1.The appropriate use of Proton Pump inhibitors in adult patients admitted in the Intensive Care Unit of a tertiary hospital
Jacklyn M. So-Cabahug ; Leticia Ibañ ; ez-Guzman
Philippine Journal of Internal Medicine 2019;57(1):6-11
Introduction:
Proton pump inhibitors (PPI) have been used as stress ulcer prophylaxis (SUP) in intensive care unit (ICU) patients due to their high risk for stress-related upper gastrointestinal (GI) bleeding. With its dramatic increase in prescription, studies have noted its misuse and associated complications. This study aimed to determine the appropriateness of the use of PPIs in adult patients in the ICU of Medical Center Manila (ManilaMed).
Methods:
This eight-month study conducted a retrospective chart review, and analyzed through descriptive statistics using Stata 13. Out of 292 patients, 188 satisfied the inclusion and exclusion criteria. The indication of use of PPI was based on the American Society of Health-System Pharmacists (ASHP) Therapeutic Guidelines on SUP.
Results:
The patients were mostly male, median age of 62 years, stay in the ICU of five days, overall hospital stay of 13 days, and 75% were admitted from the emergency room. About 58% of PPIs were prescribed in the intravenous route for an average of 10 days, 38% of which is prescribed by cardiology consultants. Of the 73% of patients prescribed PPIs, most were septic and intubated for >48 hours, as well as being older and with longer overall hospital stay. Only 53.7% were prescribed appropriately; adverse outcomes included pneumonia, GI bleeding, anemia, renal failure, combined complications and overall mortality.
Discussion:
The 46% inappropriate use of PPIs may indicate its routine use was common. The adverse outcomes, despite appropriate use, cannot be concluded as having causative effect owing to the nature of the study and given the possibility that these patients may have been sicker on admission hence prescribed the PPI.
Conclusion
Results indicated that PPI prescription in the ICU were mostly guidelines compliant. This paper recommends the development of ManilaMed’s own strategies to minimize its inappropriate use, in turn allowing proper allocation of funds and maximizing medical treatment.
Proton Pump Inhibitors
2.The Perilous PPI: Proton Pump Inhibitor as a Cause of Clinically Significant Hypomagnesaemia
Yong Ting Tai ; Chin Vong Tong
Journal of the ASEAN Federation of Endocrine Societies 2020;35(1):109-113
Proton pump inhibitors (PPIs) are the mainstay of therapy for all gastric acid related diseases and are commonly used in current clinical practice. Although widely regarded as safe, PPIs have been associated with a variety of adverse effects, including hypomagnesaemia. The postulated mechanism of PPI-related hypomagnesaemia involves inhibition of intestinal magnesium absorption via transient receptor potential melastin (TRPM) 6 and 7 cation channels. PPI-induced hypomagnesaemia (PPIH) has become a well recognized phenomenon since it was first reported in 2006. Clinical concerns arise from growing number of case reports presenting PPIH as a consequence of long-term PPI use, with more than 30 cases published to date. In this article, we report 2 cases of PPIH associated with the use of pantoprazole. Both patients presented with severe hypomagnesaemia and hypocalcaemia. One of them had associated hypokalemia and cardiac arrhythmia. A casual relation with PPIs postulated and supported by resolution of electrolyte abnormalities after discontinuation of PPIs.
Proton Pump Inhibitors
;
Hypokalemia
3.Proton Pump Inhibitors Reduce the Size and Acidity of the Gastric Acid Pocket.
Journal of Neurogastroenterology and Motility 2015;21(1):133-134
No abstract available.
Gastric Acid*
;
Proton Pump Inhibitors*
4.Is hypomagnesemia associated with using proton pump inhibitors?.
Kidney Research and Clinical Practice 2016;35(2):128-129
No abstract available.
Proton Pump Inhibitors*
;
Proton Pumps*
;
Protons*
5.Can Proton Pump Inhibitors Increase Incidence of Nonsteroidal Anti-inflammatory Druginduced Small Bowel Injury?.
The Korean Journal of Gastroenterology 2016;68(2):123-125
No abstract available.
Incidence*
;
Proton Pump Inhibitors*
;
Proton Pumps*
;
Protons*
6.Can Nocturnal Acid-breakthrough Be Reduced by Long-acting Proton Pump Inhibitors?.
Journal of Neurogastroenterology and Motility 2017;23(2):145-148
No abstract available.
Proton Pump Inhibitors*
;
Proton Pumps*
;
Protons*
7.The Effect of Proton Pump Inhibitors on Nutrition, Metabolism, Infection and Small Intestinal Bacterial Overgrowth: Safe Perspective.
Korean Journal of Medicine 2011;81(1):11-16
Proton pump inhibitors (PPIs) have been widely used to treat patients with acid-related disorders because they are perceived to be safe and effective. However, they have the potential for side effects. Many studies have examined the side effects of long-term PPI exposure. We review the side effects of long-term PPIs, focusing on nutrition, metabolism, and infection.
Humans
;
Proton Pump Inhibitors
;
Proton Pumps
;
Protons
8.Proton Pump Inhibitor-Responsive Esophageal Eosinophilia: Controversies and Its Clinical Implications.
Gut and Liver 2016;10(1):1-2
No abstract available.
*Eosinophilia
;
Eosinophilic Esophagitis
;
Humans
;
*Proton Pump Inhibitors
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