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Proton Pump Inhibitors Increase Risk

Nicole A Huijgen, Maria A J de Ridder, Katia M Verhamme, Gert R Dohle, Ann M Vanrolleghem, Miriam C J M Sturkenboom, Joop S E Laven, Régine P M Steegers-Theunissen
OBJECTIVE: To determine associations between proton-pump inhibitor (PPI) use and semen parameters in young men of couples who are planning pregnancy. DESIGN: Case-control study of a population-based registry. SETTING: Not applicable. PATIENT(S): General practitioner patients comprising 2,473 men from couples planning pregnancy with a recorded semen analysis: 241 with a low total motile sperm count (TMSC ≤1) and 714 with TMSC >1 as matched controls...
October 12, 2016: Fertility and Sterility
Tal Lorberbaum, Kevin J Sampson, Jeremy B Chang, Vivek Iyer, Raymond L Woosley, Robert S Kass, Nicholas P Tatonetti
BACKGROUND: QT interval-prolonging drug-drug interactions (QT-DDIs) may increase the risk of life-threatening arrhythmia. Despite guidelines for testing from regulatory agencies, these interactions are usually discovered after drugs are marketed and may go undiscovered for years. OBJECTIVES: Using a combination of adverse event reports, electronic health records (EHR), and laboratory experiments, the goal of this study was to develop a data-driven pipeline for discovering QT-DDIs...
October 18, 2016: Journal of the American College of Cardiology
Timothy Nguyen, Roza Gavrilova, Marina Blazhko
Older adults frequently have multiple medical conditions and consequently receive multiple medications. Cardiovascular (CV) and gastrointestinal disorders are two conditions in seniors that often require both long-term antiplatelet therapy and medications for GI prophylaxis. Clopidogrel and pantoprazole are commonly used for these conditions; however, there are potential adverse consequences secondary to drug interactions. Both of these drugs are metabolized via the cytochrome P450 system, and there is a potential for drug interactions that may result in decreased effectiveness of clopidogrel and an increased risk of adverse CV outcomes...
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Yingxi Chen, Kathryn Glass, Bette Liu, Kirsty Hope, Martyn Kirk
BACKGROUND: Salmonella infection is one of the most common foodborne bacterial pathogens, and causes a significant health burden globally. We investigated the incidence and risk factors for notification and hospitalization due to Salmonella infection in older adults. MATERIALS AND METHODS: We used the 45 and Up Study, a large-scale Australian prospective study of adults aged ≥45 years, with record linkage to multiple databases for the years 2006-2012 to estimate the incidence of notification and hospitalization for Salmonella infection and estimate hazard ratios using Cox regression...
October 6, 2016: Foodborne Pathogens and Disease
Jill J Hall, Monika Bolina, Trish Chatterley, Fakhreddin Jamali
OBJECTIVE: To review the potential drug interactions between low-dose methotrexate (LD-MTX) and nonsteroidal anti-inflammatory drugs (NSAIDs), penicillins, and proton-pump inhibitors (PPIs) given the disparity between interactions reported for high-dose and low-dose MTX to help guide clinicians. DATA SOURCES: A literature search was performed in MEDLINE (1946 to September 2016), EMBASE (1974 to September 2016), and International Pharmaceutical Abstracts (1970 to January 2015) to identify reports describing potential drug interactions between LD-MTX and NSAIDS, penicillins, or PPIs...
October 3, 2016: Annals of Pharmacotherapy
Brenda Hartman, Mary Donnelly-VanderLoo, Tiffany Watson, Colleen O'Connor, Janet Madill
The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhibitors (PPI). Long-term use of PPIs is associated with several nutritional deficiencies including B12. Currently, there are no recommendations for B12 screening among patients taking PPIs. Data were abstracted on B12 concentrations, B12-containing supplement use, medications, and select hematological values from a retrospective chart review of 658 adults, 391 with serum B12 concentrations, admitted to 6 different medical units at 2 regional hospitals in Southwestern Ontario between 2010 and 2012...
June 23, 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Iftikhar Ahmad Asim Syed, Syed Hasan Abbas Naqvi
Proton pump inhibitors are most widely prescribed medicines all over the world. Since their introduction in pharmacy, life of millions of people has changed completely. Their ability to inhibit acid secretion in stomach has changed the natural history of many once-dreaded conditions like peptic ulcer and gastroesophageal reflux disease. Operation like gastrectomy and partial gastrectomy are carried out very rarely. These medicines are considered very cost-effective, have excellent safety profile, and provide prompt symptomatic relief...
