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CAP Talk  |  Operations  |  Safety  |  Topic: Negative Effects of PPI Unproven Despite Wide Publicity
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Author Topic: Negative Effects of PPI Unproven Despite Wide Publicity  (Read 879 times)
RNOfficer
Seasoned Member

Posts: 232

« on: August 29, 2016, 08:57:26 PM »

http://www.kevinmd.com/blog/2016/08/ppis-kardashians-common.html

Every study has shown that sicker patients tend to be prescribed PPIs. They go to the doctor more often and at some point they will be prescribed these drugs if they complain of upper GI symptoms. Sick patients tend to develop other illnesses, and so PPIs will be associated with about any disease you can imagine in a database. Patients on PPIs are also more likely to have diabetes mellitus and chronic obstructive pulmonary disease, and it is only a matter of time before you see papers reporting that PPIs “cause” these diseases as well. An indicator that this is likely to be the case is that the unadjusted OR becomes much more attenuated when adjusting for confounding factors.

An old-school epidemiologist would never wake up for an odds ratio (OR) of less than two (to paraphrase the supermodel Linda Evangelista). None of the many papers reporting on the risks of PPIs have reported an adjusted OR greater than two. I am not saying that these studies should not be published, but it is important that the authors emphasize that a strong association is more likely to be causal whereas a weak association is usually due to confounding factors. This is the most likely explanation for the myriad diseases that PPIs apparently “cause.”
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MSG Mac
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Posts: 1,755
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« Reply #1 on: August 29, 2016, 10:32:04 PM »

Since CAP doesn't administer medication of any kind why is this relevant ?
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Michael P. McEleney
Lt Col CAP
MSG USA (Retired)
Mordecai
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« Reply #2 on: August 29, 2016, 10:53:45 PM »

Also, since CAP isn't full of pharmacists, can you introduce your acronyms with a definition first?
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LSThiker
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Posts: 1,675
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« Reply #3 on: August 29, 2016, 11:46:29 PM »

Also, since CAP isn't full of pharmacists, can you introduce your acronyms with a definition first?

PPI = Proton Pump Inhibitor.  The main mechanism of action for PPIs are to decrease the production and secretion of gastric acid.  They permanently prevent H+/K+ ATPase systems in the parietal cells (cells that secrete acid [HCl] in the stomach [fundus and body of the stomach more specifically]).  The fundus is the upper portion of the stomach, just where the esophagus connects, while the body of the stomach is the middle.  The lower portion is known as the antrum and the pyloric region.  These are not to be confused, although similar effects but different mechanism of action, with the H2-receptor antagonists. 

GI = gastrointestinal system.

OR = Odds ratio.  The measure of an association between an event and an outcome.  That is, in a nutshell, the odds that an event will occur given a specific set of circumstances. 

« Last Edit: August 29, 2016, 11:52:26 PM by LSThiker » Logged
Live2Learn
Seasoned Member

Posts: 394

« Reply #4 on: August 30, 2016, 11:33:00 AM »

Also, since CAP isn't full of pharmacists, can you introduce your acronyms with a definition first?

I think there is relevancy to the discussion, if for no other reason than because CAP IS full of people (a large proportion of SM and at least a few cadets) who regularly use Rx meds and an even larger number who use OTC meds.  While not a pharmacist nor a physician, the post is interesting. 
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FW
Salty & Seasoned Contributor

Posts: 2,122

« Reply #5 on: August 30, 2016, 11:50:45 AM »

While discussions like these may cause one to reach for the PPI's, it is always a good point to understand the risks/benefits in doing anything.  Taking OTC meds, or Rx meds do have consiquences if not taken "as directed".
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Pace
CAPTalk Moderator
Dark S'Member Lord
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Posts: 647

« Reply #6 on: August 30, 2016, 01:06:53 PM »

*Mr. Mackey voice* Drugs are bad, mkay.

Sorry, I'll go back under my rock now.
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Lt Col, CAP
Former C/Lt Col
Former this & that
Squadron guy
Spam
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« Reply #7 on: August 30, 2016, 03:28:41 PM »

*Mr. Mackey voice* Drugs are bad, mkay.

Sorry, I'll go back under my rock now.


Is it safer there?  We have drugs here, (transgender) sex in another thread... all we need now is...

ROCK AND ROOOOOOLLLLL!!!

Wow. What ever happened to CAP-mission centric discussion here.

Cheers,
Spam

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Alaric
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Posts: 718

« Reply #8 on: August 30, 2016, 03:45:53 PM »

What Spam said  :clap:
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Pace
CAPTalk Moderator
Dark S'Member Lord
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Posts: 647

« Reply #9 on: August 30, 2016, 03:57:05 PM »

1. Kevinmd is a pathetic pseudomedical website that will post anyone's medical propaganda that he agrees with.
2. I don't think PPIs qualify as that kind of drug.
3. All drugs have side effects, some of which may kill you slowly or quickly if taken long enough or in high enough doses.
4. The mention of sex as it pertains to public health from a health care provider's perspective should never be muted, especially around teenagers. Zika now appears to be more hype than danger. This is a grey area for captalk, and the concensus was to censor it.
5. Transgender is a fair topic of conversation as it pertains to executing our missions. No politics allowed.
6. Yes, I do live under a very cozy and safe rock.
7. You didn't get the memo about the 2017 CAP Rockfest?
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Lt Col, CAP
Former C/Lt Col
Former this & that
Squadron guy
LSThiker
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Posts: 1,675
Unit: Earth

« Reply #10 on: August 30, 2016, 04:29:44 PM »

1. Kevinmd is a pathetic pseudomedical website that will post anyone's medical propaganda that he agrees with.

Agreed.  KevinMD is more like WebMD.  I would never consider it a trusted source, rather an opinion. 

Quote
Zika now appears to be more hype than danger. This is a grey area for captalk, and the concensus was to censor it.

Disagree as an infectious disease scientist, but I agree that the media hyped it a lot like they did with WNV.  Nevertheless, I am not here to debate infectious disease topics unless I feel really compelled to enter in to it or I see complete misinformation (granted I have failed at times in the past). 
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Майор Хаткевич
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« Reply #11 on: August 30, 2016, 04:35:42 PM »

Zika is scary to an extent, especially those planning a family. I know that once we're back from our overseas vacation, I'll be getting tested to make sure I don't have it. But the post that was removed here was absolutely not appropriate for CAPTalk.
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CAP Talk  |  Operations  |  Safety  |  Topic: Negative Effects of PPI Unproven Despite Wide Publicity
 


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