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New article/research on PPI and Clostridium difficile infection (CDI). Medscape registration is free. C difficile Infection Linked to Proton Pump Inhibitors
Marginata ( talk) 15:23, 26 July 2013 (UTC)
In last week's JAMA there was some proof that PPIs increase the risk of pneumonia. Shall we put it in? JFW | T@lk 17:44, 10 Nov 2004 (UTC)
Uncontrolled or insufficiently controlled Gastroesophageal Reflux Disease can cause Pulmonary aspiration which may lead to pneumonia. Interesting that the current favoured treatment for GERD is for associated with increased risk of community-aquired pneumonia.
The above template is available; I think it should probably be used on this page? I didn't want to duplicate the information already there, but removing the present list would lose the brand name reference. --
Mithent 20:50, 20 Jun 2005 (UTC)
... is very rare, usually affects the elderly, rarely progresses to dialysis and takes more than 6 months to heal doi: 10.1111/j.1365-2036.2007.03407.x JFW | T@lk 19:00, 1 August 2007 (UTC)
doi: 10.1111/j.1365-2036.2008.03601.x - after reports about metformin causing B12 deficiency and concerns about calcium absorption in PPI treatment it was probably time we looked at B12, deficiency of which can cause haematological and neurological complications. No problems there. Good. JFW | T@lk 21:21, 13 January 2008 (UTC)
doi: 10.1001/jamaneurol.2015.4791 - http://jamanetwork.com/journals/jamaneurology/fullarticle/2487379 From Abstract: "Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline." From Introduction: "There is evidence that PPI use might affect cognition. Lam et al10 report a significant association of previous and current PPI use with vitamin B12 deficiency in a population-based sample. Vitamin B12 deficiency has been shown to be associated with cognitive decline.11 In another study,12 PPIs were observed to enhance β-amyloid (Aβ) levels in the brains of mice by affecting the enzymes β- and γ-secretase."
After talking to a pharmacist, it came to my attention that PPIs could affect the up-take of some drugs (eg. supplements, oral contraceptives, anticonvulsants, etc.). Suppose a patient were to take their PPI at the same time as any other drugs they were taking. It stands to reason that if PPIs change the acid content of the stomach then many other drugs would not be absorbed properly since they rely on the pH of the stomach to be absorbed at the proper rate. However, I can't seem to find a reliable source for these interactions (other than a pharmacist). It seems like something that people should know about PPis. Does anyone know of any sources for this? Jubbacca ( talk) 04:52, 11 March 2009 (UTC)
Here is one link I found where you can check drug interactions between PPIs and other drugs. A lot of reliable interaction checkers are found within specialized commercial pharmacy/medical software, but these aren't free. You could also look at the package insert (easily found online for brand name PPIs) for the specific PPI, and it should list some interactions under the drug interactions section. 72.229.156.157 ( talk) 09:31, 26 February 2010 (UTC)
The topic of drug interactions with PPIs merits its own section in the article. There are many drugs that are best absorbed in an acidic environment (e.g., ketoconazole, itraconazole) and taking PPIs can interfere with their absorption. TylerDurden8823 ( talk) 05:28, 2 March 2013 (UTC)
Given that, as stated with reference, all of these: " headache, nausea, diarrhea, abdominal pain, fatigue, dizziness" are "common" [reference 8] adverse effects, it does not make sense to claim that "in general, proton pump inhibitors are "well tolerated" I suggest some of the more regular maintainers of this page delete the assertion of "generally...well tolerated" Just let the referenced statements listing "common" (as well as the 'uncommon' and 'rare') adverse effects, speak for themselves and let people judge the extent to which it's well tolerated or not.-- Harel ( talk) 04:39, 15 November 2009 (UTC)