October 2016: JPMA. the Journal of the Pakistan Medical Association
Vanessa Arriola, Jessica Tischendorf, Jackson Musuuza, Anna Barker, Jeffrey W Rozelle, Nasia Safdar
BACKGROUND Clostridium difficile is the principal infectious cause of antibiotic-associated diarrhea and accounts for 12% of hospital-acquired infections. Recent literature has shown an increased risk of C. difficile infection (CDI) with proton pump inhibitor (PPI) use. OBJECTIVE To conduct a systematic assessment of the risk of hospital-acquired CDI following exposure to PPI. METHODS We searched multiple databases for studies examining the relationship between PPI and hospital-acquired CDI. Pooled odds ratios were generated and assessment for heterogeneity performed...
September 28, 2016: Infection Control and Hospital Epidemiology
Adnan Abuhammour, Asad Dajani, Mohammed Nounou, Mohammed Zakaria
BACKGROUND AND STUDY AIMS: Untreated Helicobacter pylori infection causes increased risk of gastric cancer, GI morbidity and mortality. Standard treatment for eradication of Helicobacter pylori infection, is the triple therapy which consists of a proton pump inhibitor; together with two antibiotics (amoxicillin 1000mg with clarithromycin 500mg or metronidazole 400mg) given twice daily for 7-14days. Recent evidence revealed, that cure rates of Helicobacter pylori infection with triple therapy had fallen below satisfactory targets...
September 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Jaya Chandrasekhar, Sameer Bansilal, Usman Baber, Samantha Sartori, Melissa Aquino, Serdar Farhan, Birgit Vogel, Michela Faggioni, Gennaro Giustino, Cono Ariti, Antonio Colombo, Alaide Chieffo, Annapoorna Kini, Richard Saporito, C Michael Gibson, Bernhard Witzenbichler, David Cohen, David Moliterno, Thomas Stuckey, Timothy Henry, Stuart Pocock, George Dangas, P Gabriel Steg, Roxana Mehran
BACKGROUND: Proton pump inhibitors (PPI) may decrease the availability of clopidogrel by competitive antagonism, leading to a potential increase in ischemic events. METHODS: We evaluated patients from the all-comer PARIS registry treated with dual antiplatelet therapy (DAPT) with aspirin and clopidogrel following coronary stenting for outcomes stratified by PPI use. Two-year major adverse cardiovascular events (MACE), composite of cardiac death, myocardial infarction, definite or probable stent thrombosis or target lesion revascularization (TLR), and net adverse cardiac events (NACE), composite of MACE or Bleeding Academic Research consortium (BARC) type 3 or 5 bleeding were assessed...
September 21, 2016: Catheterization and Cardiovascular Interventions
Chia-Fen Tsai, Mu-Hong Chen, Yen-Po Wang, Chi-Jen Chu, Yi-Hsiang Huang, Han-Chieh Lin, Ming-Chih Hou, Fa-Yauh Lee, Tung-Ping Su, Ching-Liang Lu
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is a serious complication of cirrhosis and is associated with gut dysbiosis. Proton pump inhibitors (PPIs), frequently prescribed to patients with cirrhosis, can contribute to small bowel bacterial overgrowth. We investigated whether PPI predisposes patients with cirrhosis to HE using a large database of patients. METHODS: We performed a case-control study nested within a sample of Taiwan National Health Insurance beneficiaries (n=1,000,000), followed longitudinally from 1998 through 2011...
September 14, 2016: Gastroenterology
Wayne A Ray, Cecilia P Chung, Katherine T Murray, Walter E Smalley, James R Daugherty, William D Dupont, C Michael Stein
BACKGROUND & AIMS: Proton-pump inhibitors (PPIs) might reduce the risk of serious warfarin-related upper gastrointestinal bleeding, but the evidence of their efficacy for this indication is limited. A gastroprotective effect of PPIs would be particularly important for patients who take warfarin with antiplatelet drugs or nonselective non-steroidal anti-inflammatory drugs (NSAIDs), which further increase the risk of gastrointestinal bleeding. METHODS: This retrospective cohort study of patients beginning warfarin treatment in Tennessee Medicaid and the 5% National Medicare Sample identified 97,430 new episodes of warfarin treatment with 75,720 person-years of follow up...
September 14, 2016: Gastroenterology
Xingyang Yi, Zhao Han, Qiang Zhou, Wen Cheng, Jing Lin, Chun Wang
OBJECTIVE: Conflicting data exist as to whether proton-pump inhibitors (PPIs) diminish the efficacy of clopidogrel. The aim of this study was to investigate the association between cytochrome P450 (CYP) genetic variants and clinical adverse outcomes of concomitant use of PPIs and clopidogrel by patients. METHODS: We consecutively enrolled 523 patients with ischemic stroke receiving clopidogrel. Platelet aggregation was measured before and after 7 to 10 days of clopidogrel treatment...
