Proton pump inhibitors from clinical pharmacist’s point of view

Czech version

Authors: PharmDr. Alena Pilková
Published in: Čas. Lék. čes. 2019; 158: 282-288
Category: Review Article

Overview

Proton pump inhibitors (PPIs) are very effective drugs in treatment and prevention of acid-related disorders. They are widely used in gastroesophageal reflux disease, gastroduodenal ulcers, Zollinger-Ellison syndrome or prevention and treatment of NSAIDs induced gastric lesions. They are also used in many other indications, although not always is their use appropriate.

PPIs are generally well tolerated and overall benefits outweigh potential harm in most of the patients. However, their long-term use is not without a risk of adverse effects and drug-drug interactions and contributes to medical expenses and polypharmacy.

As PPIs belong to most prescribed drugs, we should carefully consider the length of therapy and appropriateness of their use and regularly reevaluate the need for chronic therapy.

Keywords:

Safety – gastric toxicity – proton pump inhibitors – efficacy

Sources

Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver 2017; 11(1): 27–37.
Cash BD. The science of acid control – therapeutic implications. Medscape, 2009 May 14. Dostupné na: www.medscape.org/viewarticle/702505_4
Shi S, Klotz U. Proton pump inhibitors: an update of their clinical use and pharmacokinetics. Eur J Clin Pharmacol 2008; 64(10): 935–951.
Kirchheiner J, Glatt S, Fuhr U et al. Relative potency of proton-pump inhibitors-comparison of effects on intragastric pH. Eur J Clin Pharmacol 2009; 65(1): 19–31.
Hunt, RH, Scarpignato C. Potent acid suppression with PPIs and P-CABs: what’s new? Curr Treat Options Gastroenterol 2018; 16(4): 570–590.
Databáze léků. Státní ústav pro kontrolu léčiv, Praha. Dostupné na: www.sukl.cz/modules/medication/search.php
Petrželová M, Horák P, Hordějčuková A a kol. Omeprazolová suspenze 2 mg/ml – nová léková forma pro pediatrii. Praktické lékárenství 2017; 13(1): 18–20.
Gralnek IM, Dumonceau JM, Kuipers EJ et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47(10): a1–a46.
Konečný M, Procházka V. Racionální diagnostický a terapeutický postup u akutního krvácení do horní části trávicího traktu. Interní medicína 2009; 11(10): 446–448.
Saltzman JR. Approach to acute upper gastrointestinal bleeding in adults. UpToDate, 2019 Nov 26. Dostupné na: www.uptodate.com/contents/approach-to-acute-upper-gastrointestinal-bleeding-in-adults
Saltzman JR. Overview of the treatment of bleeding peptic ulcers. UpToDate, 2019 Nov 20. Dostupné na: www.uptodate.com/contents/overview-of-the-treatment-of-bleeding-peptic-ulcers
Weinhouse GL. Stress ulcers in the intensive care unit: Diagnosis, management, and prevention. UpToDate, 2019 Oct 20. Dostupné na: www.uptodate.com/contents/stress-ulcer-prophylaxis-in-the-intensive-care-unit
Scarpignato C, Gatta L, Zullo A et al. Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harmas of acid suppression. BMC Med 2016; 14(1): 179.
Bhatt DL, Scheiman J, Abraham NS et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2008; 52(18): 1502–1517.
Valgimigli M, Bueno H, Byrne RA et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developer in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39(3): 213–260.
Kirchhof P, Benussi S, Kotecha D et al. 2016 ESC Guidelines for the management of atrial fibrillation developer in collaboration with EACTS. Eur Heart J 2016; 37(38): 2893–2962.
Steffel J, Verhamme P, Potpara TS et al. The 2018 European Heart Rhythm Association Practical Guide in the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J 2018; 39(16): 1330–1393.
Narum S, Westergren T, Klemp M. Corticosteroids and risk of gastrointestinal bleeding: a systematic review and meta-analysis. BMJ Open 2014; 4(5): e004587.
Masclee GM, Valkhoff VE, Coloma PM et al. Risk of upper gastrointestinal bleeding from different drug combinations. Gastroenterology 2014; 147(4): 784–792.
