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A review article in U.S. Pharmacist in 2013 states that long-term use of PPIs is associated with decreased calcium absorption (causing increased risk of osteoporosis and fractures), decreased magnesium absorption (causing electrolyte disturbances), and increased risk of certain infections such as C. difficile and community-acquired pneumonia ...
Therefore, PPIs are often routinely prescribed for cirrhotic patients to treat GERD and prevent variceal bleeding. However, it has been recently shown that long term use of PPIs in patients with cirrhosis increases the risk of SBP and is associated with the development of clinical decompensation and liver-related death during long-term follow ...
A derivative of timoprazole, omeprazole, was discovered in 1979, and was the first of a new class of drug that control acid secretion in the stomach, a proton pump inhibitor (PPI). [11] [12] Addition of 5-methoxy-substitution to the benzimidazole moiety of omeprazole was also made and gave the compound much more stability at neutral pH. [6]
As of 2006, a standard triple therapy is amoxicillin, clarithromycin, and a proton pump inhibitor such as omeprazole, [15] lansoprazole, pantoprazole, or esomeprazole. Protocols with metronidazole were also in use. [15] An example of a fixed-dose combination is PantoPac, containing pantoprazole, clarithromycin, and amoxicillin. [citation needed]
At risk: No apparent necrotic bone in patients who have been treated with either oral or IV bisphosphonates No treatment indicated, Patient education N/A Stage 0: No clinical evidence of necrotic bone, but non-specific clinical findings, radiographic changes and symptoms Systemic management, including the use of pain medication and antibiotics N/A
Omeprazole and clopidogrel are metabolized by the same CYP metabolic pathway. Consequently, it has been suggested that the low-responsiveness of clopidogrel, with concomitant use of omeprazole, is caused by the competition of the CYP2C19 enzyme between these two drugs. [40]
Long-term use is sometimes described as use not shorter than three months. [2] Benzodiazepines are generally effective when used therapeutically in the short term, [3] but even then the risk of dependency can be significantly high. There are significant physical, mental and social risks associated with the long-term use of benzodiazepines. [3]
Consider that according to the chart, LSD has the same dependency risk as khat, MDMA and "solvents." LSD has no known withdrawal effects and there's no evidence of dependency, while khat and MDMA have mild withdrawal symptoms from occasional use and quite serious ones that occur after discontinuing long-term use.
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