September 16, 2016: Clinical and Applied Thrombosis/hemostasis
Vincent C C Cheng, Jonathan H K Chen, Simon Y C So, Sally C Y Wong, Pui-Hing Chau, Lisa M W Wong, Radley H C Ching, Modissa M L Ng, Wan-Mui Lee, Ivan F N Hung, Pak-Leung Ho, Kwok-Yung Yuen
OBJECTIVE To study the association between gastrointestinal colonization of carbapenemase-producing Enterobacteriaceae (CPE) and proton pump inhibitors (PPIs). METHODS We analyzed 31,526 patients with prospective collection of fecal specimens for CPE screening: upon admission (targeted screening) and during hospitalization (opportunistic screening, safety net screening, and extensive contact tracing), in our healthcare network with 3,200 beds from July 1, 2011, through December 31, 2015. Specimens were collected at least once weekly during hospitalization for CPE carriers and subjected to broth enrichment culture and multiplex polymerase chain reaction...
September 13, 2016: Infection Control and Hospital Epidemiology
David M Faleck, Hojjat Salmasian, E Yoko Furuya, Elaine L Larson, Julian A Abrams, Daniel E Freedberg
OBJECTIVES: Patients in the intensive care unit (ICU) frequently receive proton pump inhibitors (PPIs) and have high rates of Clostridium difficile infection (CDI). PPIs have been associated with CDI in hospitalized patients, but ICU patients differ fundamentally from non-ICU patients and few studies have focused on PPI use exclusively in the critical care setting. We performed a retrospective cohort study to determine the associations between PPIs and health-care facility-onset CDI in the ICU...
August 30, 2016: American Journal of Gastroenterology
Agnieszka Matuszewska, Beata Nowak, Marta Rzeszutko, Krzysztof Zduniak, Marta Szandruk, Diana Jędrzejuk, Marcin Landwójtowicz, Marek Bolanowski, Małgorzata Pieśniewska, Joanna Kwiatkowska, Adam Szeląg
BACKGROUND: Epidemiological studies suggest that long-term administration of proton pump inhibitors (PPIs) may decrease bone mineral density (BMD) and increase the risk of osteoporotic fractures. The aim of the study was to assess the influence of pantoprazole on bone metabolism in growing rats. METHODS: The experiment was carried out on twenty-four young male Wistar rats divided into two groups receiving either pantoprazole at the dose of 3mg/kg or vehicle for 12 weeks...
October 2016: Pharmacological Reports: PR
K Poole, R George, V Decraene, K Shankar, J Cawthorne, N Savage, W Welfare, A Dodgson
BACKGROUND: Over the past decade, the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has increased. Whilst basic infection prevention and control practices reduce the risk of transmission, cases of unrecognized carriage pose a potential risk of transmission. AIM: To estimate the prevalence of CPE and explore risk factors associated with colonization within a large teaching hospital with an established CPE outbreak. METHODS: All inpatients that had not previously tested positive for CPE were offered testing...
October 2016: Journal of Hospital Infection
Laura A Fortuna, Pamala A Pawloski, Emily D Parker, Nicole K Trower, Thomas E Kottke
AIMS: Daily low-dose aspirin is recommended for prevention of cardiovascular events in patients with coronary artery disease (CAD), and proton pump inhibitors (PPIs) are recommended to prevent or treat aspirin-associated gastrointestinal injury. Previous studies have reported contradictory findings regarding the risk of major adverse cardiovascular events (MACE) in patients who use PPI with aspirin therapy. We sought to examine associations between PPI use and MACE and all-cause mortality in aspirin-treated CAD patients...
January 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Lucas C Pinheiro, Gustavo H Oliveira-Paula, Rafael L Portella, Danielle A Guimarães, Celio D de Angelis, Jose E Tanus-Santos
Proton pump inhibitors (PPIs) are widely used drugs that may increase the cardiovascular risk by mechanisms not entirely known. While PPIs increase asymmetric dimethylarginine (ADMA) levels and inhibit nitric oxide production, it is unknown whether impaired vascular redox biology resulting of increased xanthine oxidoreductase (XOR) activity mediates PPIs-induced endothelial dysfunction (ED). We examined whether increased XOR activity impairs vascular redox biology and causes ED in rats treated with omeprazole...
August 4, 2016: Redox Biology
Lauren Linder, Cynthia Tamboue, Jennifer N Clements
OBJECTIVE: To review primary literature of gastric acid suppressive agents and vitamin B12 deficiency. DATA SYNTHESIS: From the published articles, proton pump inhibitors (PPIs) are associated with a higher risk of inducing vitamin B12 deficiency than histamine-2 receptor antagonists (H2RAs). Literature suggests that there is an increased risk of developing vitamin B12 deficiency in patients who are exposed to extended durations of therapy with PPIs. There are, however, some conflicting data in elderly patients suggesting that the PPI use for more than 3 years does not increase the risk of vitamin B12 deficiency...
August 12, 2016: Journal of Pharmacy Practice
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