Overuse of proton pump inhibitors.

摘要: Background: There have been concerns raised about the potential adverse effects of proton pump inhibitors, especially with long-term use. In particular, their potent action can suppress features and delay diagnosis gastric cancer, while prolonged exposure may hasten development carcinoids. Aim: To examine use inhibitors in patients at major teaching hospital Tasmania, Australia, principally to determine appropriateness therapy according published guidelines. Methods: A retrospective review medical records all prescribed any over a 7-month period, was performed. An extensive range demographic clinical variables recorded for each patient. The were also asked series questions during hospitalization extract some relevant information – if when they had undergone endoscopy. Results: 200 (52% males) mean age 69 ± 16·4 years. most common indications using acute gastrointestinal bleeding (20·9%), severe refractory ulcerating oesophagitis (17·3%), mild/moderate oesophageal reflux (17·3%) peptic ulcer (11·7%). large number inhibitor ‘other’ (39·6%). prescribing satisfied approved indications, as outlined Australian Schedule Pharmaceutical Benefits, only 37·1% cases. Endoscopy performed 54·1% prior commencing within next 7 days another 12·8% patients. Only 59% previously treated an H2-receptor antagonist before inhibitor. Even worse, 58·5% used oesophagitis. median duration admitted already receiving one drugs 450 days. Over half being concurrently other which are known cause or exacerbate gastro-oesophageal disease, 18% smokers. Conclusions: Whereas undoubtedly effective agents, studies practice consistently suggest over-use endoscopy, who do not fit criteria, ‘less powerful’ agents should sufficiently patient’s symptoms. This poses economic safety concerns, particularly light suggestion that these could cancer.