Indeed and there is a recent longitudinal observational cohort study of US veterans which suggests that use of PPIs carries an increased risk of death. [1] Richwil ( talk) 12:43, 27 July 2017 (UTC)
References
{{
cite journal}}
: Cite uses deprecated parameter |authors=
(
help)
Is it true that proton pump inhibitors are more efficacious in the Asian population? Should this also be mentioned in the article? 72.229.156.157 ( talk) 03:31, 24 February 2010 (UTC)
In any population there are some people who are "Slow Metabolisers" of PPIs which means that they nretain the PPIs longer in their system which makes it more dose effective ast the same dose rates. Asian populations have a higher proportion of " Slow Metabolisers than Caucasians. ResearchScientist007 — Preceding unsigned comment added by ResearchScientist007 ( talk • contribs) 05:24, 3 December 2012 (UTC)
I don't remember reading anything about increased risk of fractures. The paragraph about that is unsourced. Does anyone have a source? Thanks. 174.99.120.98 ( talk) 00:54, 20 August 2011 (UTC) There are sources there now. The first review is of about 15000 fractures and 150,000 control cases. It seems to have been cited lots of times and resulted in follow-up studies. It is not a review article but it seems worth including to me. Blue Rasberry (talk) 15:18, 14 September 2012 (UTC)
Yes osteoporosis is listed as an adverse risk in the BNF, it should be included. — Preceding unsigned comment added by Mat8989 ( talk • contribs) 08:44, 4 April 2013 (UTC)
Reading the FDA source, it indicates that 3 x 14 day per 365 days max for OTC treatment, doesn't carry that warning for people taking under the advisement of a physician. This should be changed in the article to reflect this. There IS a risk of fracture, but many people are on physician-ordered doses of PPI's for longer terms. 174.95.209.14 ( talk) 00:20, 11 November 2011 (UTC)
I propose merging Discovery and development of proton pump inhibitors here. That article contains a lot of valuable material that is not related to discovery and development, so I think the main article would profit from a merger. -- ἀνυπόδητος ( talk) 18:58, 9 February 2012 (UTC)
Oppose Indeed there is much material on Discovery and development of proton pump inhibitors that should be copied or moved to Proton-pump inhibitor but both the articles should remain. Each has its own significance. Besides, merging both will make Proton-pump inhibitor excessively long. Diptanshu Talk 01:59, 10 November 2013 (UTC)
Did the NHS of Great Britain recommend the use of probiotics? I can find no evidence of this. It seems unlikely given this was announced earlier in the same year. http://www.nutraingredients.com/Regulation/EFSA-slams-door-on-probiotic-health-claims-again-Prunes-pass. Good news about the prunes though. - Dave Crosby ( talk) 08:34, 23 February 2013 (UTC)
IO Device in this dif you added a bunch of content based on this source. PloS classifies that as a "research paper" not a review. As of today it is not even indexed in pubmed yet. I reverted on the basis that is a primary source, per MEDRS. Jytdog ( talk) 03:40, 11 June 2015 (UTC)
The primary PLoSone source [ PMID 26061035] above was used by another new editor again and was reverted. I have updated the cardiovascular risks with reviews, consensus and publicly available secondary sources indicating the complex and confounding problems to any associations. The PLoSone article may be incorporated in future reviews but here is one author's comment on that paper if we want a balanced view. Jrfw51 ( talk) 14:17, 20 August 2015 (UTC)
Here's a nice editorial in JAMA Internal Medicine accompanying the article on PPIs and kidney disease, which also reviews all the other major adverse effects of PPIs. The table summarizes it very well. The usual caveats about association vs. causation apply.
http://archinte.jamanetwork.com/article.aspx?articleid=2481153
Editorial | February 2016
Adverse Effects Associated With Proton Pump Inhibitors
Adam Jacob Schoenfeld, MD1; Deborah Grady, MD, MPH1,2
JAMA Intern Med. 2016;176(2):172-174. doi:10.1001/jamainternmed.2015.7927.
