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Intragastric pH during Continuous Infusion with Pantoprazole in Patients with Bleeding Peptic Ulcer

dc.contributor.authorVan Rensburg C.J.
dc.contributor.authorHartmann M.
dc.contributor.authorThorpe A.
dc.contributor.authorVenter L.
dc.contributor.authorTheron I.
dc.contributor.authorLuhmann R.
dc.contributor.authorWurst W.
dc.date.accessioned2011-05-15T16:15:20Z
dc.date.available2011-05-15T16:15:20Z
dc.date.issued2003
dc.identifier.citationAmerican Journal of Gastroenterology
dc.identifier.citation98
dc.identifier.citation12
dc.identifier.issn00029270
dc.identifier.other10.1016/j.amjgastroenterol.2003.08.025
dc.identifier.urihttp://hdl.handle.net/10019.1/13296
dc.description.abstractOBJECTIVES: In managing patients with bleeding peptic ulcers, prevention of rebleeding is a particular challenge to hemostasis and fibrinolysis, both of which involve reactions that are impaired in acidic gastric environment. Therefore, such patients are expected to benefit from profound acid suppression. The present investigation aimed to establish a safe and, with regard to pH elevation, effective treatment that, based on in vitro evidence, should provide clinical benefit in this patient population. METHODS: Patients with acute bleeding peptic ulcers (Forrest Ia, Ib, IIa) after successful endoscopic hemostasis were enrolled in two pilot studies (N = 20 each). They were given an intravenous bolus injection of 80 mg of pantoprazole immediately followed by continuous infusion of either 6 mg/h or 8 mg/h pantoprazole for 72 h. Intragastric pH was measured continuously over 24 h and, if possible, for up to 48 h. RESULTS: Intragastric pH increased rapidly to values of about 6 with both treatments. For the 0-24 h period, the median pH values were 6.1 (68% range 4.5-7.4) and 6.1 (68% range 5.2-6.7) in patients receiving 6 mg/h and 8 mg/h continuous infusion, respectively; the values for the 0-48 h period were 5.9 (4.9-6.7) and 6.3 (5.5-7.0), respectively. The median percentage time that pH was ≥6 during the 0-48 h interval was 47% (68% range 28-89) for the 6 mg/h treatment group and 64% (68% range 41-84) for the 8 mg/h treatment group. Both treatment regimens with pantoprazole were well tolerated based on electrocardiographic measurements, vital signs, clinical laboratory values, and adverse events. CONCLUSIONS: Compared with the infusion with 6 mg/h pantoprazole, the continuous infusion of 8 mg/h pantoprazole showed a lower interindividual variability of the intragastric pH and a greater percentage of time that pH was ≥6. Thus, with regard to safety and efficacy, an initial 80-mg bolus injection, followed by 8 mg/h continuous infusion, seems to be the adequate treatment in patients with a high risk of rebleeding. © 2003 by Am. Coll. of Gastroenterology.
dc.subjectpantoprazole
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectbolus injection
dc.subjectclinical article
dc.subjectclinical protocol
dc.subjectconstipation
dc.subjectcontinuous infusion
dc.subjectcontrolled study
dc.subjectdrug safety
dc.subjectdrug tolerability
dc.subjectelective surgery
dc.subjectelectrocardiography
dc.subjectfemale
dc.subjectfibrinolysis
dc.subjectgastrointestinal endoscopy
dc.subjectgood clinical practice
dc.subjectheadache
dc.subjecthemostasis
dc.subjecthuman
dc.subjecthyperglycemia
dc.subjectin vitro study
dc.subjectinformed consent
dc.subjectinsomnia
dc.subjectiron deficiency anemia
dc.subjectmale
dc.subjectnausea
dc.subjectpeptic ulcer bleeding
dc.subjectpilot study
dc.subjectpriority journal
dc.subjectrash
dc.subjectrecurrent disease
dc.subjectrhinitis
dc.subjectstomach acid secretion
dc.subjectstomach acid suppression
dc.subjectstomach pH
dc.subjectthrombocytopenia
dc.subjectthrombophlebitis
dc.subjectvomiting
dc.subject2-Pyridinylmethylsulfinylbenzimidazoles
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAnti-Ulcer Agents
dc.subjectBenzimidazoles
dc.subjectFemale
dc.subjectGastrointestinal Hemorrhage
dc.subjectGastroscopy
dc.subjectHumans
dc.subjectHydrogen-Ion Concentration
dc.subjectInfusions, Intravenous
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectOmeprazole
dc.subjectPeptic Ulcer
dc.subjectPilot Projects
dc.subjectProspective Studies
dc.subjectRecurrence
dc.subjectSulfoxides
dc.subjectTreatment Outcome
dc.titleIntragastric pH during Continuous Infusion with Pantoprazole in Patients with Bleeding Peptic Ulcer
dc.typeArticle
dc.description.versionArticle


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