A Pilot Study of Efficacy and Safety of Continuous Intravenous Infusion of Pantoprazole in the Treatment of Severe Erosive Esophagitis

Cai, Qiang; Barrie, Mahmoud; Olejeme, Henry; Rosenberg, Marc D.

doi:10.1007/s10620-007-0044-6

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…PPIs only inhibit stimulated parietal cells with active proton pumps and this is most successfully and rapidly achieved by administering a bolus dose intravenously (providing 100% bioavailability theoretically); continuous infusion then provides a steady state of the drug to inactivate any newly synthesized proton pumps, as well as any newly recruited proton pumps on parietal cells which continue to be stimulated by gastrin, histamine and food [40]. In one study, oral and IV pantoprazole were equipotent in raising intra-gastric pH, when administered at the same dose and intervals [41].…”

Section: Intra-gastric Ph Studies-oral Versus Intravenous Ppimentioning

confidence: 99%

“…The conventional dosage of infusional IVPPIs (80 mg bolus followed by 8 mg/h for 72 h), used in several studies and endorsed by consensus statements have been challenged by studies which have found no difference between high dosage and low dosage IVPPI [41,50,51]. Conducted a study across 11, Italian centers, and found no difference in in-hospital rebleeding and overall mortality rates, in patients who were given the conventional high dose PPI infusion, compared with those who had a standard dose of 40 mg IV daily for 72 h [52].…”

Section: Post-endoscopic Intravenous Ppimentioning

confidence: 99%

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Oral Ppi VS IV Ppi in Hospitalized Patient

2018

JGDS

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Objectives: Of this study have been produced in order to promote effective use of proton pump inhibitors (PPIs) and (H2RAs) histamine II receptor antagonists at AL-Zahraa University Hospital (ZUH) in Lebanon. The aims: Of the study are to ensure PPIs use is limited to situations where there is indicated and there is a clear evidence of benefit, in order to decrease the cost when possible without affecting the patient’s clinical outcome. Setting: Medical and surgical in-patients floors at AL-Zahraa University Hospital (ZUH) were used for this study, which include 57medical and 43 surgical beds. Methods: In this study 100 patients files were reviewed for appropriate IVPPIs uses in two separate time intervals, over six months period started on January 1st, 2016 and ended on June 30th, 2016 and divided into two equal separate time intervals, pre implementation and post implementation of restriction dispensing policy, in order to determine the proper indication and the cost impact of restriction procedure. The main outcomes measure the cost difference between pre and post restriction periods. Results: During the pre-restriction period, the majority of IVPPIs vials were dispensed to patients able to tolerate oral medications with no proper indications to IVPPIs use, the daily consumption of IVPPIs were 48 vials (960 $) in the pre-restriction period as compared to only 2 vials (40$) in the post restriction period, therefore the associated daily cost was reduced from 960$ to 40$. Conclusion: This study highlighted the impact of proper use of PPIs based on implantation of the dispensing authorization restriction form of IVPPIS use which based on the international protocols for peptic ulcer drugs uses, leading to statistically significant in hospital patient’s daily cost reduction by 24 folds.

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Section: Intra-gastric Ph Studies-oral Versus Intravenous Ppimentioning

confidence: 99%

Section: Post-endoscopic Intravenous Ppimentioning

confidence: 99%

Oral Ppi VS IV Ppi in Hospitalized Patient

2018

JGDS

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“…The decision to administer IV bolus PPI probably rests on a patient's ability to swallow oral PPIs. In a pilot study looking at the safety and efficacy of highdose infusional pantoprazole in the treatment of erosive esophagitis, patients with grade 4 esophagitis were randomized to receiving either high dose infusional or intermittent bolus IV pantoprazole (40 mg daily for 72 h) [Cai et al 2008]. Both groups were treated with oral pantoprazole 40 mg daily for 4 days afterwards.…”

Section: Intravenous Ppi In Gastroesophageal Reflux Diseasementioning

confidence: 99%

Review: A clinical guide to using intravenous proton-pump inhibitors in reflux and peptic ulcers

Pang

Graham

2010

Therap Adv Gastroenterol

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Intravenous (IV) proton-pump inhibitors (PPIs) are potent gastric acid suppressing agents, and their use is popular in clinical practice. Both IV and oral PPIs have similarly short half-lives, and their effects on acid secretion are similar, thus their dosing and dosage intervals appear to be interchangeable. The possible exception is when sustained high pHs are required to promote clot stabilization in bleeding peptic ulcers. Continuous infusion appears to be the only form of administration that reliably achieves these high target pHs. IV PPI is indicated in the treatment of high-risk peptic ulcers, complicated gastroesophageal reflux, stress-induced ulcer prophylaxis, ZollingerEllison syndrome, and whenever it is impossible or impractical to give oral therapy. The widespread use of PPIs has been controversial. IV PPIs have been linked to the development of nosocomial pneumonia in the intensive care setting and to spontaneous bacterial peritonitis in cirrhotic patients. This review discusses the use of IV PPI in different clinical scenarios, its controversies, and issues of appropriate use.

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“…Future targets for study include more extensive trials on the use of continuous iv pantoprazole in the treatment of severe erosive esophagitis and longterm studies on the safety and efficacy of oral suspension formulation. 58 In addition, expanding FDA approval for the use of pantoprazole in children and adolescents is currently being considered. 59,60…”

Section: Conclusion and Future Targetsmentioning

confidence: 99%

An update on the use of pantoprazole as a treatment for gastroesophageal reflux disease

Mathews

Reid

Tian

et al. 2010

CEG

Self Cite

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Gastroesophageal reflux disease (GERD) is a chronic, recurrent disease that affects nearly 19 million people in the US. The mainstay of therapy for GERD is acid suppression. Proton pump inhibitors (PPIs) are the most effective medication for both initial treatment and maintenance therapy of GERD. Pantoprazole, a first-generation PPI, was approved by the FDA in 2000 for the treatment of erosive esophagitis associated with GERD. It has been used in more than 100 different countries worldwide. It is one of the few PPIs available in multiple forms: a delayed-release oral capsule, oral suspension, and intravenous. Pantoprazole been shown to improve acid reflux-related symptoms, heal esophagitis, and improve health-related quality of life more effectively than histamine-2 receptor antagonists. Evaluated in over 100 clinical trials, pantoprazole has an excellent safety profile, is as efficacious as other PPIs, and has a low incidence of drug interactions. It has also been shown to be safe and effective in special patient populations, such as the elderly and those with renal or moderate liver disease.

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A Pilot Study of Efficacy and Safety of Continuous Intravenous Infusion of Pantoprazole in the Treatment of Severe Erosive Esophagitis

Abstract: Severe erosive esophagitis can be completely healed in a few days if pantoprazole is given intravenously and continuously for 72 h. It is safe to give pantoprazole intravenously and continuously for treatment of severe erosive esophagitis.

Cited by 5 publications

References 21 publications

Oral Ppi VS IV Ppi in Hospitalized Patient

Oral Ppi VS IV Ppi in Hospitalized Patient

Review: A clinical guide to using intravenous proton-pump inhibitors in reflux and peptic ulcers

An update on the use of pantoprazole as a treatment for gastroesophageal reflux disease

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