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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Are The Ill Effects Of Incorrect Prescription?

It has become routine practice with most of the Indian doctors to prescribe PPIs viz Pantoprazole/ Rabeprozole along with NSAIDS like Diclofenac/ /Aceclofenac/ Piroxicam etc. with Domperidone. Is it justifiable? Initially when Omeprazole was introduced , the dosage recommended was 20 or 40 mg once daily 15 minutes to 30 minutes before breakfast. Beyond that precipitation of Achlorhydria was mentioned and more than 40 mg/ day of Omeprazole was discouraged. These days 40mg of Rabeprazole / Pantaprazole in BID doses or even more is being prescribed. Is it really justified? Are there any references supporting higher doses?
Tue, 9 Dec 2014
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General & Family Physician,  's  Response
Hello
Since this is not a question regarding for disease but logical or illogical .
So , when I started my practice as a medical officer in 1980 , there was ocid ( omeprazole 20-40 mg ) ,once or twice , you are right .
In 1980 -1981 I only attend one case of myocardial infarction .
Now a days I don't know , how many cases I have treated .
Pantoprazole or rabeprazole are advised once in day , you are right , but all studies based on exchange of papers and nobody is here to listen the doctor , what he want to tell them .
They take ( consume ) spicy , greasy , oily , fried , pizza, burger , sweets and each and every thing ,which produces HYPER ACIDITY or gastritis .
But above all one thing is responsible for gastritis or hyper acidity is TENSION or anxiety .
Hectic hurried life , spirit , smoking are also responsible for gastritis , so how the doctor will control these symptoms , none other than HIGH doses , so the prime aim is to provide relief not logic.
Any how , my English is not good but I tried my the best to explain.
Good luck.
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What Are The Ill Effects Of Incorrect Prescription?

Hello Since this is not a question regarding for disease but logical or illogical . So , when I started my practice as a medical officer in 1980 , there was ocid ( omeprazole 20-40 mg ) ,once or twice , you are right . In 1980 -1981 I only attend one case of myocardial infarction . Now a days I don t know , how many cases I have treated . Pantoprazole or rabeprazole are advised once in day , you are right , but all studies based on exchange of papers and nobody is here to listen the doctor , what he want to tell them . They take ( consume ) spicy , greasy , oily , fried , pizza, burger , sweets and each and every thing ,which produces HYPER ACIDITY or gastritis . But above all one thing is responsible for gastritis or hyper acidity is TENSION or anxiety . Hectic hurried life , spirit , smoking are also responsible for gastritis , so how the doctor will control these symptoms , none other than HIGH doses , so the prime aim is to provide relief not logic. Any how , my English is not good but I tried my the best to explain. Good luck.