So after tonight's meetings, I thought I'd try to catch up on my reading, seeing as how I got distracted by HealthTap's Summer 2013 Top Doctors Competition. It turns out that one of the major issues w/post-hospital care is sorting through all the medications our patients are discharged on, some of which may not really be necessary. Case in point are proton pump inhibitors (PPIs) which are often used during hospitalization to prevent stress ulcers and then just left on the discharge medication list even if the patient never had any complaints prior to hospitalization.
You can argue that PPIs must be safe because after all, they're available over-the-counter w/o prescription. Surely, we wouldn't allow them to be made freely available to the public if there were some concern, right? Yet, of late, they've been linked to osteoporotic fractures, possibly due to their adverse effect on calcium absorption. If that weren't bad enough, PPI use has also been linked to community acquired pneumonia & cardiac dysrhythmia, as well as C difficile diarrhea. So it shouldn't be any surprise to find a retrospective case-control study published earlier this month in the Mayo Clinic Proceedings in which the authors again linked PPI use to C difficile infection, this time during hospitalization.
This doesn't mean that you shouldn't take your PPI if you need it. But like any other medication, procedure or surgery, don't take it if you don't need it! In other words, make sure benefit exceeds risk.
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