Segurança e efetividade do uso de inibidores da bomba de próton em idosos : uma overview

Abstract

Proton pump inhibitors (PPIs) are drugs indicated for the therapy of diseases related to gastric hypersecretion, such as dyspepsia, duodenal and non-duodenal ulcers, gastroesophageal reflux disease and eradication by H. Pylori, as they suppress acid release gastric through inhibition of the enzyme H+/K+-ATPase. This drug class is among the most prescribed worldwide, and are widely used drugs by the elderly in an attempt to alleviate food discomforts by suppressing gastric secretion and raising stomach pH. The uses of PPIs have few side effects and good safety. However, recent studies have shown that in chronic use, PPIs are proving to be a warning factor, as adverse effects such as bone fractures, pneumonia, dementia, poor absorption of nutrients, intestinal infections, and even cognitive decline in the elderly are increasing significantly affecting the quality of life of the elderly. The present work aims, through an OVERVIEW, to determine a mapping of systematic reviews on the safety and effectiveness of the use of Proton Pump Inhibitors in the elderly. For this, a comprehensive search of systematic reviews that addressed the safety and effectiveness of the use of proton pump inhibitors in the elderly was carried out in the PubMed and SciELO databases. The search strategy was defined following the PRISMA and COCHRANE recommendations. The screening, eligibility and data extraction steps were performed in duplicate using the Rayyan platform – Intelligent Systematic Review, in cases of disagreement, they were resolved by discussion. After the screening and eligibility process, 3 systematic reviews were included. The main outcomes found corroborate data from clinical trials showing a substantial benefit for gastroprotection in the prevention of gastrointestinal events associated with NSAID therapy in elderly patients, success of interventions in different population groups, whether community, hospital or residential patients, where the ingredients Key to successful interventions may include clinician motivation and an effective way with specific interventions for describing PPIs. Finally, data showed that the use of PPIs was not significantly associated with the risk of dementia, but the results may be clinically significant and useful in discussing the potential risks of PPI therapy with patients. Therefore, it was possible to infer that despite an adequate effectiveness profile, the chronic use of PPI in the elderly is associated with an increased risk of numerous adverse reactions, including bone diseases, kidney damage, dementia, Clostridium difficile infection, magnesium deficiency, iron and vitamin b2 e, this predicts the need for rationality in the prescription and the indication for the shortest period of time possible