The rates of common adverse events reported during treatment with proton pump inhibitors used in general practice in England: cohort studies
وتصريح أكثر من رائع من المؤلف: When choosing between alternative drugs prescribers will need to make some assessment of their comparative efficacy, cost, and side-effect profile [6]. However, the importance of side-effects is often forgotten [11], despite the likelihood that even minor side-effects can impact on patients' acceptability, tolerance and compliance with treatment, as well as have implications for sickness absence from work, costs of treating side-effects, and the costs of additional contact with health services. وهذا هام جدا في المسنين بالخصوص.--احمد شوقي محمدين 21:18، 15 أكتوبر 2016 (ت ع م)
وللمسنين: We also observed an increasing risk of diarrhoea associated with lansoprazole, but not pantoprazole, with increasing age. This suggests the hypothesis that older age may be a risk factor for diarrhoea in patients prescribed lansoprazole. --احمد شوقي محمدين 21:18، 15 أكتوبر 2016 (ت ع م)
وأيضاً تصريح أكثر من رائع: The observed event rates are likely to be an underestimate of the adverse events experienced by patients, because they may not report them to their general practitioner or the general practitioner may not have reported them on the green form. Nevertheless, since these events were infrequently reported even after prompted surveillance suggests that these drugs are well tolerated in the general practice setting. لهذا يجب إجراء دراسات محددة عن مشاكل الإبصار في المسنين مع هذه الأدوية. وأيضاً: It has previously be shown that reporting of events increases when doctors' attention is drawn to specific problems [34, 35].--احمد شوقي محمدين 21:18، 15 أكتوبر 2016 (ت ع م)
المؤلف يتحدث عن طريقة إستهلاك هذه الأدوية في الجدول رقم 1: Omeprazole, the first drug on the UK market, was more frequently prescribed for peptic ulcer, oesophageal reflux and hiatus hernia than lansoprazole or pantoprazole. Lansoprazole (second on the market) was almost twice as frequently prescribed for dyspepsia than omeprazole, and pantoprazole (third on the market) was over two-and-a-half times as frequently prescribed for dyspepsia than omeprazole. والرابط للجدول التالي يوضح كثرة إستخدام هذه الأدوية في عسر الهضم العام (حوالي 10-25% من الحالات الموصوف لها) وألم البطن العام (5-9% من الحالات الموصوف لها) وسبب آخر غير القرح أو عسر الهضم العام أو ألم البطن (حوالي 15% من الحالات الموصوف لها) وهذه أرقام مفزعة. ومتوسط العمر 55-58 عام وهذا يوضح التعمر. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014999/table/tbl1/ --احمد شوقي محمدين 21:18، 15 أكتوبر 2016 (ت ع م)
المؤلف لم يعاق إلا على مشاكل الجهاز الهضمي مثل الإسهال رغم إعترافه بالمشاكل الأخرى ويتحدث عن عيب تقارير الحالات. Experience of the adverse effects of proton pump inhibitors is greatest for omeprazole, which has been on the market longest [12]. There have been case reports of sexual disturbances [13], gynaecomastia [14], gout [15], lethargy [16], polyarthralgia [17], campylobacter gastroenteritis [18], atrophic gastritis [19], angiooedema [20], subacute myopathy [21], and ocular damage [22]. Case reports are an important method of improving knowledge about drug side-effects but data on the frequency of occurrence of adverse events are not readily available to prescribing doctors, who are therefore unable to put these isolated cases into a population perspective. There is also limited data comparing the side-effect profiles of proton pump inhibitors when used outside the carefully monitored setting of randomised controlled trials. However, relatively weak evidence has recently been published from physician and patient surveys linking lansoprazole with an increased frequency of side-effects, especially diarrhoea, abdominal cramps and headache, when used in the clinical setting [23–25]. Furthermore, a case series reported that microscopic colitis and associated diarrhoea were related to initiation of lansoprazole, and that colonic histology normalized on discontinuation of the drug [26].--احمد شوقي محمدين 21:18، 15 أكتوبر 2016 (ت ع م)
