What are some indications for PPI use, both short and long term
Proton-pump inhibitors are groups of medications used by people to reduce the production of stomach acid. When used on a short term basis, PPI can successfully help treat gastroesophageal reflux conditions. Also, the drugs can effectively facilitate duodenal and gastric ulcer healing regardless of whether Helicobacter pylori initiate the disease. Besides, the use of PPIs in the short run can help prevent gastroduodenal lesions that develop due to NSAIDs use (Abbas et al., 2019). The drugs also treat ulcer bleeding and inhibit the recurrence of bleeding after undertaking endoscopic hemostasis. However, the use of PPIs, in the long run, can bring other harmful health complications to the patients. Long term use of PPIs can cause Clostridium difficile infection because dugs can alter the colonic microbiome, thus reducing colonization resistance.
What the latest research indicates related to the safety and adverse effects of long-term use of proton pump inhibitors. Summarize your findings and cite references
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The study conducted by Kinoshita, Ishimura, & Ishihara indicated that PPIs are safe to be used in the long term as they prevent gastric acid secretion. The long term use of the drugs also inhibits the recurrence of aspirin-induced gastroduodenal ulcers (Kinoshita et al., 2018). Despite the safeness, the research also produced some adverse impacts of long term use of PPIs, such as increasing the risk of dementia due to beta-amyloid buildup. PPIs long-term use interrupts the activities of the scavenger enzymes like the V-ATPase, thus resulting in beta-amyloid accumulation. Proton pump inhibitors also lead to pneumonia conditions when used in the long term. The PPIs can increase the gastric acid pH by suppressing the release of acid in the organ. The high pH enhances bacterial growth, thus resulting in tracheal colonization and impaired immune function, causing pneumonia. Subsequently, PPIs may reduce the effectiveness of the antiplatelet agents by inhibiting particular CYP enzymes that the enzymes required to become activated.
Also, the long term use of PPIs may contribute to the development of kidney conditions. PPIs may cause renal dysfunction because of their ability to reduce the regeneration of renal tubular cells, alter gene expression, raise oxidative stress, and induce chronic kidney injury (Lassalle et al., 2018). Furthermore, the drugs increase the risk of hypomagnesemia because of the inducement of the pH that alters the affinity of magnesium receptors. Hypomagnesemia is dangerous because it can lead to the development of cardiovascular diseases, osteoporosis, and diabetes. The research also explained how using PPIs in the long term may cause bone fracture as the drugs impede calcium absorption. Lastly, the drugs increase mortality rates when used for a long time, especially with the dangerous health complications that patients experience.
What impact do these findings have on your nursing practice
The research findings produced qualitative evidence concerning PPIs use. Even though PPIs remain the essential agent that controls gastric acid secretion and healing gastrointestinal ulcers, their chronic use should be examined. As a result, I intend to limit the extensive use of these drugs on patients, especially if a clear indication is not available. Also, the findings have made me plan to undertake revision and awareness concerning the possible health challenges associated with the use of PPIs. Also, I plan to educate patients on the importance of implementing lifestyle modifications such as dietary, physical exercise, and weight loss. They may help decrease the use of Proton-pump inhibitors in some people.
References
Abbas, M. K., Zaidi, A. R. Z., Robert, C. A., Thiha, S., & Malik, B. H. (2019). The Safety of Long-Term Daily Usage of a Proton Pump Inhibitor. A Literature Review, Cureus , vol. 11, no. 9. https://doi.org/10.7759/cureus.5563
Kinoshita, Y., Ishimura, N., & Ishihara, S. (2018). Advantages and Disadvantages of Long-Term Proton Pump Inhibitor Use. Journal of Neurogastroenterology and Motility , vol. 21, no. 2, pp. 182. https://doi.org/10.5056/jnm18001
Lassalle, M., Le Tri, T., Bardou, M., Biour, M., Kirchgesner, J., Rouby, F., & Dray-Spira, R. (2020). Use of Proton Pump Inhibitors in Adults in France: A Nationwide Drug Utilization Study. Europeans Journal of Clinical Pharmacology , vol. 76, no. 3, pp. 449-457. https://doi.org/10.1007/s00228-019-02810-1
