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magnesium deficiency ppi

Iván Igaz, Gábor Simonyi, Sándor Balogh, Miklós Szathmári
In the last few decades, proton-pump inhibitors have become the mainstay of the treatment of acid-related disorders. Despite their efficacy, these drugs are not without risks. Recently several articles have been published on their long-term adverse effects. Among these adverse effects, the higher risk of bone fractures, the vitamin B12 and magnesium deficiencies and the higher risk of Clostridium difficile infection may be relevant. As these drugs are prescribed more and more frequently all over the world, the knowledge of the long-term adverse effects is very important not only for the specialists but for the general practitioners as well...
May 2018: Orvosi Hetilap
Amy Louise Ross Russell, Martin Prevett, Paul Cook, Charles Simon Barker, Ashwin Arnold Pinto
Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors...
February 15, 2018: Practical Neurology
Li-Yuan Yu, Lu-Ning Sun, Xue-Hui Zhang, Yue-Qi Li, Lei Yu, Zi-Qing-Yun Yuan, Ling Meng, Hong-Wen Zhang, Yong-Qing Wang
Proton pump inhibitors (PPIs) are known as a class of pharmaceutical agents that target H+ /K+ -ATPase, which is located in gastric parietal cells. PPIs are widely used in the treatment of gastric acid-related diseases including peptic ulcer disease, erosive esophagitis and gastroesophageal reflux disease, and so on. These drugs present an excellent safety profile and have become one of the most commonly prescribed drugs in primary and specialty care. Except for gastric acid-related diseases, PPIs can also be used in the treatment of Helicobacter pylori infection, viral infections, respiratory system diseases, cancer and so on...
May 2017: Advances in Therapy
Narongrit Thongon, Jirawat Penguy, Sasikan Kulwong, Kanyanat Khongmueang, Matthana Thongma
Hypomagnesemia is the most concerned side effect of proton pump inhibitors (PPIs) in chronic users. However, the mechanism of PPIs-induced systemic Mg2+ deficit is currently unclear. The present study aimed to elucidate the direct effect of short-term and long-term PPIs administrations on whole body Mg2+ homeostasis and duodenal Mg2+ absorption in rats. Mg2+ homeostasis was studied by determining the serum Mg2+ level, urine and fecal Mg2+ excretions, and bone and muscle Mg2+ contents. Duodenal Mg2+ absorption as well as paracellular charge selectivity were studied...
November 2016: Pflügers Archiv: European Journal of Physiology
Erica M Elliott
The use of medications that block gastric acid secretion, such as proton pump inhibitors, has rapidly escalated in the United States. Although originally intended for short-term treatment of specific conditions, PPIs have expanded to long-term use with unanticipated consequences, including mineral deficiencies related to lack of sufficient stomach acid needed for extraction of minerals from the foods and supplements ingested. Herein, the author reports on a case of a patient with tachycardia and other arrhythmias that had been resistant to the medications prescribed by a series of cardiologists...
November 2016: Explore: the Journal of Science and Healing
P Fatuzzo, G Portale, V Scollo, L Zanoli, Antonio Granata
Hypomagnesemia is a common but often overlooked problem in hospitalized patients. Unrecognized hypomagnesemia can cause serious complications. The association of hypokalemia and hypocalcemia is strongly evocative of a magnesium deficiency. Research into the causes of hypomagnesemia is imperative, as it will definitely change the approach, treatment and prognosis. We report the case of a 65-year-old man with chronic hypocalcemia and hypokalemia associated with cerebellar syndrome, a solitary seizure and cerebellar hyperintensities on magnetic resonance imaging...
April 2017: Journal of Nephrology
E Gould, C Clements, A Reed, L Giori, J M Steiner, J A Lidbury, J S Suchodolski, M Brand, T Moyers, L Emery, M K Tolbert
BACKGROUND: Chronic proton pump inhibitor administration has been associated with electrolyte and cobalamin deficiency, disrupted bone homeostasis, hypergastrinemia, and rebound acid hypersecretion in humans. It is unknown if this occurs in cats. OBJECTIVES: Prolonged oral omeprazole results in altered bone mineral density or content, serum calcium, magnesium, cobalamin, and gastrin concentrations in healthy cats. ANIMALS: Six healthy adult DSH cats...
