Bolus or Intravenous Infusion of Ranitidine: Effects on Gastric pH and Acid Secretion

Ballesteros, M.

doi:10.7326/0003-4819-112-5-334

Cited by 75 publications

(29 citation statements)

References 11 publications

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“…Both a meta-analysis (19) and large randomized controlled trial (20) failed to show any reduction in recurrent bleeding rates. These findings may be due to the rapid onset of tolerance to the H 2 RAs (21,22), and their subsequent inability to maintain high intragastric pH, even with continuous infusion (11).…”

Section: Discussionmentioning

confidence: 96%

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Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

Enns

Andrews

Fishman

et al. 2004

Canadian Journal of Gastroenterology

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BACKGROUND:Intravenous forms of proton pump inhibitors (IV PPI) are routinely used for patients with acute upper gastrointestinal bleeding, but a significant concern for their inappropriate use has been suggested.PATIENTS and METHODS:All consecutive patients who received IV PPI (pantoprazole) over 20 months in six Canadian hospitals were reviewed. Prescribing practices, endoscopic findings and outcomes were recorded.RESULTS:A total of 854 patients received IV PPI. Over 90% of patients were given IV PPI for treatment of known or suspected active upper gastrointestinal bleeding. Most patients (69%) underwent upper endoscopy, and 58% of these patients had peptic ulcer disease (PUD). The majority of patients who had endoscopy (57%) had IV PPI administered in advance of the procedure. Of the 334 patients who had IV PPI given in advance, 46 (13.8%) were found to have high risk bleeding PUD stigmata at endoscopy. The remaining 288 patients (86.2%) with advance IV PPI had low-risk PUD lesions or non-PUD lesions; IV PPI was continued after endoscopy in 164 (56.9%) of these patients.CONCLUSIONS:IV PPI is often used before endoscopy in suspected upper gastrointestinal bleed and maintained, regardless of endoscopic findings, after the endoscopy in many Canadian centres. Further study is required to support these clinical practices.

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Section: Discussionmentioning

confidence: 96%

“…This is consistently achieved with a bolus of 80 mg followed by a continuous infusion of IV PPI, as used in key clinical studies (11). The optimal timing of administration of IV PPI is not known.…”

mentioning

confidence: 99%

Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

Enns

Andrews

Fishman

et al. 2004

Canadian Journal of Gastroenterology

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“…These agents require frequent dosing, and there is some evidence to suggest that continuous infusions of the intravenous formulations may achieve better pH control than bolus administration. 21,22 Tolerance to H 2 -receptor antagonist acid inhibition develops within 72 hours of commencement. 23,24 Adverse effects include central nervous system disturbances, especially in elderly patients with intravenous administration.…”

Section: Specific Stress Ulcer Prophylaxismentioning

confidence: 99%

Is Prophylaxis for Stress Ulceration Useful?

Hayes¹,

Marsh²

2010

Evidence-Based Practice of Critical Care

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“…Collins and Langman [52] performed a meta-analysis of tenance of gastric pH4.0 for 65-85% of the day [47,48]. In general, the effects of even high-dose IV H 2 RA therapy 27 published and unpublished, randomized controlled trials (RCTs) of therapy.…”

Section: Physiology Of Acid Suppressionmentioning

confidence: 99%

Critical Review of Acid Suppression in Nonvariceal, Acute, Upper Gastrointestinal Bleeding

Yacyshyn

Thomson²

2000

Dig Dis

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Nonvariceal, upper gastrointestinal (GI) bleeding is a very common source of morbidity and mortality. The concept of ulcer clot dissolution being facilitated by a low gastric pH has allowed us to better understand the pathophysiology of nonvariceal upper GI bleeding. Placebo-controlled trials have shown the benefit of oral proton pump inhibitor administration in contrast to H₂ receptor antagonists. Furthermore, our recent experience with intravenous proton pump inhibitors has reinforced these observations.

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Bolus or Intravenous Infusion of Ranitidine: Effects on Gastric pH and Acid Secretion

Cited by 75 publications

References 11 publications

Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

Is Prophylaxis for Stress Ulceration Useful?

Critical Review of Acid Suppression in Nonvariceal, Acute, Upper Gastrointestinal Bleeding

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