Why is my PPI not working?

CPD

AP Staff

March 12, 2000

References

Gastro-oesophageal reflux in adults [published August 2022]. In: Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. At: www.tg.org.au
Daniels B, Schaffer A, Buckley NA, et al. The impact of tightened prescribing restrictions on proton pump inhibitor use in Australia: an evaluation using interrupted time series analysis. Pharmacoepidemiol Drug Saf 2022;31(3):370–8.
Fass R. Approach to refractory gastroesophageal reflux disease in adults. UpToDate. Current to September 2023.
MacFarlane B. Management of gastroesophageal reflux disease in adults: a pharmacist’s perspective. Integr Pharm Res Pract 2018;7:41–52.
Shin JM, Sachs G. Pharmacology of proton pump inhibitors. Curr Gastroenterol Rep 2008;10(6):528–34.
Reimer C, Lødrup AB, Smith G, et al. Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add-on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor. Aliment Pharmacol Ther 2016;43(8):899–909.
Yadlapati R, Gyawali CP, Pandolfino JE, et al. AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review. Clin Gastroenterol Hepatol 2022;20(5):984–94.e1.
Sansom LN, ed. Australian pharmaceutical formulary and handbook. 2024. Gastro-oesophageal reflux; [updated 2023]. At: https://apf.psa.org.au/non-prescription-medicine-guides/gastro-oesophageal-reflux/gather-patient-information
Montoro-Huguet MA. Dietary and nutritional support in gastrointestinal diseases of the upper gastrointestinal tract (I): Esophagus. Nutrients 2022;4819(14):1–24.
Mungan Z, Pinarbasi Simsek B. Which drugs are risk factors for the development of gastroesophageal reflux disease? Turk J Gastroenterol 2020;28(Supp1):S38–S43.
Ichikawa H, Sugimoto M, Sugimoto K, et al. Rapid metabolizer genotype of CYP2C19 is a risk factor of being refractory to proton pump inhibitor therapy for reﬂux esophagitis. Rapid J Gastroenterol Hepatol 2016;31(4):716–26.
Ionova Y, Ashenhurst J, Zhan J, et al. CYP2C19 allele frequencies in over 2.2 million direct-to-consumer genetics Research participants and the potential implication for prescriptions in a large health system. Clin Transl Sci 2020;13:1298–1306.
RACGP. Genomics in General Practice. (Last updated 12/01/2022).
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ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?