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Are there indications for intravenous acid-inhibition in the prevention and treatment of upper GI bleeding?


, : Are there indications for intravenous acid-inhibition in the prevention and treatment of upper GI bleeding?. Scandinavian Journal of Gastroenterology. Supplement: 10-20

Administration of acid-inhibiting drugs in the prevention of stress ulcer bleeding is based on the hypothesis that pepsin activity is pH-dependent. In the treatment of peptic ulcer bleeding, acid-inhibition is based on the hypothesis that clot formation and clot lysis depend on intraluminal pH. Medications used in the prophylaxis of stress ulcer bleeding comprise antacids, sucralfate, H2-receptor antagonists and proton pump inhibitors (PPIs). Two studies show that prophylaxis with ranitidine is more effective than prophylaxis with sucralfate. PPIs give a more predictable and sustained pH control during prolonged dosing than ranitidine. Two trials show that patients who receive omeprazole run a significantly lower risk of bleeding than patients receiving ranitidine. The optimal initial treatment for bleeding peptic ulcers in patients with active bleeding or non-bleeding visible vessel is endoscopic therapy. Among patients with non-bleeding visible vessels or adherent clots who do not undergo endoscopic therapy, acid-inhibition with PPIs may significantly reduce rebleeding rate and need for surgery. After endoscopic therapy acid-inhibition with PPIs may have a beneficial effect on hemostasis. One direct comparative trial showed no significant difference in clinical outcomes between patients whether treated with high-dose or low-dose PPI. The use of multiple medications to treat concurrent conditions in ICU patients or bleeding peptic ulcer patients increases the risks of clinically important metabolic drug interactions. More recently developed PPIs are less dependent on CYP2C19 and probably have a lower potential for metabolic drug interactions. For both indications the optimal dose PPI has to be established.

US$29.90

PMID: 11232484


Other references

Brunk D.G.; Rich P.J.; Rhodes D., 1988: Compartmentation of glutamine and asparagine. Plant Physiology (Rockville) 86(4 SUPPL): 125

Petry, M.P.llina, L., 1983: Agricultural projections in the medium term; thoughts on empirical methods. Economie rurale: (155) 41-42

Hanham, A.F.; Dunn, B.P.; Stich, H.F., 1983: Clastogenic activity of caffeic acid and its relationship to hydrogen peroxide generated during autooxidation. Caffeic acid is a clastogenic cinnamic acid found in a conjugated form in a variety of foods. The possibility that the biological activity of caffeic acid is due to hydrogen peroxide generated during its autooxidation in solution was investigated...

Abrahamsen, D.; Weininger, O., 2011: The mind and death of a genius. Psychoanalytic Review 34(3): 336-356

Lorenz J., 1991: The Bathonian (Middle Jurassic); a geological stage in the Paris Basin notable due to its building stones. Colloques du CTHS: ges 117-125. 1991.

Bertolino, P.; Holmberg, R.; Reissmann, E.; Andersson, O.; Berggren, P-Olof.; Ibáñez, C.F., 2008: Activin B receptor ALK7 is a negative regulator of pancreatic beta-cell function. All major cell types in pancreatic islets express the transforming growth factor (TGF)-beta superfamily receptor ALK7, but the physiological function of this receptor has been unknown. Mutant mice lacking ALK7 showed normal pancreas organogenesis...

Pettitt, J.M., 1977: Dutton, R. H, Limnological theses and dissertations concerning Texas waters, 1897-1976. Texas Journal of Science, 281-4: 295-338

Eisenberg, S., 2011: Accessing implanted ports: still a source of controversy. In delivering safe care to their patients, oncology nurses should be familiar with the proper use and maintenance of implanted ports. Yet, despite the ubiquitous presence of implanted ports, accessing techniques and patency maintenance remain cont...

Safonov A.S., 1972: Nomograms for interpreting phase curves of magnetotelluric soundings. Vestnik Moskovskogo Universiteta, Seriya 4, Geologiya Moscow

Ovchinnikov Y.A., 1970: Principles of specific alkali metal ion binding by peptide and protein systems. Renold, A E 8th International Congress on Biochemistry Symposium 339p 58-59