OBjECTiVES 1. Describe the proposed mechanism of the interaction between clopidogrel and proton pump inhibitors. 2. Summarize the pharmacologic/pharmacodynamic evidence for the interaction between clopidogrel and proton pump inhibitors. 3. Summarize the clinical evidence for the interaction between clopidogrel and proton pump inhibitors. 4. Describe the food and Drug Administration’s updated wa...

Proton pump inhibitors inhibit the gastric H+/K+-ATPase via covalent binding to cysteine residues of the proton pump. All proton pump inhibitors must undergo acid accumulation in the parietal cell through protonation, followed by activation mediated by a second protonation at the active secretory canaliculus of the parietal cell. The relative ease with which these steps occur with different pro...

There is currently a lack of evidence to suggest superior clinical efficacy of one oral proton pump inhibitor over any other. Proton pump inhibitors display similar doseresponse relationships with similar potencies and efficacies at the equivalent dose. The decision to select one proton pump inhibitor over another is likely to be based on the agents’ licensed indication, patient tolerability an...

Intravenous (IV) administration of a proton pump inhibitor (PPI) is a faster way to achieve gastric acid suppression than oral administration of the same agent. Peak suppression after IV administration occurs within hours, compared with several days later after oral administration. Thus the IV route of administration offers a faster onset of gastric suppression, achievement of intragastric pH c...

staphylococcus aureus causes a wide variety of infections worldwide. methicillin-resistant s. aureus is one of most common causes of nosocomial and community acquired infections. the fluoroquinolones are an important class of antibiotics that used to treat infections caused by s. aureus. today, a significant increase in the rate of ciprofloxacin resistance in methicillin-resistant s. aureus str...

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with anothe...