Talk:Proton-pump inhibitor

message: New article/research on PPI and Clostridium difficile infection (CDI).  Medscape registration is free.  
C difficile Infection Linked to Proton Pump Inhibitors
Marginata (talk) 15:23, 26 July 2013 (UTC)
thread_title:  ''Clostridium difficile'' 

message: :PPIs are the class - there isn't really any need for classification. Techelf 07:01, 10 Nov 2004 (UTC)
replies: text: Thanks for pointing out the JAMA article, I've put a brief spiel in the main article which you can expand if you like. Techelf 07:52, 11 Nov 2004 (UTC)
thread_title:  Classification of Proton Pump Inhibitor? 

message: Uncontrolled or insufficiently controlled Gastroesophageal Reflux Disease can cause Pulmonary aspiration which may lead to pneumonia.  Interesting that the current favoured treatment for GERD is for associated with increased risk of community-aquired pneumonia.
:See above. JFW | T@lk 20:25, 15 Jun 2005 (UTC)
thread_title:  Pneumonia 

message: The above template is available; I think it should probably be used on this page? I didn't want to duplicate the information already there, but removing the present list would lose the brand name reference. -- Mithent 20:50, 20 Jun 2005 (UTC)
thread_title:  Template 

message: ... is very rare, usually affects the elderly, rarely progresses to dialysis and takes more than 6 months to heal  JFW | T@lk 19:00, 1 August 2007 (UTC)
thread_title:  Interstitial nephritis 

message: - after reports about metformin causing B12 deficiency and concerns about calcium absorption in PPI treatment it was probably time we looked at B12, deficiency of which can cause haematological and neurological complications. No problems there. Good. JFW | T@lk 21:21, 13 January 2008 (UTC)
replies: text: - review of all the long-term adverse effects. JFW | T@lk 12:33, 27 September 2009 (UTC)
thread_title:  Don't worry about B12 

message: - 
http://jamanetwork.com/journals/jamaneurology/fullarticle/2487379
From Abstract:
"Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline."
From Introduction:
"There is evidence that PPI use might affect cognition. Lam et al10 report a significant association of previous and current PPI use with vitamin B12 deficiency in a population-based sample. Vitamin B12 deficiency has been shown to be associated with cognitive decline.11 In another study,12 PPIs were observed to enhance β-amyloid (Aβ) levels in the brains of mice by affecting the enzymes β- and γ-secretase."
:Reported associations of long-term PPI use with B12 deficiency and dementia are here, but we use secondary sources (reviews) such as ref 23 and 24.  In WP, we aim for a balanced, long-term view rather than reporting every new primary study, particularly as animal research does not always have relevance for human medical conditions. Jrfw51 (talk) 10:28, 9 September 2017 (UTC)
thread_title:  Or maybe worry about B12? 

message: After talking to a pharmacist, it came to my attention that PPIs could affect the up-take of some drugs (eg. supplements, oral contraceptives, anticonvulsants, etc.). Suppose a patient were to take their PPI at the same time as any other drugs they were taking.  It stands to reason that if PPIs change the acid content of the stomach then many other drugs would not be absorbed properly since they rely on the pH of the stomach to be absorbed at the proper rate.  However, I can't seem to find a reliable source for these interactions (other than a pharmacist).  It seems like something that people should know about PPis.  Does anyone know of any sources for this? Jubbacca (talk) 04:52, 11 March 2009 (UTC)
thread_title:  Drug Interactions ?

message: Given that, as stated with reference, all of these: " headache, nausea, diarrhea, abdominal pain, fatigue, dizziness" are "common" [reference 8] adverse effects, it does not make sense to claim that "in general, proton pump inhibitors are "well tolerated" I suggest some of the more regular maintainers of this page delete the assertion of "generally...well tolerated" Just let the referenced statements listing "common" (as well as the 'uncommon' and 'rare') adverse effects, speak for themselves and let people judge the extent to which it's well tolerated or not.--Harel (talk) 04:39, 15 November 2009 (UTC)
thread_title:  Delete "Well tolerated" 

message: Is it true that proton pump inhibitors are more efficacious in the Asian population? Should this also be mentioned in the article? 72.229.156.157 (talk) 03:31, 24 February 2010 (UTC)
replies: text: The issue is finding sources. If you have a source which talks about this then share.  Blue Rasberry (talk) 15:18, 14 September 2012 (UTC)
thread_title:  Pharmacogenomics in ethnically Asian populations 

