Excessive use of Omeprazole or Protonix

crashcartqueen, BSN, RN · Apr 27, 2016

Yep!! Gotta have their "chest burny" medicine

GSDlvrRN, MSN · Apr 27, 2016

Yep! Omeprazole, pantoprazole, esomeprazole, famotidine, Tums.............. seems like everyone is getting one or the other before breakfast!

Phledd · Apr 27, 2016

Yep, most definitely.

I remember when Carafate was all the rage. And Propulsid too, though that turned out to be a bad idea....eek.

jdub6 · Apr 27, 2016

I believe this has a lot to do with core or quality measures for hospital discharge. Numerous conditions and meds are seen as "every pt with this must be on ppi." Most md,resident and student notes I read in the hospital have a whole section (along with neuro, respiratory, gi or along with pt issues like sepsis, diarrhea, etc) labeled "prophylaxis" that addresses heparin and the like along with gi prophylaxis which almost always means the meds you mentioned.

I do wonder if this is a bit overboard,although gi bleeds are certainly bad, there is increasing evidence that links some of these meds to cdiff, which is also bad and pretty common in ltc pts.

Perhaps the facility can look into ways to catch when these can be discontinued (many pts start them due to a course of treatment with steroids or the like which is likely to be very temporary but I think a lot of times the gi med is just continued forever).

bebbercorn · Apr 28, 2016

They are continued without discretion by a LOT of providers, and as many are OTC people assume they are safe, despite more and more documented risks with long term use...

Medscape: Medscape Access

"If they sell it over the counter, it must be safe..."

Riiiiiiight.

CapeCodMermaid, RN · May 1, 2016

Overuse of these medications can lead to CDiff. We get almost 100% of patients from the hospital on a PPI. Unless they have an active diagnosis of GI bleed, we ask the PCP to discontinue the med. People take far too many medications as it is.

littlespitfire · May 5, 2016

Yup. All our new admits from the hospital have omeprazole. It's their standing order... Most of the time they don't even know they were taking it. There was an article another nurse posted at work discussing effects in elderly patients of ppi and other meds. it drives me nuts, I'm a night walker and my 5 am med pass is everyone on synthroid, Lasix, aldactone, dig, and ppi. So basically I'm waking every person up at 5 am. Oh, and any qid meds are 6 am too... Usually ivabt. Here sir, let me shake you awake so you can take your omeprazole at the butt crack of dawn, even though you never had gerd or heartburn in your life and will probably refuse it anyway...

iShaybie, ADN · May 5, 2016

Overuse of these medications can lead to CDiff. We get almost 100% of patients from the hospital on a PPI. Unless they have an active diagnosis of GI bleed, we ask the PCP to discontinue the med. People take far too many medications as it is.

This is pretty alarming. I've been on famotidine for about 6 months and was on protonix for a year before it. And I still wake up in the middle of the night to take a few tums.

I could only imagine how terrible I'd feel if my pcp took me off; but the side effects you named make me afraid too!

CapeCodMermaid, RN · May 5, 2016

I'm assuming you aren't 80+ years old and don't live in a facility. I took a PPI for a while- had no side effects but I'm not 80+ and don't live in a facility. I don't go anywhere without a bottle of TUMS in my purse or desk or car or.....

caliotter3 · May 5, 2016

Tried to DC self off omeprazole, symptoms struck again with a vengeance. Vet has my doggie on the med too.

jdub6 · May 10, 2016

Just today I saw an ad on TV from a medical malpractice law firm looking for clients who have had renal problems up to and including esrd while or after taking a ppi. Supposedly there are two studies that found a correlation between these meds and kidney damage. Obviously this is not a reliable source to change your practice by- but I found it interesting. And couldn't help but think that every dialysis pt in the country will be calling them because it seems like anyone with chronic issues or who has been in the hospital is given these meds.