Proton Pump Inhibitors (PPIs)
The primary function of proton pump inhibitors (PPIs) is to reduce the production of gastric acid. As the most potent versions of acid secretion inhibition known today, PPIs affect pronounced results that are meant to be long lasting.
Individuals suffering from conditions such as Barrett's esophagus, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), Zollinger-Ellison syndrome, dyspepsia, and gastrinomas have been treated with proton pump inhibitors. PPIs have also been used to prevent the stress of gastritis for patients who suffer from this type of uncomfortable inflammation of the stomach. However, within the medical field it is a widely accepted fact that the use of proton pump inhibitors may not be effective in every case and cannot produce reliable results every time. Additionally, the FDA soundly warns against using the devices more than three times a year.
Side Effects of Proton Pump Inhibitors
A big draw to the use of PPIs is the fact that very few short-term effects have been recorded in incidence reports among users. However, in the long run, use of PPI drugs could be more detrimental than beneficial to some of the patients to whom the drug has been prescribed.
Generally, short-term PPI use has not been linked to any serious side effects. However, patients who have taken PPIs for extended periods of time, usually for more than one year, may be at risk of bone fracture. The FDA therefore recommends no more than three fourteen-day treatment courses in a one-year time period.
One study of 135,000 people aged 50 or older found that those taking high doses of PPIs for more than one year were 2.6 times more likely to break a hip. Those taking lower doses of PPIs for one to four years were 1.2 to 1.6 times more likely to break a hip. One theory associated with the increased risk of bone fracture is that the reduction of stomach acid may reduce the amount of calcium dissolved in the stomach. Another theory is that PPIs may cause decreased vitamin B12 absorption, which may increase bone fragility. Another theory is that PPIs may affect the normal breakdown and rebuilding of bone by interfering with the production of bone cells called osteoclasts.
Some of the lesser side effects that may be experienced while taking PPIs may include:
- Abdominal pain
Although the side effects of PPIs may be rare, they are serious in nature and when they occur they are often cause for alarm. Among the most severe of the potential risk hazards of proton pump inhibitors is the exacerbated effects they have on those who suffer from bone fractures and breaks. PPIs have also been reported as the cause for increased risks of GI bacterial infections. Other studies have found that daily use of a proton pump inhibitor drugs could result in diarrheal disease. The readiness with which many doctors approach usage of PPIs, particularly in cases of heartburn and dyspepsia greatly increases the potential for adverse side effects such as those described above.
The leading types of PPIs, taken orally as a pill or liquid, include:
- Dexilant (Dexlansoprazole)
- Nexium (Esomeprazole)
- Prevacid (Lansoprazole)
- Prilosec (Omeprazole)
- Protonix (Pantoprazole)
- Aciphex (Rabeprazole)
Dangers of Taking Proton Pump Inhibitors During Pregnancy
A recent study conducted by the University of Pennsylvania revealed that babies born to mothers who used PPIs during the first trimester of pregnancy were twice as likely to have congenital heart defects as children in the regular population. Specific defects include septal defects (holes in the heart) and left and right ventricular defects. The study examined 208,951 pregnancies, and did not reveal the reason behind increased risks, but did find a clear correlation.
Heartburn is a frequent occurrence during pregnancy and those symptoms can be quite severe. For that reason, doctors may prescribe PPIs to relieve symptoms, or women may purchase over-the-counter drugs, but the new study suggests that other options for controlling symptoms should be used if at all possible.
The FDA categorizes drugs by their effect on fetuses in the following way:
- The drug is completely safe for use during pregnancy;
- The drug appears to be safe in animal studies but there is not enough human data available;
- The effect of the drug on the fetus is not yet known; and
- The use of the drug is unsafe for fetuses and may cause birth defects.
All of the PPIs on the market are classified as B, C or D.
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Drug side effects can be substantially life altering for some, especially when the potential for risk outweighs the relief that certain prescription medications promise to the patients who use them. This is particularly true when the medications are overprescribed or wrongly prescribed to a patient who should not be taking them in the first place. At this point, the matter is no longer one of prescription medication use, but rather one of dangerous drug use.
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