Proton-pump inhibitors

Abstract

Proton-pump inhibitors (PPIs) are a class of drugs that profoundly suppress gastric acid secretion, and thus have become the treatment of choice for gastro-oesophageal reflux disease and peptic ulcer disease. PPIs are considered safe and effective. It is essential that clinicians understand the appropriate use of PPIs, given the significant economic burden of inappropriate prescribing and safety concerns. Long-term safety concerns and possible drug interactions have led to a more conservative approach to PPI use. Some of these concerns may have been overstated, but they serve to highlight the need for ongoing vigilance because even a small increased risk of an adverse event may translate to a large number, considering that the use of PPIs is widespread. This review focuses on the use of oral PPIs in the ambulatory setting, and recent concerns regarding the adverse effects of PPIs.