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Pharmacy and Wellness Review

Abstract

Proton pump inhibitors (PPIs) are among the most commonly prescribed and widely used medications for the treatment of gastrointestinal (GI) disorders. PPIs irreversibly inhibit the H+/K+-ATPase enzyme, effectively reducing gastric acid secretion and providing sustained relief for acid-related conditions. With the approval of over-the-counter (OTC) PPIs, the number of individuals taking these medications for prolonged periods of time without routine monitoring for the appropriateness of therapy has increased. The overuse of OTC PPIs can be attributed to a number of factors, including ease of access, perceived safety, inadequate understanding of OTC PPI treatment intervals, and a lack of awareness regarding the consequences of long-term therapy. An increasing number of studies are revealing the detrimental effects of long-term PPI use: vitamin and mineral deficiencies, osteoporosis, exacerbation of kidney disease, and increased risk of Clostridioides difficile (C. diff) infection. As the number of patients utilizing these medications increases, the role of pharmacists in mitigating the risks associated with long-term PPI use is paramount for patient safety. Pharmacists are positioned to provide patient-centered care and can play pivotal roles in educating patients about the safe use of OTC PPIs and collaborating with prescribers to identify candidates for PPI deprescribing.

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