May 2016: Journal of Veterinary Internal Medicine
Cristóbal de la Coba Ortiz, Federico Argüelles Arias, Carlos Martín de Argila de Prados, Javier Júdez Gutiérrez, Antonio Linares Rodríguez, Aida Ortega Alonso, Enrique Rodríguez de Santiago, Manuel Rodríguez-Téllez, María Isabel Vera Mendoza, Lara Aguilera Castro, Ángel Álvarez Sánchez, Raúl Jesús Andrade Bellido, Fidencio Bao Pérez, Manuel Castro Fernández, Froilán Giganto Tomé
INTRODUCTION: In the last few years a significant number of papers have related the use of proton-pump inhibitors (PPIs) to potential serious adverse effects that have resulted in social unrest. OBJECTIVE: The goal of this paper was to provide a literature review for the development of an institutional position statement by Sociedad Española de Patología Digestiva (SEPD) regarding the safety of long-term PPI use. MATERIAL AND METHODS: A comprehensive review of the literature was performed to draw conclusions based on a critical assessment of the following: a) current PPI indications; b) vitamin B12 deficiency and neurological disorders; c) magnesium deficiency; d) bone fractures; e) enteric infection and pneumonia; f) interactions with thienopyridine derivatives; e) complications in cirrhotic patients...
April 2016: Revista Española de Enfermedades Digestivas
Lívia Marcela dos Santos, Ricardo Ayello Guerra, Marise Lazaretti-Castro, José Gilberto H Vieira, Evandro de Souza Portes, Magnus R Dias-da-Silva
PURPOSE: Magnesium is an important electrolyte for very many cell functions and its deficiency may lead to a wide spectrum of diseases. We report a clinical case of hypomagnesemia resulting from the chronic use of a proton pump inhibitor (PPI). PPIs are drugs widely used in medical practice, and a growing number of cases of PPIs causing hypomagnesemia have been described. Our aim was to monitor the clinical and electrolyte findings during recovery from hypomagnesemia caused by long-term PPI use...
December 2015: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
Jeffrey H William, John Danziger
The association of proton-pump inhibitor (PPI) use and hypomagnesemia has garnered much attention over the last 5 years. A large body of observational data has linked chronic PPI use with hypomagnesemia, presumably due to decreased intestinal absorption and consequent magnesium deficiency. However, despite the increasing prevalence of this highly popular class of medicine, and despite potential significant risks associated with magnesium depletion, including cardiac arrhythmias and seizures, there are no well-designed studies to delineate the nature of this observed association...
June 2016: Journal of Clinical Pharmacology
Nathan S S Atkinson, D John M Reynolds, Simon P L Travis
Proton pump inhibitors (PPIs) are widely used though an association with hypomagnesaemia and hypocalcaemia has only been described since 2006. Patients typically present after years of stable dosing with musculoskeletal, neurological or cardiac arrhythmic symptoms, but it is likely that many cases are under-recognised. Magnesium levels resolve rapidly on discontinuation of PPI therapy and hypomagnesaemia recurs rapidly on rechallenge with any agent in the class. The cellular mechanisms of magnesium homeostasis are increasingly being understood, including both passive paracellular absorption through claudins and active transcellular transporters, including the transient receptor potential channels (TRPM6) identified in the intestine and nephron...
July 2015: Intestinal Research
Patrícia João Matias, Ana Azevedo, Ivo Laranjinha, David Navarro, Marco Mendes, Carina Ferreira, Tiago Amaral, Cristina Jorge, Inês Aires, Célia Gil, Aníbal Ferreira
BACKGROUND: Hypomagnesaemia is a cardiovascular (CV) risk factor in the general population. The aim of this study was to evaluate the relationship between pre-dialysis magnesium (Mg) and CV risk markers, [including pulse pressure (PP), left ventricular mass index (LVMI) and vascular calcifications (VC)], and mortality in haemodialysis (HD) patients. METHODS: We performed a 48-month prospective study in 206 patients under pre-dilution haemodiafiltration with a dialysate Mg concentration of 1 mmol/l...
2014: Blood Purification
Jeroen H F de Baaij, Joost G J Hoenderop, René J M Bindels
Magnesium (Mg(2+)) is an essential ion to the human body, playing an instrumental role in supporting and sustaining health and life. As the second most abundant intracellular cation after potassium, it is involved in over 600 enzymatic reactions including energy metabolism and protein synthesis. Although Mg(2+) availability has been proven to be disturbed during several clinical situations, serum Mg(2+) values are not generally determined in patients. This review aims to provide an overview of the function of Mg(2+) in human health and disease...
