In a combined statement from the AHA, ACC, and ACG, they have recommended expanding use of PPI’s in patients on antiplatelet or NSAID agents at risk for GI bleeding (guidelines). In patients who need an antiplatelet agent, they should be prescribed a PPI if they are at risk for GI bleeding (history of GI bleed or PUD, need for 2 or more antiplatelets, or concomitant anti-coagulation). Additionally, those starting anti-platelet therapy monotherapy with >1 risk factor (age>60, steroids, dyspepsia or GERD ) should also be started on a PPI. Also, in those with a history of PUD, Hyplori testing (and treatment) should be done before starting antiplatelet therapy. All of this is summarized in the following figure (figure)
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December 15, 2008 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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