When should a proton pump inhibitor not be used?
On One Hand: Proton Pump Inhibitor UseA proton pump inhibitor (PPI) decreases gastric acid secretion by irreversibly blocking the H+/K+ ATPase (gastric proton pump) of the gastric parietal cell. PPIs such as Prilosec (omeprazole), Prevacid (lansoprazole), Protonix (pantoprazole) and Nexium (esomeprazole) are more effective than H2 antagonists (ranitidine). The PPIs are used for dyspepsia, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), Barrett’s esophagus, stress gastritis prevention, gastrinomas and Zollinger-Ellison syndrome.On the Other: Contraindications/WarningsIn general, PPIs are well tolerated. An absolute contraindication is prior allergic reaction to PPI. A PPI can sometimes cause erythema multiforme, pancreatitis, Stevens Johnson syndrome and acute interstitial nephritis. There is an increased risk of Clostridium difficile infection and pneumonia. PPI use can also alter absorption of vitamin B12 leading to a deficiency. If taking Plavix (clopidogrel), a P
