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Deprescribing proton pump inhibitors:

Proton pump inhibitors are often viewed as safe and well tolerated medications, and while the incidence of side effects, such as diarrhea,impaired B12 absorption, hypomagnesemia, Clostridium difficile infection, hip fractures, and pneumonia might be small, older people might be at higher risk of these conditions. When PPIs are inappropriately prescribed or used for too long, they can contribute to polypharmacy with its attendant risks of nonadherence, prescribing cascades, adverse reactions, medication errors, drug interactions, emergency department visits, and hospitalization
The target population includes adults older than 18 years of age (including the elderly) taking a continuous PPI for longer than 28 days for the purpose of treating GERD or esophagitis. The guideline does not apply to those with Barrett esophagus, those with severe esophagitis ,or those with documented history of bleeding gastrointestinal (GI) ulcers. Individual situations in which there might be risk factors that warrant continued use of PPIs are also outlined.



Reference :
http://www.cfp.ca/content/63/5/354.long

Thiazide diuretics can contribute to each of the following
metabolic effects EXCEPT
A. Hypomagnesemia
B. Hypouricemia
C. Hypercalcemia
D. Hypertriglyceridemia
E. Hyponatremia

Ticagrelor versus Clopidogrel in symptomatic PAD patients

Ticagrelor did not demonstrate a benefit over clopidogrel in symptomatic peripheral artery disease (PAD) patients, according to the results of the EUCLID Trial -
See more at: https://www.acc.org/latest-in-cardiology/articles/2016/11/10/15/11/sun-445pmet-euclid-effects-of-ticagrelor-vs-clopidogrel-in-pad-aha-2016 .o3CDSkKJ.dpuf
https://www.acc.org/latest-in-cardiology/articles/2016/11/10/15/11/sun-445pmet-euclid-effects-of-ticagrelor-vs-clopidogrel-in-pad-aha-2016

EUCLID: Ticagrelor vs. Clopidogrel in Symptomatic PAD Patients - American College of Cardiology Ticagrelor did not demonstrate a benefit over clopidogrel in symptomatic peripheral artery disease (PAD) patients, according to the results of the