QUESTION Crying is common in infants; however, caring for infants with inconsolable crying, previously also known as colic or reflux, is often extremely distressing for parents. Is there a benefit to using gastric acid suppression (eg, proton pump inhibitors [PPIs]) in these infants? ANSWER The use of PPIs in infants and children has increased in recent years. The efficacy of proton pump inhi...

BACKGROUND Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter. METHODS We prospectively assessed 100 patients with gastroesophageal reflux disease before and after sphincter augmentation. The study did not...

BACKGROUND AND PURPOSE evidence suggests that some proton pump inhibitors can attenuate the antiplatelet effect of clopidogrel. The significance of this potential drug interaction in patients with cerebrovascular disease is unknown. METHODS we conducted a nested case-control study of all Ontario residents aged ≥ 66 years newly treated with clopidogrel after a stroke between April 1, 2002, and...

BACKGROUND Five proton pump inhibitors are now available for use in North America. Claims of differences in the clinical efficacy of different strengths and/or agents have been made. AIM To identify any consistent evidence of differences in outcomes between agents or doses within this class of drugs. METHODS A search of the medical literature was performed in two electronic databases, and r...

INTRODUCTION AND OBJECTIVE Polymorphisms in genes encoding drug metabolizing enzymes may lead to varied enzyme activity and inter-individual variability in drug efficacy and/or toxicity. Since CYP2C19 and CYP3A4 genes code for enzymes involved in metabolizing wide variety of drugs including proton pump inhibitors, we sought to identify polymorphisms in these genes in order to study their impact...

Background: Five proton pump inhibitors are now available for use in North America. Claims of differences in the clinical efficacy of different strengths and/or agents have been made. Aim: To identify any consistent evidence of differences in outcomes between agents or doses within this class of drugs. Methods: A search of the medical literature was performed in two electronic databases, and ra...

INTRODUCTION Proton pump inhibitors, which are widely used as acid-inhibitory agents for the treatment of peptic ulcers, are mainly metabolized by 2C19 isoenzyme of cytochrome P450 (CYP2C19). CYP2C19 has genetic polymorphisms, associated with extensive, poor, intermediate or ultra-rapid metabolism of proton pump inhibitors. Genetic polymorphisms of CYP2C19 could be of clinical concern in the tr...

BACKGROUND Most proton pump inhibitors inhibit the bioactivation of clopidogrel to its active metabolite. The clinical significance of this drug interaction is unknown. METHODS We conducted a population-based nested case-control study among patients aged 66 years or older who commenced clopidogrel between Apr. 1, 2002, and Dec. 31, 2007, following hospital discharge after treatment of acute m...

OBJECTIVE To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction. DESIGN Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark. PARTICIPANTS All aspirin treated patients surviving 30 days after a first myocardial infarction from 1997 to...