Proton pump inhibitor: Difference between revisions

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==Adverse effects==
==Adverse effects==
Proton pump inhibitors may be associated with [[spontaneous bacterial peritonitis]].<ref name="pmid19337238">{{cite journal |author=Bajaj JS, Zadvornova Y, Heuman DM, ''et al.'' |title=Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites |journal=Am. J. Gastroenterol. |volume=104 |issue=5 |pages=1130–4 |year=2009 |month=May |pmid=19337238 |doi=10.1038/ajg.2009.80 |url=http://dx.doi.org/10.1038/ajg.2009.80 |issn=}}</ref> These drugs may also be associated with hospital-acquired [[pneumonia]]<ref name="pmid19470989">Herzig SJ, Howell MD, Ngo LH, Marcantonio ER. Acid-suppressive medication use and the risk for hospital-acquired pneumonia. JAMA. 2009 May 27;301(20):2120-8. PMID 19470989</ref>, ''[[Clostridium difficile]]'' diarrhea, and [[fracture]]s.
Proton pump inhibitors may be associated with [[spontaneous bacterial peritonitis]].<ref name="pmid19337238">{{cite journal |author=Bajaj JS, Zadvornova Y, Heuman DM, ''et al.'' |title=Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites |journal=Am. J. Gastroenterol. |volume=104 |issue=5 |pages=1130–4 |year=2009 |month=May |pmid=19337238 |doi=10.1038/ajg.2009.80 |url=http://dx.doi.org/10.1038/ajg.2009.80 |issn=}}</ref> Recent starting of these drugs may also be associated with [[pneumonia]] acquired in the community<ref name="pmid18794558">Sarkar M, Hennessy S, Yang YX. Proton-pump inhibitor use and the risk for community-acquired pneumonia. Ann Intern Med. 2008 Sep 16;149(6):391-8. PMID 18794558</ref> or hospital<ref name="pmid19470989">Herzig SJ, Howell MD, Ngo LH, Marcantonio ER. Acid-suppressive medication use and the risk for hospital-acquired pneumonia. JAMA. 2009 May 27;301(20):2120-8. PMID 19470989</ref>. These drugs may be associated with ''[[Clostridium difficile]]'' diarrhea, and [[fracture]]s.


==Drug interactions==
Proton pump inhibitors, which are metabolized by the CYP2C19 isoenzyme of [[cytochrome P-450]], may<ref name="pmid19258584">{{cite journal |author=Ho PM, Maddox TM, Wang L, ''et al.'' |title=Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome |journal=JAMA |volume=301 |issue=9 |pages=937–44 |year=2009 |month=March |pmid=19258584 |doi=10.1001/jama.2009.261 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=19258584 |issn=}}</ref> (especially inhibitors other than [[pantoprazole]]<ref name="pmid19176635">Juurlink DN, Gomes T, Ko DT, Szmitko PE, Austin PC, Tu JV, Henry DA, Kopp A, Mamdani MM. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ. 2009 Mar 31;180(7):713-8. Epub 2009 Jan 28. PMID 19176635</ref>) or may not<ref name="pmid19106083">{{cite journal |author=Simon T, Verstuyft C, Mary-Krause M, ''et al.'' |title=Genetic determinants of response to clopidogrel and cardiovascular events |journal=N. Engl. J. Med. |volume=360 |issue=4 |pages=363–75 |year=2009 |month=January |pmid=19106083 |doi=10.1056/NEJMoa0808227 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=19106083&promo=ONFLNS19 |issn=}}</ref> increase adverse cardiac events when given to patients taking [[clopidogrel]] for [[coronary heart disease]].
Proton pump inhibitors, which are metabolized by the CYP2C19 isoenzyme of [[cytochrome P-450]], may<ref name="pmid19258584">{{cite journal |author=Ho PM, Maddox TM, Wang L, ''et al.'' |title=Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome |journal=JAMA |volume=301 |issue=9 |pages=937–44 |year=2009 |month=March |pmid=19258584 |doi=10.1001/jama.2009.261 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=19258584 |issn=}}</ref> (especially inhibitors other than [[pantoprazole]]<ref name="pmid19176635">Juurlink DN, Gomes T, Ko DT, Szmitko PE, Austin PC, Tu JV, Henry DA, Kopp A, Mamdani MM. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ. 2009 Mar 31;180(7):713-8. Epub 2009 Jan 28. PMID 19176635</ref>) or may not<ref name="pmid19106083">{{cite journal |author=Simon T, Verstuyft C, Mary-Krause M, ''et al.'' |title=Genetic determinants of response to clopidogrel and cardiovascular events |journal=N. Engl. J. Med. |volume=360 |issue=4 |pages=363–75 |year=2009 |month=January |pmid=19106083 |doi=10.1056/NEJMoa0808227 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=19106083&promo=ONFLNS19 |issn=}}</ref> increase adverse cardiac events when given to patients taking [[clopidogrel]] for [[coronary heart disease]].


