Moderator EMEDPA Posted July 9, 2020 Moderator Share Posted July 9, 2020 https://time.com/5863532/covid-19-heartburn/ Interesting. might advise folks to switch to H2s for now, which are actually protective: https://www.cnn.com/2020/05/09/health/famotidine-covid-19-correlation-study/index.html or consider alternatives: https://pubmed.ncbi.nlm.nih.gov/26742306/ Quote Link to comment Share on other sites More sharing options...
Joelseff Posted July 10, 2020 Share Posted July 10, 2020 I remember this coming out early on and tjoght I read it was debunked or at least found that PPI use in covid pts were not significantly affected... I can try to find the followup article. Edited to add: I take it back! [emoji23] ok... Found a recent one saying that PPI do increase risk of covid 19 by up to 2x as likely while H2RAs carry a 15% less likelihood of infection. It's thought to be from the reduced acidity that promotes more susceptibility to enteric pathogens which SARS-cov2 is. https://www.medscape.com/viewarticle/933645 https://www.medscape.com/viewarticle/933697 Hmmm... Gotta have that conversation with my GERDies! Sent from my SM-G975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted July 10, 2020 Share Posted July 10, 2020 Great. Another hit piece on PPI’s. Reminds me of the dementia fiasco that still plaques the medication. Not discrediting the preliminary research but it does appear to be, once again, correlation rather than causation. Nobody should be on a ppi without necessity. That being said, there are very necessary circumstances including Barrett’s, ulcers, esophagitis, pylori, etc. I have lost count how many pts I’ve had lately that can not acquire famotidine because it is out of stock (largely due to its unproven benefit in covid as with other drugs). These are people that actually need this drug clinically and it’s being sucked up by folks with zero clinical reason or symptom. There a few options remaining with similar side effect profiles. 1 1 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted July 10, 2020 Share Posted July 10, 2020 Great. Another hit piece on PPI’s. Reminds me of the dementia fiasco that still plaques the medication. Not discrediting the preliminary research but it does appear to be, once again, correlation rather than causation. Nobody should be on a ppi without necessity. That being said, there are very necessary circumstances including Barrett’s, ulcers, esophagitis, pylori, etc. I have lost count how many pts I’ve had lately that can not acquire famotidine because it is out of stock (largely due to its unproven benefit in covid as with other drugs). These are people that actually need this drug clinically and it’s being sucked up by folks with zero clinical reason or symptom. There a few options remaining with similar side effect profiles.Yeah I remember the PPI and the Ranitidine hoopla when I worked in GI last year. I always give my pts the choice but I fully go over risks of stopping acid control esp PPI like Barret etc. Esp if my pt has esophageal erosions. It's like the ARB scare a few years ago too. I agree that this may likely be more correlary vs causative as with everything else in medicine, we gotta have the conversation with our pts and ultimately have them decide with our guidance. Sent from my SM-G975U using Tapatalk 2 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted July 10, 2020 Share Posted July 10, 2020 Add that Zantac causes cancer and Pepcid is even harder to find. Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted July 11, 2020 Share Posted July 11, 2020 Nationwide back order on famotidine as of today thanks to the rumors. Nobody wants to use Tagamet. This leaves us with PPIs for acid suppression. Of course there’s always carafate but its efficacy only goes so far in uncomplicated GERD. Roll out the baclofen and low dose elavil. Quote Link to comment Share on other sites More sharing options...
MediMike Posted July 11, 2020 Share Posted July 11, 2020 So here's the piece... https://journals.lww.com/ajg/Documents/AJG-20-1811_R1(PUBLISH AS WEBPART).pdf It was an online survey and there were quite a few discrepancies with the information entered (i.e. a large # of individuals with high school education or less claiming >$200k/yr) making one wonder how accurate the information was. With that being said, physiologically it makes sense. Unfortunately we have evidence of a great number of things that make physiologic sense which don't actually play out in the real world. Correlation ain't always causation amiright? Think about who else is probably on PPIs besides your GERDers, most elderly folk who are on DAPT post PCI, diabetics, and oftentimes those individuals who are chronically unwell. But who knows? If there's a safe alternative maybe consider it? Also consider that the lead author is the co-editor in chief of the journal in which it was published... 2 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted July 11, 2020 Share Posted July 11, 2020 (edited) Great, next you will tell me a bad golf swing increases risk for Covid-19.....why not. I've pretty much hit every one of the top 5 risk factors anyway, what's one more..... Edited July 11, 2020 by Cideous 1 Quote Link to comment Share on other sites More sharing options...
MediMike Posted July 11, 2020 Share Posted July 11, 2020 56 minutes ago, Cideous said: Great, next you will tell me a bad golf swing increases risk for Covid-19.....why not. I've pretty much hit every one of the top 5 risk factors anyway, what's one more..... I mean, the worse I play the more I drink...or is it the other way around...? Quote Link to comment Share on other sites More sharing options...
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