Several points that should be noticed during PPI treatment for peptic ulcers in elderly patients

Proton pump inhibitor(PPI) is used for the treatment of peptic ulcer diseases for the following three purposes. Firstly, it is used to facilitate the ulcer healing and pain relief. Secondly, it is used for the eradication of H. pylori to minimize the recurrence of ulcer diseases. Thirdly, intravenous infusion of PPI is used for the hemostasis in patients with bleeding ulcers. Plasma concentration and acid suppressing effect of PPI are reported to be slightly augmented when standard doses of PPI are used in elderly cases. Since PPI is a safe drug and age-related increase in its plasma concentration is not remarkable, the dose adjustment of PPI may not be necessary even in elderly patients. Some PPIs are, however, reported to have metabolic interactions with other drugs such as diazepam and digoxin. Therefore drug interaction should be considered when the PPI is administered to the elderly with accompanying diseases.