Vol 13, No 2 (2019)
Review paper
Published online: 2019-06-05
Proton pump inhibitors in palliative care
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Palliat Med Pract 2019;13(2):95-100.
Abstract
The gold standard treatment for peptic ulcer disease, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome is the class of medications known as the proton pump inhibitors (PPIs). Omeprazole, the prototype of this group belongs to the chemical class of benzimidazoles; substitution of R groups account for the variation in properties and side-effect profile of the different members of this drug class. Highly potent blocker of gastric acid secretion, this class of medications exert their effects via a dose-dependent inhibitory action on hydrogen-potassium ATPase proton pump located on the luminal side of the gastric parietal cell. Proton pump inhibitors are mostly indicated in the treatment of chemotherapy induced gastroesophageal reflux disease (GERD), in addition, they are first line agents for the treatment of dyspepsia, Helicobacter Pylori eradication, and the prevention and treatment of NSAID and glucocorticosteroid-induced ulcers. There is evidence to support the use of PPIs for treatment of hemoptysis and to limit the incidence of rebleeding palliative patients with peptic ulceration, for metastatic esophageal and gastric carcinoma. The side effect profiles vary with each drug and there is potential for drug interactions especially in the setting of polypharmacy among palliative care patients.
Keywords: proton pump inhibitors (PPI)polytherapypalliative medicinegastroesophageal reflux disease (GERD)
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