Research is showing that the numbers of proton pump inhibitors (PPIs) are being over prescribed during hospital stays and subsequently on discharge. There are studies published that show there are opportunities for substantial cost savings in relation to PPI prescription if there were some clinical guidelines used across the board nationwide. In addition to the costs, there are also risks for devastating side effects of continued use. There is a need to have a more defined reason for the administration and continuation of PPI’s.
The need for proton pump inhibitors Being admitted to a hospital is a scary thing – especially when unexpected. There is a common trend seen among patients when they are admitted. They are usually less mobile, taking multiple medications and prone to stress ulcers from the hospital stay itself. All of the aforementioned reasons can cause stress ulcers. This means there is a reflux of stomach contents into the lower esophagus. Excess stomach acid occurs when the patient is immobile due to the gastric contents moving from a lower pressure to a higher pressure. (Lewis, 2007 p.1003) Typically, this occurs when the patient is in a supine position or with an increase in abdominal pressure. There are a variety of reasons why the decreased pressure in the lower esophageal sphincter - ranging from medications to diet.
Doctors know this is a common manifestation and for that reason they will prescribe a proton pump inhibitor or PPI when the patient is admitted. PPI’s work by decreasing the amount of acid produced in the stomach. Some examples of these medications are omeprazole, lansoprazole, and pantoprazole. These medications are used to treat erosive esophagitis, which is damage to the esophagus from stomach...
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...cking a PPI: It comes down to cost. Journal Of Family Practice, 57(4), 231-236.
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In a separate analysis we divided the patients to 2 groups, a group that used Proton pump inhibitor (omeprazole) and the control group; we found that out of 98 patients, 7 patients had PEP (5 sever, 1mild, 1 moderate) compared to 91patients that did not use PPI had 5 PEP. P value =0.7703
Jones, John D. (2003). Developing an effective generic prescription drug program. Benefits Quarterly, 19(1): 14-18. Retrieved on January 2014 from Proquest at http://search.proquest.com.ezproxy.trident.edu:2048/docview/194951070/1431E31606748D5718A/1?accountid=28844
... (2013) IMS health study points to a declining cost curve for U.S. medicines in 2012 Retrieved from http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=8659cf4add48e310VgnVCM10000076192ca2RCRD&vgnextchannel=437879d7f269e210VgnVCM10000071812ca2RCRD&vgnextfmt=default
McLeod, M., Ahmed, Z., Barber, N., and Franklin, B. D. (2014). A national survey of inpatient medication systems in English NHS hospitals. BMC health services research, 14(1), p93.
Histamine 2 Receptor Antagonist versus Proton Pump Inhibitors for the Prophylaxis of Stress Related Ulcers in the ICU
This service is experienced, documented, evaluated and paid for as Pharmaceutical Care. Pharmaceutical Care consists of a philosophy of practice, patient care process as well as a patient management system. Pharmaceutical Care has common integrated vocabulary consistent with other patient care practices such as medicine, dentistry and nursing. Philosophy of pharmaceutical care consists of a description of the social need for the practice, a concise and clear statement of individual practitioner responsibilities to meet this social need, the expectation to be patient-centered and the requirement to function within the caring paradigm. This philosophy of practice is expected and practiced by all health care professionals. The patient care processes must be consistent with the patient care processes of all other health care providers. These processes include the assessment of the client’s pharmaceutical needs, a health care plan that is constructed to meet the specific needs of the client and a process in which evaluates the health care plan to gauge the efficacy of decisions made and actions taken. Pharmaceutical care management system includes all resources needed to manage the client’s needs, which include the space provided, such as a clinic or hospital, an appointment system for patients, appropriate and ethical documentation, reporting of patient care, evaluation of decisions made and actions taken and payment of service
Patients who struggle to pay for their medication, struggle with life. The Pharmaceutical Industry( Big Pharma) makes the important name brand drugs expensive, they are forcing people to take the medication, and they are also forcing them to refill the prescriptions even if they don’t need them; every pill counts! The cost of medication from 2009 to 2016 has increased by 400%. The Tactics of Big Pharma have been found to be wrong by many people and their own companies. Insurance companies are paying for patients’ over priced medications, sometimes the insurance doesn’t even cover it because it is so overpriced. The pharmaceutical company should start applying new drugs that are less expensive, than taking money for themselves. Big Pharma
Per capita spending on prescription drugs in America is far greater than any other country. Kesselheim goes on to say that this is a natural result of America’s free market approach to healthcare resulting in monopolies. These healthcare monopolies are not held accountable for their high drug prices. The claims that these costs can be justified through research and development is rubbish, according to
Patients should avoid alcohol and tobacco. They should also eat small meals and avoid diets high in fat as these can exacerbate abdominal pain and diarrhea.
Some indigestion and heartburn medications can suppress the production of stomach acid, which is needed to absorb vitamin B12.
Acid reflux is experienced when gastric acids from the stomach move into the esophagus. The esophagus is the tube used to transport food from the mouth to the stomach to be digested. This tube is supposed to close after the food has been transported, blocking the acid in the stomach from entering the esophagus. Sometimes
For GERD therapy and diagnosis, the most important thing should be to reduce gastric acidity. There should be a food restriction excluding food that can lower LES pressure and patients’ weight and nutrition should be monitored for any loss or deficiencies. Before going into any diagnosis, GERD is commonly associated with overweight or obesity, impaired nutrient utilization, inadequate vitamin or mineral intake, swallowing difficulty or altered GI function. So for its assessment, patients should see if they have for upper GI disorder and find any food nutrition related history. GERD treatment goal is to increase LES competence, decrease in acid secretion and protect esophageal mucosa. Medications include in antacids, foaming agents, H2 antagonists proton pump inhibitors and prokinetics and if these do not work surgery is another choice such as fundoplication. Changing in nutrition diet is very critical. Nutrition wise, patient should definitely reduce in gastric acidity, consume smaller and more frequent meals. Foods that are recommended include food group
Hanlon, J. T., Schmader, K. E., Ruby, C. M., & & Weinberger, M. (2001). Suboptimal prescribing in older inpatients and outpatients. Journal of the American Geriatrics Society, 49 200–209(2), 200-209.
It is necessary to pay attention to how ones body reacts to the food and drink you consume to see what eases your discomforts and what causes your acid reflux conditions. When determining a heartburn remedy one may possibly either have to remove acidic foods and or perhaps you have to ingest additional acid to enable proper absorption and breakdown of food in your
Omeprazole belongs to the family of medications called proton pump inhibitors (PPIs). It slows or prevents the production of acid within the stomach and is used to treat conditions where reduction in acid secretion is required for proper healing including stomach and intestinal ulcers (gastric and duodenal ulcers), the prevention and treatment of ulcers associated with medications known as NSAIDs, reflux oesophagitis, Zollinger-Ellison syndrome, heartburn, and gastro oesophageal reflux disease (GERD). Omeprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and this allows the stomach and oesophagus to heal. This essay will discuss the therapeutic effect and uses of Omeprazole, its mechanism of action, administration and dosage, dose-related and non-d...