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drug adverse effects of H2-receptor antagonists

Adverse effects: 1) increased risk of community-acquired pneumonia* (0.02%) risk may be greater for: a) elderly b) COPD c) asthma d) immunocompromised 2) increased risk of hospital-acquired pneumonia [3][4] 3) increased risk of necrotizing enterocolitis in very low birth weight infants 4) increased risk of hip fracture [5] - no increase in risk [6] 5) use during the 1st 6 months of life associated with increased risk for food allergy during childhood (RR=2.2) [7] 6) increased risk for allergy * Low pH of stomach acid is antimicrobial. In the absence of acid, refluxed & aspirated gastric contents may contain pathogen that causes pneumonia.

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DRUGS: H2 receptor antagonist FORM: drug adverse effects h2 receptor antagonist

References

  1. Prescriber's Letter 11(12): 2004 Community-Acquired Pneumonia Risk with Acid-Suppressive Drugs Detail-Document#: 201207 (subscription needed) http://www.prescribersletter.com
  2. Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB. Risk of community-acquired pneumonia and use of gastric acid- suppressive drugs. JAMA. 2004 Oct 27;292(16):1955-60. PMID: 15507580
  3. Prescriber's Letter 16(7): 2009 Overuse of Acid Suppressing Drugs in the Hospital Detail-Document#: 250720 (subscription needed) http://www.prescribersletter.com
  4. Eom C-S et al. Use of acid-suppressive drugs and risk of pneumonia: Systematic review and meta-analysis. CMAJ 2010 Dec 20 PMID: 21173070 http://www.cmaj.ca/cgi/content/abstract/cmaj.092129v1
  5. Corley DA, Kubo A, Zhao W, Quesenberry C. Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients. Gastroenterology 2010; 139(1):93-101. Epub 2010 Mar 27. PMID: 20353792
  6. Eom CS, Park SM, Myung SK, Yun JM, Ahn JS. Use of acid-suppressive drugs and risk of fracture: a meta-analysis of observational studies. Ann Fam Med. 2011 May-Jun;9(3):257-67. doi: 10.1370/afm.1243. PMID: 21555754
  7. Mitre E, Susi A, Kropp LE, et al Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr. Published online April 2, 2018 PMID: 29610864 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2676167
  8. Jordakieva G, Kundi M, Untersmayr E et al Country-wide medical records infer increased allergy risk of gastric acid inhibition. Nature Communications. volume 10, Article number: 3298 (2019) PMID: 31363098 Free PMC Article https://www.nature.com/articles/s41467-019-10914-6