Proton pump inhibitors

Abstract

Proton pump inhibitors (PPI’s) are a class of drugs that profoundly suppress gastric acid secretion and have thus become the treatment of choice for gastro-oesophageal reflux disease (GORD) and peptic ulcer disease (PUD). PPI’s are considered safe and effective. It is essential that clinicians understand the appropriate use of PPI’s 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 it does serve to highlight the need for ongoing vigilance as even a small increased risk for an adverse event may translate to large numbers considering the widespread use of PPI’s. This review will focus on the use of oral PPI’s in the ambulatory setting and recent concerns regarding adverse effects of PPI’s.