% CI 0.93-1.10 and HR 0.95 95% CI 0.87-1.03, respectively). The incidence of colorectal cancer (n=2280) was significantly lower in PPI users (HR 0.75, 95% CI 0.61-0.92), but not in H2RA users (HR 1.13, 95% CI 0.97-1.31). This association was strengthened with increasing duration (p=0.006) and potency (p=0.005) of PPI use and held regardless of BMI or NSAID use. PPI or H2RA use was not associated with endometrial cancer (n=1231) (HR 0.81, 95% CI 0.61-1.07 and HR 1.13, 95% CI 0.91-1.40, respectively), but showed a trend in decreased risk with increasing PPI potency (P=0.048). Conclusions: Among postmenopausal women, PPI use, but not H2RA use, demonstrated an inverse, dose-responsive association with colorectal cancer incidence. This was consistent with preclinical data that FAS inhibition prevents colon cancer progression and supports further investigation of this commonly used medication as a cancer preventive agent. PPI use was not associated with incidence of breast or endometrial cancer.
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Hoque, Majedul. "Exploring and understanding adverse effect of Proton Pump Inhibitors." Hospital Pharmacology - International Multidisciplinary Journal 11, no. 2 (2024): 1396–402. http://dx.doi.org/10.5937/hpimj2402396h.
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Introduction: Over the past few decades, proton pump inhibitors (PPIs) have been used more often; nonetheless, there are concern regarding misuse and the severe adverse effects that have been described. Methods: This paper will present information from relevant professional/scientific sources including Scopus, EBSCO, PubMed regarding unwanted adverse events of PPIs. Topic: The causality of correlations between PPI usage and possible adverse effects is unknown. Increased risk of kidney, liver, and cardiovascular disease; dementia; gastrointestinal tract enteroendocrine tumors; susceptibility to respiratory and gastrointestinal infections; and reduced nutritional absorption are just a few of the long-term adverse effects of widespread use of PPI that have come to light. Thus, given growing concerns regarding PPI overuse in the general population, the purpose of this investigation is to review the relationship between PPI usage and the risk of major side consequences. Conclusion: Due to the numerous known side effects of PPIs on the system, further study is necessary, including changing the drug's molecular structure and creating a new medication from its parent. By administering these drugs effectively for the relevant diagnosis, reevaluating patients' symptoms on a regular basis to determine the least amount and duration of therapy, and closely monitoring any potential side effects, it is feasible to minimize expenditures with health risk and maximize beneficial outcomes.
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Coşgunarslan, Aykağan, Emin Murat Canger, and Damla Soydan Çabuk. "Proton pump inhibitors and mandibular bone quality: A preliminary study." Dentomaxillofacial Radiology 50, no. 6 (2021): 20200505. http://dx.doi.org/10.1259/dmfr.20200505.
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Objectives: Proton pump inhibitors (PPI) provide a long-lasting anti-acidic effect by inhibiting the proton pump, and they are one of the most commonly prescribed drugs worldwide. PPIs adversely affect the bone structure via deficiency of vitamins and minerals. The aim of this study was to investigate the possible PPI-induced bone changes in the mandible on panoramic radiographs with the methods of fractal analysis and panoramic morphometric indices. Methods: Panoramic radiographs of 402 patients were used (201 PPI users, 201 control group). Fractal analysis was performed on 4 regions of interests (ROI): 1- upper part of the ramus, 2- angulus, 3- anterior of the mental foramen, 4- distal of the middle ramus. Also, the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) were performed on radiographs. Results: There were significant differences in terms of ROI3, MCW, and KI between the control and study groups (p < 0.05) while there was no significant difference for ROI1, ROI2, ROI4, and PMI (p > 0.05). Males were severely affected than females. Conclusions: Osteoporotic changes were detected in the trabecular and cortical bone in the mental foramen region in PPI users with fractal analysis and morphometric indices, while there were no differences for mandibular ramus and angulus regions according to fractal analysis.
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La Cava, Piera, Annalisa Chiarenza, Daniele Tibullo, et al. "The Effect of the Interaction between Proton Pump Inhibitors (PPI) and Tyrosine Kinase Inhibitors (Imatinib, Nilotinib and Dasatinib)." Blood 110, no. 11 (2007): 2957. http://dx.doi.org/10.1182/blood.v110.11.2957.2957.
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Abstract Background: Proton Pump Inhibitors (PPI) (omeprazole, lansoprazole and pantoprazole) are widely used for the treatment of the gastro-oesophageal reflux disease, as well as other acid- related disorders. All PPI act by covalent binding to the proton pump of the gastric parietal cell and inhibition of the H+, K+ -adenosine triphosphatase [ATPase]. It is known that imatinib mesylate enters the cells through an active pump called hOCT-1. We therefore investigated whether proton pump inhibitors (PPI) could affect OCT-1 function thereby modifying the sensitivity of CML cells to Imatinib and other Tyrosine Kinase Inhibitors (TKI) such as Nilotinib and Dasatinib. Methods: We pretreated K562 cell line for 2 hours with increasing dose of omeprazole (5, 50, and 100 mM), lansoprazole (5, 50, and 100 mM) and pantoprazole (9, 50, and 100 mM). Imatinib (1mM), Dasatinib (5 nM), Nilotinib (0,1 mM) were added and their cytotoxicity was evaluated after 24 hours of incubation using cell death assays (Trypan Blue). As a control the cells were pretreated with ranitidine, an histamine H(2)- receptor blocker, but not proton pump inhibitors. Results: (Table1). Imatinib induced citotoxicity was significantly reduced when cells were pre-treated with 100 μM-omeprazole, 50 and 100 μM-pantoprazole, 50 and 100 μM-lansoprazole. Dasatinib induced cytotoxicity was only slightly decreased at the different doses of PPI, while nilotinib induced cytotoxicity was significantly increased by the highest doses of PPI. Conclusion: Our data provide evidence that proton pump inhibitors might interfere with TKIs activity. The reduction of imatinib cytotoxicity could be due to PPI interaction with OCT-1 that is the active transporter of imatinib. On the contrary, the increase of nilotinib cytotoxicity could be due to PPI inhibition of the efflux pumps such as ABCB1. Similar data (except for dasatinib) have already been reported at 2007 EHA meeting (White, #907) but using very high dose of PPI (> 200 μM). We here demonstrate that this phenomenon starts at low-intermediate concentration of PPI (that are closer to those achievable in vivo after standard dose administration). These interactions may also modify the toxic profile of the TKI and should be kept in mind in clinical practice. Table I Imatinib induced citotoxicity 47,5% at different concentration PPI (μM): 5 9 50 100 omeprazole 47% 45% 33,8% p value 0,7 0,54 <0,0005 pantoprazole 46,4% 28% 21,5% p value 0,67 0,0005 <0,0005 lansoprazole 45% 35,9% 33,8% p value 0,26 0,005 <0,0005 Dasatinib induced citotoxicity 29% at different concentration PPI (μM): 5 9 50 100 omeprazole 26% 27% 27% p value 0,01 0,11 0,11 pantoprazole 28,9% 27% 20,2% p value 11 0,03 0,005 lansoprazole 27% 24% 22,3% p value 0,17 0,009 0,0017 Nilotinib induced citotoxicity 27% at different concentration PPI (μM): 5 9 50 100 omeprazole 27% 30,5% 40,4% p value 0,8 0,09 <0,0005 pantoprazole 25,5% 30,3% 25,5% p value 0,47 0,001 0,01 lansoprazole 29% 34,2% 37,9% p value 0,49 0,02 <0,0005