message: I don't remember reading anything about increased risk of fractures. The paragraph about that is unsourced. Does anyone have a source? Thanks. 174.99.120.98 (talk) 00:54, 20 August 2011 (UTC)
thread_title:  Risk of fractures 

message: Reading the FDA source, it indicates that 3 x 14 day per 365 days max for OTC treatment, doesn't carry that warning for people taking under the advisement of a physician. This should be changed in the article to reflect this. There IS a risk of fracture, but many people are on physician-ordered doses of PPI's for longer terms. 174.95.209.14 (talk) 00:20, 11 November 2011 (UTC)
thread_title:  14 Day Course OTC 

message: I propose merging Discovery and development of proton pump inhibitors here. That article contains a lot of valuable material that is not related to discovery and development, so I think the main article would profit from a merger. --ἀνυπόδητος (talk) 18:58, 9 February 2012 (UTC)
replies: text: I do not support this, but I do support greater interlinking of the articles. That article is part of a series on "discovery and development" of every class of drugs. You can see all these articles in this template. There is a large and significant field which focuses on drug development without talking about the drug class itself as this article does.  Blue Rasberry (talk) 15:13, 14 September 2012 (UTC)
replies: text: I do not support this and agree with Blue rasberry. I've included the section title and a referral to make it more obvious this information is available on wiki in the article. Mat8989 (talk) 08:42, 4 April 2013 (UTC)
replies: text: But the two articles now point to each other, each one saying the other approach has now surpassed it - setting aside the actual situation / science, both of the statements can't be true - brilliant circular statements.  I can see not combining but the articles need editing to be in agreement.  The history makes it clear which is correct but why should a reader who presumably faces taking a new prescription med have to do this analysis?70.211.3.255 (talk) 04:32, 14 June 2013 (UTC)
replies: text: Also against the merge, though editing both articles to be better is always a good plan. Hwttdz (talk) 14:36, 12 July 2013 (UTC)
replies: text: I think you should merge because wikipedia is full of rule following nazis 50.132.103.137 (talk) 20:55, 20 June 2013 (UTC)
thread_title:  Merge discussion 

message: Did the NHS of Great Britain recommend the use of  probiotics?  I can find no evidence of this.  It seems unlikely given this was announced earlier in the same year. http://www.nutraingredients.com/Regulation/EFSA-slams-door-on-probiotic-health-claims-again-Prunes-pass. Good news about the prunes though. - Dave Crosby (talk) 08:34, 23 February 2013 (UTC)
thread_title:  "NHS of Great Britain recommended the use of a probiotic, Lactobacillus casei" 

message: in this dif you added a bunch of content based on this source. PloS classifies that as a "research paper" not a review.  As of today it is not even indexed in pubmed yet.  I reverted on the basis that is a primary source, per MEDRS. Jytdog (talk) 03:40, 11 June 2015 (UTC)
thread_title:  Primary source 

message: The primary PLoSone source [] above was used by another new editor again and was reverted.  I have updated the cardiovascular risks with reviews, consensus and publicly available secondary sources indicating the complex and confounding problems to any associations. The PLoSone article may be incorporated in future reviews but  here is one author's comment on that paper if we want a balanced view.  Jrfw51 (talk) 14:17, 20 August 2015 (UTC)
thread_title: Cardiovascular risks

message: Here's a nice editorial in JAMA Internal Medicine accompanying the article on PPIs and kidney disease, which also reviews all the other major adverse effects of PPIs. The table summarizes it very well. The usual caveats about association vs. causation apply. 
http://archinte.jamanetwork.com/article.aspx?articleid=2481153
Editorial | February 2016
Adverse Effects Associated With Proton Pump Inhibitors
Adam Jacob Schoenfeld, MD1; Deborah Grady, MD, MPH1,2
JAMA Intern Med. 2016;176(2):172-174. doi:10.1001/jamainternmed.2015.7927. 
Table.  Evidence Supporting the Potential Adverse Effects of Proton Pump Inhibitor Drugs
CONCLUSIONS Available evidence suggests that PPI use is associated with an increased risk of both acute and chronic kidney disease, hypomagnesemia, C difficile infection, and osteoporotic fractures. 
--Nbauman (talk) 03:05, 17 February 2016 (UTC)
thread_title:  JAMA IM 

message: http://circres.ahajournals.org/content/118/12/e36.abstract
"Chronic exposure to PPIs impaired endothelial function and accelerated human endothelial senescence by Reducing Telomere length". 
ee1518 (talk) 06:11, 5 July 2016 (UTC)
thread_title:  Chronic exposure to PPIs reduce Telomere length.