Fejfar T, Vaňásek T, Brůha R a kol. Léčba krvácení v důsledku portální hypertenze při jaterní cirhóze – aktualizace doporučených postupů ČHS ČLS JEP. Gastroenterologie a hepatologie 2017; 71(2): 105–116.
Garcia-Tsao G, Sanyal AJ, Grace ND et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology 2007; 46(3): 922–938.
Numico G, Fusco V, Franco P et al. Proton pump inhibitors in cancer patients: how useful they are? A review of most common indications for their use. Crit Rev Oncol Hematol 2017; 111: 144–151.
Vyzula R a kol. Modrá kniha České onkologické společnosti. Masarykův onkologický ústav, Brno, 2019.
IBM Corporation. Micromedex: Drug Interactions. Platné znění databáze k září 2019.
van Leeuwen RWF, Jansman FGA, HUnfeld NG et al. Tyrosine kinase inhibitors and proton pump inhibitors: an evaluation of treatment options. Clin Pharmacokinet 2017; 56(7): 683–688.
Gan TJ, Diemunsch P, Habib AS et al. Consensus guidelines for the management of postoperative nauzea and vomiting. Anesth Analg 2014; 118(1): 85–113.
Raeder J, Dahl V, Bjoernestad E et al. Does esomeprazole prevent post-operative nausea and vomiting? Acta Anaesthesiol Scand 2007; 51(2): 217–25.
XU HB, Wang HD, Li CH et al. Proton pump inhibitor use and risk of spontaneous bacterial peritonitis in cirrhotic patients: a systematic review and meta-analysis. Genet Mol Res 2015; 14(3): 7490–7501.
Tsai CF, Chen MH, Wang YP et al. Proton pump inhibitors increase risk for hepatic encephalopathy in patients with cirrhosis in a population study. Gastroenterology 2017; 152(1): 134–141.
Joint Formulary Committee. BNF 76: September 2018 – March 2019. Pharmaceutical Press, London, 2018.
Domínguez-Muñoz JE, Iglesias-García J, Iglesias-Rey M et al. Optimising the therapy of exocrine pancreatic insufficiency by the association of a proton pump inhibitor to enteric coated pancreatic extracts. Gut 2006; 55(7): 1056–1057.
Nehra AK, Alexander JA, Loftus CG et al. Proton pump inhibitors: review of emerging concerns. Mayo Clin Proc 2018; 93(2): 240–246.
Pabla D, Akhlaghi F, Zia H. A comparative pH-dissolution profile study of selected commercial levothyroxine products using inductively coupled plasma mass spektrometry. Eur J Pharm Biopharm 2009; 72(1): 105–110.
Costa-Rodrigues J, Reis S, Teixeira S et al. Dose-dependent inhibitory effects of proton pump inhibitors on human ostaoclastic and osteoblastic cell activity. FEBS J 2013; 280(20): 5052–5064.
Schepisi R, Fusco S, Sganga F et al. Inappropriate use of proton pump inhibitors in elderly patients discharged from acute care hospitals. J Nutr Health Aging 2016; 20(6): 665–670.
Vachek J, Tesař V, Zakiyanov O et al. Farmakoterapie v těhotenství a při kojení. Maxdorf, Praha, 2016.
Haastrup P, Paulsen MS, Begtrup LM et al. Strategies for discontinuation of proton pump inhibitors: a systematic review. Fam Pract 2014; 31(6): 625–630.
Tesař V. Biologická a cílená léčba. Mladá fronta, Praha, 2018.
Tran-Duy A, Connell NJ, Vanmolkot FH et al. Use of proton pump inhibitors and risk of iron deficiency: a population-based case-control study. J Intern Med 2019; 285(2): 205–214.

Labels

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management

Clinical pharmacy in the Czech Republic

Is safe pharmacotherapy worthwhile?

Specialization in clinical pharmacy

Paediatric clinical pharmacist: a potential benefit?

Drug administration via feeding tubes: examples, working group

Clinically significant drug interactions of antiretrovirals

Intrapleural alteplase therapy: what are the knowns and unknowns?

Management of metabolic adverse effects of everolimus in patients with renal carcinoma

Medication treatment of singultus in palliative care

Combination of mirtazapine and paroxetine: possible clinically demonstrated interaction?

Complication during hospitalization of geronto-psychiatric patient for fatal Stevens-Johnson syndrome – a multidisciplinary approach

Sleep and its disturbances in neurology