Overuse of proton pump inhibitors and its consequences

Abstract

Direct inhibition of H+ ion excretion to the gastric lumen makes proton pump inhibitors (PPI) the most effective drugs against gastric acid-related diseases. Over recent years usage of proton pump inhibitors has increased dramatically. Due to the low costs, high efficacy and rarity of adverse effects, their use is prevalent and often it does not correspond with existing medical guidelines. The literature lists stress ulcer prophylaxis among patients with low risk of bleeding, routine 'gastroprotective' medication during treatment and non-specific abdominal symptoms as the most common patterns of off-label PPI use. This article summarizes the influence of PPI therapy on gastric mucosa, absorption and occurrence of adverse effects. The authors note that their low awareness among physicians contributes to wide and imprudent use of drugs of this group.

The Utilization Evaluation of Intravenous Pantoprazole for Stress Ulcer Prophylaxis in a Major Teaching Hospital

“…The decision to choose an appropriate dosage form rest on several aspects, like the patient's ability to receive oral medicine, the patient's hemodynamic status in addition to intestinal penetrability, and absorptive volume (6). Currently, there has been a trend concerning overutilization of SUP in hospitalized patients because evidence-based implemented guidelines on who should take SUP in patients are not followed consistently (1,7,8). Inappropriate use of medicine was previously documented in this center while evaluating albumin usage's appropriateness (9).…”

“…Implementing a rational prescribing guideline led to an increase in the inappropriateness of prescriptions and cost reduction. Inappropriate and unsupervised administration of IV pantoprazole can lead to increased therapeutic cost (wastage), adverse effects associated with injection, and also increasing the occurrence of community-acquired pneumonia (10), spontaneous bacterial peritonitis (11), vitamins and minerals malabsorption (12), bone fractures (13), and clostridium difficile infection (6,8,14). Pharmacists encourage appropriate SUP by preparing and applying therapeutic guidelines and educational courses built upon the best accessible evidence.…”

Uso de inibidores de bomba de prótons entre estudantes de medicina, de uma Instituição de Ensino Superior (IES), da zona da mata mineira e as consequências à curto e longo prazo

“…Segundo Kazberuk et al (2016) na prática, alguns dos usos irracionais mais comuns de medicamentos são prescrições excessivas de antibióticos, inibidores da bomba de prótons (IBP) e glicocorticoides. Desse modo, uma classe medicamentosa que se tornou muito utilizada pela população e merece destaque é a dos Inibidores de Bomba de Prótons (IBPs).…”

Prescribing pattern of proton pump inhibitors among patients admitted to medical ward at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

“…6 Many drug utilization studies have reported the widespread inappropriate use of PPIs,which could lead to serious and poor health outcomes. [7][8][9][10] Therefore, research is needed to investigate the use of PPIs in clinical settings.…”

“…The prescription pattern of PPIs has been investigated worldwide, including the Middle East. [7][8][9][10][11][12] Despite the introduction of a standard guideline for prescribing PPIs, findings from the previous studies indicated patients' need for appropriate prescription and use of PPIs. In Saudi Arabia, data related to PPI prescription are limited to those reported in the literature.…”