Table. Evidence Supporting the Potential Adverse Effects of Proton Pump Inhibitor Drugs
CONCLUSIONS Available evidence suggests that PPI use is associated with an increased risk of both acute and chronic kidney disease, hypomagnesemia, C difficile infection, and osteoporotic fractures.
-- Nbauman ( talk) 03:05, 17 February 2016 (UTC)
http://circres.ahajournals.org/content/118/12/e36.abstract "Chronic exposure to PPIs impaired endothelial function and accelerated human endothelial senescence by Reducing Telomere length".
ee1518 ( talk) 06:11, 5 July 2016 (UTC)
doi:10.1053/j.gastro.2017.01.031 JFW | T@lk 14:56, 24 March 2017 (UTC)
Don't get fooled by the trio of Jytdog, Alexbrn, and Zefr. They ask for MEDRS, but when you figure it out and provide a proper Pubmed-index secondary source, they come back at you with the likes Talk:Hydroxytyrosol#Role_in_human_health. Together the three support each other and force their agenda through. It's all a big scam, possibly to maintain sales and market share of hazardous pharmaceuticals. -- Acyclic ( talk) 02:59, 16 July 2017 (UTC)
I have updated with two recent MEDRS compliant reviews [1] and [2] discussing the balance of benefits and risks. These are well worth careful reading. Jrfw51 ( talk) 17:19, 16 July 2017 (UTC)
Article says "They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump." While the source cited says the same thing, surely this is an error in the source. Otherwise, it would seem you would take a PPI once and never need it again. Bcostley ( talk) 18:59, 28 October 2021 (UTC)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855237/
Thanks! — Preceding unsigned comment added by Bcostley ( talk • contribs) 00:31, 29 October 2021 (UTC)
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Proton-pump inhibitor.
|
The
contentious topics procedure applies to this page. This page is related to
COVID-19, broadly construed, which has been
designated as a contentious topic. Editors who repeatedly or seriously fail to adhere to the purpose of Wikipedia, any expected standards of behaviour, or any normal editorial process may be blocked or restricted by an administrator. Editors are advised to familiarise themselves with the contentious topics procedures before editing this page. |
Proton-pump inhibitor received a peer review by Wikipedia editors, which is now archived. It may contain ideas you can use to improve this article. |
This article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||||||||||
|
New article/research on PPI and Clostridium difficile infection (CDI). Medscape registration is free. C difficile Infection Linked to Proton Pump Inhibitors
Marginata ( talk) 15:23, 26 July 2013 (UTC)
In last week's JAMA there was some proof that PPIs increase the risk of pneumonia. Shall we put it in? JFW | T@lk 17:44, 10 Nov 2004 (UTC)
Uncontrolled or insufficiently controlled Gastroesophageal Reflux Disease can cause Pulmonary aspiration which may lead to pneumonia. Interesting that the current favoured treatment for GERD is for associated with increased risk of community-aquired pneumonia.
The above template is available; I think it should probably be used on this page? I didn't want to duplicate the information already there, but removing the present list would lose the brand name reference. --
Mithent 20:50, 20 Jun 2005 (UTC)
... is very rare, usually affects the elderly, rarely progresses to dialysis and takes more than 6 months to heal doi: 10.1111/j.1365-2036.2007.03407.x JFW | T@lk 19:00, 1 August 2007 (UTC)
doi: 10.1111/j.1365-2036.2008.03601.x - after reports about metformin causing B12 deficiency and concerns about calcium absorption in PPI treatment it was probably time we looked at B12, deficiency of which can cause haematological and neurological complications. No problems there. Good. JFW | T@lk 21:21, 13 January 2008 (UTC)
doi: 10.1001/jamaneurol.2015.4791 - http://jamanetwork.com/journals/jamaneurology/fullarticle/2487379 From Abstract: "Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline." From Introduction: "There is evidence that PPI use might affect cognition. Lam et al10 report a significant association of previous and current PPI use with vitamin B12 deficiency in a population-based sample. Vitamin B12 deficiency has been shown to be associated with cognitive decline.11 In another study,12 PPIs were observed to enhance β-amyloid (Aβ) levels in the brains of mice by affecting the enzymes β- and γ-secretase."
