Proton pump inhibitor: Difference between revisions

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Proton pump inhibitors are metabolized by the CYP2C19 isoenzyme of [[cytochrome P-450]]. This may be less true for [[pantoprazole]] and [[esomeprazole]].<ref name="pmid19081411">{{cite journal |author=Siller-Matula JM, Spiel AO, Lang IM, Kreiner G, Christ G, Jilma B |title=Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel |journal=Am. Heart J. |volume=157 |issue=1 |pages=148.e1–5 |year=2009 |month=January |pmid=19081411 |doi=10.1016/j.ahj.2008.09.017 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-8703(08)00822-3 |issn=}}</ref>
Proton pump inhibitors are metabolized by the CYP2C19 isoenzyme of [[cytochrome P-450]]. This may be less true for [[pantoprazole]] and [[esomeprazole]].<ref name="pmid19081411">{{cite journal |author=Siller-Matula JM, Spiel AO, Lang IM, Kreiner G, Christ G, Jilma B |title=Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel |journal=Am. Heart J. |volume=157 |issue=1 |pages=148.e1–5 |year=2009 |month=January |pmid=19081411 |doi=10.1016/j.ahj.2008.09.017 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-8703(08)00822-3 |issn=}}</ref>


Starting proton pump inhibitors in  healthy volunteers may induce acid-related symptoms PPIs are stopped<ref name="pmid19362552">{{cite journal| author=Reimer C, Søndergaard B, Hilsted L, Bytzer P| title=Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. | journal=Gastroenterology | year= 2009 | volume= 137 | issue= 1 | pages= 80-7, 87.e1 | pmid=19362552
 
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19362552 | doi=10.1053/j.gastro.2009.03.058 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>


==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> 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.
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.
Starting proton pump inhibitors in  healthy volunteers may induce acid-related symptoms PPIs are stopped<ref name="pmid19362552">{{cite journal| author=Reimer C, Søndergaard B, Hilsted L, Bytzer P| title=Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. | journal=Gastroenterology | year= 2009 | volume= 137 | issue= 1 | pages= 80-7, 87.e1 | pmid=19362552
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19362552 | doi=10.1053/j.gastro.2009.03.058 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> This is problematic considering how often PPIs are incorrectly prescribed.<ref name="pmid17848420">{{cite journal| author=Wohlt PD, Hansen LA, Fish JT| title=Inappropriate continuation of stress ulcer prophylactic therapy after discharge. | journal=Ann Pharmacother | year= 2007 | volume= 41 | issue= 10 | pages= 1611-6 | pmid=17848420
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17848420 | doi=10.1345/aph.1K227 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>


==Drug interactions==
==Drug interactions==

Revision as of 20:08, 5 October 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.

Starting proton pump inhibitors in healthy volunteers may induce acid-related symptoms PPIs are stopped[6] This is problematic considering how often PPIs are incorrectly prescribed.[7]

Drug interactions

Proton pump inhibitors, which are metabolized by the CYP2C19 isoenzyme of cytochrome P-450, may[8] (especially inhibitors other than pantoprazole[9]) or may not[10] 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. ↑ Reimer C, Søndergaard B, Hilsted L, Bytzer P (2009). "Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy.". Gastroenterology 137 (1): 80-7, 87.e1. DOI:10.1053/j.gastro.2009.03.058. PMID 19362552. Research Blogging.
  7. ↑ Wohlt PD, Hansen LA, Fish JT (2007). "Inappropriate continuation of stress ulcer prophylactic therapy after discharge.". Ann Pharmacother 41 (10): 1611-6. DOI:10.1345/aph.1K227. PMID 17848420. Research Blogging.
  8. ↑ 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.
  9. ↑ 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
  10. ↑ 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.
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