January 2015: Physiological Reviews
Joel J Heidelbaugh
Proton pump inhibitors (PPIs) remain the superior choice worldwide in antisecretory therapy in the evidence-based treatment of upper gastrointestinal disorders including gastroesophageal reflux disease, erosive esophagitis, dyspepsia and peptic ulcer disease. PPI overutilization in ambulatory care settings is often a result of failure to re-evaluate the need for continuation of therapy, or insufficient use of on-demand and step-down therapy. Nonjudicious use of PPIs creates both preventable financial as well as medical concerns...
June 2013: Therapeutic Advances in Drug Safety
Noa Markovits, Ronen Loebstein, Hillel Halkin, Martin Bialik, Janet Landes-Westerman, Joseph Lomnicky, Daniel Kurnik
Evidence for the association between hypomagnesemia and proton pump inhibitors (PPIs), highlighted by the 2011 FDA Drug Safety Communication, rests mainly on studies in hospitalized patients. Our objectives were to determine the prevalence of hypomagnesemia and its association with PPIs in the community setting. We performed a retrospective cross-sectional analysis of a large health maintenance organization administrative database, including ambulatory patients with ≥1 serum magnesium concentrations between 2008 and 2011, the lowest referred to as "index magnesium...
August 2014: Journal of Clinical Pharmacology
E Ströker, L Leone, Y Vandeput, I Borbath, C Lefebvre
The association between proton pump inhibitor (PPI) therapy and hypomagnesaemia has been recognized since 2006. We report the case of a 51-year-old woman who developed severe symptomatic hypomagnesaemia after a long-term PPI therapy given for recurrent peptic ulcer disease. Hypomagnesaemia could only partially be resolved during substitution therapy, but was corrected after withdrawal of the PPI. Recurrence of hypomagnesaemia occurred after retreatment with PPIs, supporting the causal relationship. An underlying gastric acid hypersecretion (Zollinger-Ellison syndrome) was highly suspected and eventually controlled by a combination of a histamine 2-receptor antagonist and octreotide, without the need for further PPI therapy after 2 years of follow-up...
January 2014: Acta Clinica Belgica
Lukasz Zbigniew Krupa, Ian Wilfred Fellows
The introduction of proton pump inhibitors (PPIs) in the late 1980s optimised the medical treatment of acid-related disorders. They are potent medications and have a good safety profile. However, long-term therapy with PPIs may carry undesired side effects, one of which is hypomagnesaemia. This entity is likely to be under-reported. We present a clinical case which illustrates this important clinical problem. We present the case of a 73-year-old woman who was admitted to the hospital with supraventricular tachycardia due to hypomagnesaemia while using lansoprazole, followed by the literature review on this subject...
2014: BMJ Case Reports
Vito Domenico Corleto, Stefano Festa, Emilio Di Giulio, Bruno Annibale
PURPOSE OF REVIEW: This review summarizes the recent literature on the potential side-effects of proton pump inhibitors (PPIs) and known interactions with the metabolism/absorption of other drugs. RECENT FINDINGS: Data confirm that PPIs are a very well tolerated drug class. Their high safety, efficacy and wide distribution lead to overuse, inappropriate dosage or excessive duration of treatment. Despite the absorption of micronutrients or other plausible effects on the development of bacterial infections linked to PPI-induced hypochlorhydria, it is difficult to demonstrate an association between PPI and specific symptoms...
February 2014: Current Opinion in Endocrinology, Diabetes, and Obesity
Carlos Centeno, José Mario López Saca
PURPOSE OF REVIEW: Patients with advanced diseases are exposed to many causes of hypomagnesaemia, the most frequent being pharmacological causes through the administration of chemotherapy, antibiotics, proton pump inhibitors, and so on. The objective of this review is to demonstrate the importance of measuring magnesium levels in the blood of these patients. RECENT FINDINGS: In the last decade, studies have been published showing a direct relationship between low levels of magnesium and nonspecific symptoms including pain that is difficult to control...
December 2013: Current Opinion in Supportive and Palliative Care
Julia Fashner, Alfred Chege Gitu
More than 11 million individuals receive proton pump inhibitor (PPI) prescriptions each year in the United States. Although PPIs are effective treatment for peptic ulcers and esophagitis and provide symptom relief for many other conditions, their use carries risks. They decrease gastric acid and can lower blood levels of drugs whose absorption is acid dependent, including several antiretroviral and cancer therapy drugs. Other drugs, such as digoxin, may be absorbed more extensively when gastric acid is reduced; thus, digoxin toxicity may occur with PPI use...
October 2013: FP Essentials
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