After talking to a pharmacist, it came to my attention that PPIs could affect the up-take of some drugs (eg. supplements, oral contraceptives, anticonvulsants, etc.). Suppose a patient were to take their PPI at the same time as any other drugs they were taking. It stands to reason that if PPIs change the acid content of the stomach then many other drugs would not be absorbed properly since they rely on the pH of the stomach to be absorbed at the proper rate. However, I can't seem to find a reliable source for these interactions (other than a pharmacist). It seems like something that people should know about PPis. Does anyone know of any sources for this? Jubbacca ( talk) 04:52, 11 March 2009 (UTC)
Here is one link I found where you can check drug interactions between PPIs and other drugs. A lot of reliable interaction checkers are found within specialized commercial pharmacy/medical software, but these aren't free. You could also look at the package insert (easily found online for brand name PPIs) for the specific PPI, and it should list some interactions under the drug interactions section. 72.229.156.157 ( talk) 09:31, 26 February 2010 (UTC)
The topic of drug interactions with PPIs merits its own section in the article. There are many drugs that are best absorbed in an acidic environment (e.g., ketoconazole, itraconazole) and taking PPIs can interfere with their absorption. TylerDurden8823 ( talk) 05:28, 2 March 2013 (UTC)
Given that, as stated with reference, all of these: " headache, nausea, diarrhea, abdominal pain, fatigue, dizziness" are "common" [reference 8] adverse effects, it does not make sense to claim that "in general, proton pump inhibitors are "well tolerated" I suggest some of the more regular maintainers of this page delete the assertion of "generally...well tolerated" Just let the referenced statements listing "common" (as well as the 'uncommon' and 'rare') adverse effects, speak for themselves and let people judge the extent to which it's well tolerated or not.-- Harel ( talk) 04:39, 15 November 2009 (UTC)
Indeed and there is a recent longitudinal observational cohort study of US veterans which suggests that use of PPIs carries an increased risk of death. [1] Richwil ( talk) 12:43, 27 July 2017 (UTC)
References
{{
cite journal}}
: Cite uses deprecated parameter |authors=
(
help)
Is it true that proton pump inhibitors are more efficacious in the Asian population? Should this also be mentioned in the article? 72.229.156.157 ( talk) 03:31, 24 February 2010 (UTC)
In any population there are some people who are "Slow Metabolisers" of PPIs which means that they nretain the PPIs longer in their system which makes it more dose effective ast the same dose rates. Asian populations have a higher proportion of " Slow Metabolisers than Caucasians. ResearchScientist007 — Preceding unsigned comment added by ResearchScientist007 ( talk • contribs) 05:24, 3 December 2012 (UTC)
I don't remember reading anything about increased risk of fractures. The paragraph about that is unsourced. Does anyone have a source? Thanks. 174.99.120.98 ( talk) 00:54, 20 August 2011 (UTC) There are sources there now. The first review is of about 15000 fractures and 150,000 control cases. It seems to have been cited lots of times and resulted in follow-up studies. It is not a review article but it seems worth including to me. Blue Rasberry (talk) 15:18, 14 September 2012 (UTC)
Yes osteoporosis is listed as an adverse risk in the BNF, it should be included. — Preceding unsigned comment added by Mat8989 ( talk • contribs) 08:44, 4 April 2013 (UTC)
Reading the FDA source, it indicates that 3 x 14 day per 365 days max for OTC treatment, doesn't carry that warning for people taking under the advisement of a physician. This should be changed in the article to reflect this. There IS a risk of fracture, but many people are on physician-ordered doses of PPI's for longer terms. 174.95.209.14 ( talk) 00:20, 11 November 2011 (UTC)