==References==
==References==
<references/>
<references/>

Revision as of 07:01, 26 August 2009

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In medicine, proton pump inhibitors (PPI) are medications that "inhibit H(+)-K(+)-exchanging atpase. They are used as anti-ulcer agents and sometimes in place of histamine H2 antagonists for gastroesophageal reflux."[1] They are also used as part of curative [therapy] for Helicobacter pylori, in combination with antibiotics.

Metabolism

Proton pump inhibitors are metabolized by the CYP2C19 isoenzyme of cytochrome P-450. This may be less true for pantoprazole and esomeprazole.[2]

Adverse effects

Proton pump inhibitors may be associated with spontaneous bacterial peritonitis.[3] Recent starting of these drugs may also be associated with pneumonia acquired in the community[4] or hospital[5]. These drugs may be associated with Clostridium difficile diarrhea, and fractures.

Drug interactions

Proton pump inhibitors, which are metabolized by the CYP2C19 isoenzyme of cytochrome P-450, may[6] (especially inhibitors other than pantoprazole[7]) or may not[8] increase adverse cardiac events when given to patients taking clopidogrel for coronary heart disease.

References

  1. Anonymous (2024), Proton pump inhibitor (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Siller-Matula JM, Spiel AO, Lang IM, Kreiner G, Christ G, Jilma B (January 2009). "Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel". Am. Heart J. 157 (1): 148.e1–5. DOI:10.1016/j.ahj.2008.09.017. PMID 19081411. Research Blogging.
  3. Bajaj JS, Zadvornova Y, Heuman DM, et al. (May 2009). "Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites". Am. J. Gastroenterol. 104 (5): 1130–4. DOI:10.1038/ajg.2009.80. PMID 19337238. Research Blogging.
  4. Sarkar M, Hennessy S, Yang YX. Proton-pump inhibitor use and the risk for community-acquired pneumonia. Ann Intern Med. 2008 Sep 16;149(6):391-8. PMID 18794558
  5. Herzig SJ, Howell MD, Ngo LH, Marcantonio ER. Acid-suppressive medication use and the risk for hospital-acquired pneumonia. JAMA. 2009 May 27;301(20):2120-8. PMID 19470989
  6. Ho PM, Maddox TM, Wang L, et al. (March 2009). "Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome". JAMA 301 (9): 937–44. DOI:10.1001/jama.2009.261. PMID 19258584. Research Blogging.
  7. Juurlink DN, Gomes T, Ko DT, Szmitko PE, Austin PC, Tu JV, Henry DA, Kopp A, Mamdani MM. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ. 2009 Mar 31;180(7):713-8. Epub 2009 Jan 28. PMID 19176635
  8. Simon T, Verstuyft C, Mary-Krause M, et al. (January 2009). "Genetic determinants of response to clopidogrel and cardiovascular events". N. Engl. J. Med. 360 (4): 363–75. DOI:10.1056/NEJMoa0808227. PMID 19106083. Research Blogging.