<prompt> Which is not a long term adverse effect of proton pump inhibitors?Pelvic fracturePneumoniaVitamin -B12 deficiencyHypothyroidism  <response>: Proton pump inhibitors PPI - They are the strongest acid inhibiting drugs. - All PPI are prodrugs. - They are enteric coated - They are irreversible inhibitors of the proton pump. So, they work like hit run drugs. - They inhibit CYP2C19. - Adverse effects o Osteoporosis calcium deficiency o Megaloblastic anaemia Vitamin B12 deficiency o Increased infection like pneumonia o Carcinoid tumor seen in rats and mice o hypergatrinemia following withdrawal of drug 