Evaluation of Intragastric pH in Acutely Ill Patients

Herrmann, Virginia M.

doi:10.1001/archsurg.1979.01370280165027

Cited by 32 publications

(3 citation statements)

References 20 publications

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“…When this dose was increased to 300 mg every 3 hours as a maximum, cimetidine was effective in keeping the pH above 4.0 in 74% of patients. Herrmann and Kaminski [37] in contrast found cimetidine superior to antacid in neutralizing ability when 2 fixed doses were compared. The mean intragastric pH with cimetidine (300 mg intravenously every 6 hours) was significantly higher than with antacid (30 ml every 2 hours), and was consistently greater than 5.0.…”

Section: Discussionmentioning

confidence: 90%

The role of histamine and histamine receptors in the pathogenesis and treatment of erosive gastritis

Gurll

Damianos

1981

World j. surg.

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Experiments have demonstrated the importance of histamine and intraluminal acid in the pathogenesis of gastric stress erosions. Histamine H2 receptor antagonists were found to protect against stress ulcers and bleeding in experimental animals and in patients at risk. The seriousness of this clinical problem has been almost eliminated by the use of antacids or histamine antagonists designed to reduce intraluminal gastric acidity.

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Section: Discussionmentioning

confidence: 90%

The role of histamine and histamine receptors in the pathogenesis and treatment of erosive gastritis

Gurll

Damianos

1981

World j. surg.

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“…From our results, additional clinical benefit from higher dose infusions would not be expected. 3 Box-whisker plots ofmedian pH values on alltreatments during the 24 hours, fastedperiod (0900-1300plus 2400-0800h), andfed period (1300-2400h). In theseplots the median is shown as a solid horizontal line and the box around it represents the two quartiles.…”

Section: Time (H)mentioning

confidence: 99%

Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer.

Merki

Witzel

Kaufman

et al. 1988

Gut

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SUMMARY Three double blind crossover studies were carried out to assess the ability of primed infusions of famotidine to raise intragastric pH over 24 hours in 12 duodenal ulcer patients. pH was measured continuously using intragastric electrodes and solid state recording devices. The studies compared the effects of placebo, famotidine 10 mg bolus injection iv followed by continuous infusions of 3.2 mg/h and 4 mg/h in random order. Gastric acidity decreased significantly with both dose regimens (p<00005) but the effects of either dosage were similar. During fasting median pH rose from 1.35 to 7.1 and 7.05 respectively. During the day, when standard meals were taken, median pH rose from 1.30 to 4-3 and 3.65 respectively. Despite continuous infusions the H2-antagonist was less effective during this time. The latter finding raises questions about gastric secretory control during the day when food is eaten.Intravenous antisecretory drugs are commonly used in patients with gastrointestinal bleeding,'2 in intensive care units34 and in anaesthesia.'6 The aim of such therapy is to raise the pH of the gastric milieu to a level at which peptic activity is minimal so that clot or mucosal digestion is limited. While it has been suggested that rebleeding from peptic lesions is decreased when pH rises to about pH 4,7 clear evidence that H2-receptor antagonists reduce rebleeding rates or mortality is lacking. A positive trend suggesting efficacy of cimetidine and ranitidine exists' and a possible reason for such limited success is that existing dosage regimens produce less than optimum changes in gastric pH.' It is clear that greater pharmacodynamic responses follow continuous infusions of H2-antagonists compared with bolus injections. 1"14 We have therefore measured the effect of continuous infusions of the new H2-receptor antagonist, famotidine (MSD, Yamanouchi), on gastric acidity measured continuously by intragastric glass electrodes.

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“…Conse-quently, treatment of upper GI bleeding has been suggested to include either a complete inhibition of acid secretion or total neutral ization of secreted acid [7]. The H2-receptor antagonists have been shown to substantially increase intragastric pH in healthy subjects [8] but the reports on their effectiveness in patients who are critically ill are conflicting [9][10][11][12][13]. Moreover, no controlled trial of suffi cient magnitude has shown convincing evi dence in favour of H2-receptor antagonist therapy in patients with upper GI bleeding [14].…”

mentioning

confidence: 99%

Intravenous Omeprazole: Effect on 24-Hour Intragastric pH in Duodenal Ulcer Patients

Lind

Moore²,

Olbe

1986

Digestion

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This study was aimed to identify an intravenous dosage regime of omeprazole which would sufficiently suppress acid secretion to maintain intragastric pH > 4 continuously. Thirteen duodenal ulcer patients in remission received omeprazole in daily intravenous doses ranging from 40 to 200 mg. Doses were successively increased as dictated by patient response. The intragastric pH data indicated that omeprazole given in twice or thrice daily regimes in total intravenous amounts of 200, 160 and 160 mg over a consecutive 3-day period markedly inhibited acid secretion and maintained intragastric pH > 4 with few and short-term exceptions.

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Evaluation of Intragastric pH in Acutely Ill Patients

Cited by 32 publications

References 20 publications

The role of histamine and histamine receptors in the pathogenesis and treatment of erosive gastritis

The role of histamine and histamine receptors in the pathogenesis and treatment of erosive gastritis

Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer.

Intravenous Omeprazole: Effect on 24-Hour Intragastric pH in Duodenal Ulcer Patients

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