I propose merging Discovery and development of proton pump inhibitors here. That article contains a lot of valuable material that is not related to discovery and development, so I think the main article would profit from a merger. -- ἀνυπόδητος ( talk) 18:58, 9 February 2012 (UTC)
Oppose Indeed there is much material on Discovery and development of proton pump inhibitors that should be copied or moved to Proton-pump inhibitor but both the articles should remain. Each has its own significance. Besides, merging both will make Proton-pump inhibitor excessively long. Diptanshu Talk 01:59, 10 November 2013 (UTC)
Did the NHS of Great Britain recommend the use of probiotics? I can find no evidence of this. It seems unlikely given this was announced earlier in the same year. http://www.nutraingredients.com/Regulation/EFSA-slams-door-on-probiotic-health-claims-again-Prunes-pass. Good news about the prunes though. - Dave Crosby ( talk) 08:34, 23 February 2013 (UTC)
IO Device in this dif you added a bunch of content based on this source. PloS classifies that as a "research paper" not a review. As of today it is not even indexed in pubmed yet. I reverted on the basis that is a primary source, per MEDRS. Jytdog ( talk) 03:40, 11 June 2015 (UTC)
The primary PLoSone source [ PMID 26061035] above was used by another new editor again and was reverted. I have updated the cardiovascular risks with reviews, consensus and publicly available secondary sources indicating the complex and confounding problems to any associations. The PLoSone article may be incorporated in future reviews but here is one author's comment on that paper if we want a balanced view. Jrfw51 ( talk) 14:17, 20 August 2015 (UTC)
Here's a nice editorial in JAMA Internal Medicine accompanying the article on PPIs and kidney disease, which also reviews all the other major adverse effects of PPIs. The table summarizes it very well. The usual caveats about association vs. causation apply.
http://archinte.jamanetwork.com/article.aspx?articleid=2481153
Editorial | February 2016
Adverse Effects Associated With Proton Pump Inhibitors
Adam Jacob Schoenfeld, MD1; Deborah Grady, MD, MPH1,2
JAMA Intern Med. 2016;176(2):172-174. doi:10.1001/jamainternmed.2015.7927.
Table. Evidence Supporting the Potential Adverse Effects of Proton Pump Inhibitor Drugs
CONCLUSIONS Available evidence suggests that PPI use is associated with an increased risk of both acute and chronic kidney disease, hypomagnesemia, C difficile infection, and osteoporotic fractures.
-- Nbauman ( talk) 03:05, 17 February 2016 (UTC)
http://circres.ahajournals.org/content/118/12/e36.abstract "Chronic exposure to PPIs impaired endothelial function and accelerated human endothelial senescence by Reducing Telomere length".
ee1518 ( talk) 06:11, 5 July 2016 (UTC)
doi:10.1053/j.gastro.2017.01.031 JFW | T@lk 14:56, 24 March 2017 (UTC)
Don't get fooled by the trio of Jytdog, Alexbrn, and Zefr. They ask for MEDRS, but when you figure it out and provide a proper Pubmed-index secondary source, they come back at you with the likes Talk:Hydroxytyrosol#Role_in_human_health. Together the three support each other and force their agenda through. It's all a big scam, possibly to maintain sales and market share of hazardous pharmaceuticals. -- Acyclic ( talk) 02:59, 16 July 2017 (UTC)
I have updated with two recent MEDRS compliant reviews [1] and [2] discussing the balance of benefits and risks. These are well worth careful reading. Jrfw51 ( talk) 17:19, 16 July 2017 (UTC)
Article says "They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump." While the source cited says the same thing, surely this is an error in the source. Otherwise, it would seem you would take a PPI once and never need it again. Bcostley ( talk) 18:59, 28 October 2021 (UTC)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855237/
Thanks! — Preceding unsigned comment added by Bcostley ( talk • contribs) 00:31, 29 October 2021 (UTC)