8 ms·

This is a big hammer. Please note this section: "A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such

This is a big hammer. Please note this section: "A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole." Induced hemophilia is no joke.

merpnderp 5y ago
Do people really get holes in their stomach often enough that this regiment would cause them to bleed to death?
- kahrl 5y ago
  Yes. Absolutely. GI issues are some of the most common medical problems. Ucers, polyps, sores, diverticula...
  - QuercusMax 5y ago
    My dad got a hole in his stomach from taking too much Advil (ibuprofen) for pain related to a broken vertebra.
    - kahrl 5y ago
      jeez. NSAIDs can do some nasty stuff when taken regularly. Most people just pop 'em like candy.
allturtles 5y ago
To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.
- favorited 5y ago
  Right. PPIs are available without prescriptions in the US, and are considered very low risk medications.
  - MarcoZavala 5y ago
  - jonathan-adly 5y ago
    Using PPIs for a short duration is safe, using PPIs chronically is not safe and the risks have to be weighted very carefully. It's by far the most intervened on medications by clinical pharmacists (usually discontinuing for inappropriate use)
    - allturtles 5y ago
      Maybe. Here's a skeptical view: "Despite a large number of studies, the overall quality of evidence for adverse effects of long-term use of PPIs is low to very low." [0] [0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/
      - jonathan-adly 5y ago
        10 years ago, as a young post-grad I spent a ridiculous amount of hours analyzing ALL the published peer-reviewed literature on the pros/cons of PPI prophylaxis for CVD patients and published my results in a peer reviewed article. I am literally the expert in that topic lol. Here is a nice paper[0] by Adly (me!), et al. I am biased, but I find it to be very comprehensive (and an excellent cure for insomnia!) [0]: https://pubmed.ncbi.nlm.nih.gov/23386069/ https://pubmed.ncbi.nlm.nih.gov/23386069/
        sizzle 5y ago
        Awesome, what else can you teach us about PPI that isn’t mainstream knowledge
tasogare 5y ago
> Induced hemophilia is no joke. Note that this is one of the possible side effect mentionned in Pfizer documentation of their covid vaccine, reported in article research articles like [1], and it doesn't seem to bother too much people. [1] https://pubmed.ncbi.nlm.nih.gov/33783953/ https://pubmed.ncbi.nlm.nih.gov/33783953/
- smileybarry 5y ago
  I don't see where the research article mentions a link to Pfizer (i.e.: acknowledgement, confirmed side effect, etc.) and googling the terms + "pfizer" brings up no official documentation about it.
senectus1 5y ago
yikes, PPI's. As a GERD sufferer thats come off PPI's after years of use, I wonder if non GERD sufferers will get the "kick back" when they come off the PPI's.

merpnderp 5y ago

Do people really get holes in their stomach often enough that this regiment would cause them to bleed to death?

kahrl 5y ago
Yes. Absolutely. GI issues are some of the most common medical problems. Ucers, polyps, sores, diverticula...
- QuercusMax 5y ago
  My dad got a hole in his stomach from taking too much Advil (ibuprofen) for pain related to a broken vertebra.
  - kahrl 5y ago
    jeez. NSAIDs can do some nasty stuff when taken regularly. Most people just pop 'em like candy.

allturtles 5y ago

To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.

favorited 5y ago
Right. PPIs are available without prescriptions in the US, and are considered very low risk medications.
- MarcoZavala 5y ago
- jonathan-adly 5y ago
  Using PPIs for a short duration is safe, using PPIs chronically is not safe and the risks have to be weighted very carefully. It's by far the most intervened on medications by clinical pharmacists (usually discontinuing for inappropriate use)
  - allturtles 5y ago
    Maybe. Here's a skeptical view: "Despite a large number of studies, the overall quality of evidence for adverse effects of long-term use of PPIs is low to very low." [0] [0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/
    - jonathan-adly 5y ago
      10 years ago, as a young post-grad I spent a ridiculous amount of hours analyzing ALL the published peer-reviewed literature on the pros/cons of PPI prophylaxis for CVD patients and published my results in a peer reviewed article. I am literally the expert in that topic lol. Here is a nice paper[0] by Adly (me!), et al. I am biased, but I find it to be very comprehensive (and an excellent cure for insomnia!) [0]: https://pubmed.ncbi.nlm.nih.gov/23386069/ https://pubmed.ncbi.nlm.nih.gov/23386069/
      - sizzle 5y ago
        Awesome, what else can you teach us about PPI that isn’t mainstream knowledge

tasogare 5y ago

> Induced hemophilia is no joke. Note that this is one of the possible side effect mentionned in Pfizer documentation of their covid vaccine, reported in article research articles like [1], and it doesn't seem to bother too much people. [1] https://pubmed.ncbi.nlm.nih.gov/33783953/ https://pubmed.ncbi.nlm.nih.gov/33783953/

smileybarry 5y ago
I don't see where the research article mentions a link to Pfizer (i.e.: acknowledgement, confirmed side effect, etc.) and googling the terms + "pfizer" brings up no official documentation about it.

senectus1 5y ago

yikes, PPI's. As a GERD sufferer thats come off PPI's after years of use, I wonder if non GERD sufferers will get the "kick back" when they come off the PPI's.