Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva.

Autor:	de la Coba Ortiz C; Sección de Aparato Digestivo. , Hospital de Cabueñes, España., Argüelles Arias F; UGC Aparato Digestivo, H. Universitario Virgen Macarena, España., Martín de Argila de Prados C; Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, España., Júdez Gutiérrez J; Departamento de Gestión del Conocimiento, Sociedad Española de Patología Digestiva SEPD, España., Linares Rodríguez A; Servicio Aparato Digestivo, Sanatorio Nuestra Señora de Covadonga, España., Ortega Alonso A; UGC Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, España., Rodríguez de Santiago E; Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, España., Rodríguez-Téllez M; UGC Intercentros de Aparato Digestivo , Hospital Universitario Virgen de la Macarena (HUVM), España., Vera Mendoza MI; Servicio Aparato Digestivo, Hospital Universitario Puerta de Hierro Majadahonda, ESPAÑA., Aguilera Castro L; Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal. , España., Álvarez Sánchez Á; Servicio de Aparato Digestivo, Hospital Clínico San Carlos. Universidad Complutense de Madrid., España., Andrade Bellido RJ; Unidad de Gestión Clinica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, España., Bao Pérez F; Sección Aparato Digestivo, Hospital San Eloy, España., Castro Fernández M; Servicio de Aparato Digestivo, Hospital Universitario de Valme, España., Giganto Tomé F; Servicio de Aparato Digestivo, Hospital Universitario Central de Asturias, España.
Jazyk:	angličtina
Zdroj:	Revista espanola de enfermedades digestivas [Rev Esp Enferm Dig] 2016 Apr; Vol. 108 (4), pp. 207-24.
DOI:	10.17235/reed.2016.4232/2016
Abstrakt:	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. Results: Current PPI indications have remained unchanged for years now, and are well established. A general screening of vitamin B12 levels is not recommended for all patients on a PPI; however, it does seem necessary that magnesium levels be measured at therapy onset, and then monitored in subjects on other drugs that may induce hypomagnesemia. A higher risk for bone fractures is present, even though causality cannot be concluded for this association. The association between PPIs and infection with Clostridium difficile is mild to moderate, and the risk for pneumonia is low. In patients with cardiovascular risk receiving thienopyridines derivatives it is prudent to adequately consider gastrointestinal and cardiovascular risks, given the absence of definitive evidence regardin potential drug-drug interactions; if gastrointestinal risk is found to be moderate or high, effective prevention should be in place with a PPI. PPIs should be cautiously indicated in patients with decompensated cirrhosis. Conclusions: PPIs are safe drugs whose benefits outweigh their potential side effects both short-term and long-term, provided their indication, dosage, and duration are appropriate.
Databáze:	MEDLINE
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