Loss of Efficacy of Famotidine in the Control of Gastric Acid Secretion in Patients with Zollinger-Ellison Syndrome Reversed by Omeprazole

Corleto, Vito D.; Annibale, Bruno; Saggioro, A.; Puoti, M.; Cassetta, Michele; Torsoli, A; Fave, G. Delle

doi:10.3109/00365528909091294

Cited by 5 publications

(5 citation statements)

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“…Most patients with ZES who require histamine H2-receptor antagonists every 4 to 8 hours can be treated effectively with a single daily dose of omeprazole, although about 10% to 25% of patients require omeprazole every 12 hours [33,36,47]. In most studies gastric acid hypersecretion is controlled with less than 80 mg of omeprazole per day, but occasional patients require more than 200 mg/day [29,31,32,[34][35][36][37]47].…”

Section: Long-term Medical Management Of Gastric Acid Hypersecretionmentioning

confidence: 99%

Control of gastric acid hypersecretion in the management of patients with Zollinger‐Ellison syndrome

et al. 1993

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During the last 5 years important advances have occurred in the control of gastric acid hypersecretion in Zollinger-Ellison syndrome (ZES). The increased availability of potent gastric acid antisecretory agents such as histamine H2-receptor antagonists and more recently the H+K(+)-ATPase inhibitors such as omeprazole and lansoprazole have made it possible to medically control acid secretion in all patients. Increased understanding of the variation in antisecretory drug dosage between individual patients has led to identification of criteria to ensure effective antisecretory control and to the recognition of subgroups of patients who require special monitoring. Effective regimens for parenteral antisecretory control during surgery have been established. The importance of parathyroidectomy in patients with multiple endocrine neoplasia type I with ZES and the possible usefulness of highly selective vagotomy have been investigated. We review here the new data that led to increased understanding in each of these areas from our studies and studies by others.

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Section: Long-term Medical Management Of Gastric Acid Hypersecretionmentioning

confidence: 99%

Control of gastric acid hypersecretion in the management of patients with Zollinger‐Ellison syndrome

et al. 1993

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“…is not yet approved for use in the United States, a number of studies [42,[51][52][53][54][55][56][57][58] have shown this to be an extremely potent and long-acting agent with a duration of action of more than 48 hours, which allows once-or twice-daily dosing in all patients with ZES. Omeprazole has been shown to cause enterochromaffin-like cell (ECL) hyperplasia and carcinoid tumors in rats [52,59,60] but not mice.…”

Section: Diagnosis Of Zes Should Be Established By Measur-mentioning

confidence: 99%

Zollinger-Ellison Syndrome in the Intensive Care Setting

London

Frucht

Doppman

et al. 1989

J Intensive Care Med

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drome in the intensive care setting. J Intensive Care Med 1989;4:272-283 Management of patients with Zollinger-Ellison syndrome differs markedly from management of patients with idiopathic gastric acid hypersecretion or routine peptic ulcer disease. Because of the possible complications arising from gastric acid hypersecretion or from complications caused by the gastrinoma itself, patients with these disorders frequently present to critical care physicians. It is important that critical care physicians be familiar with the acute presentation of patients with Zollinger-Ellison syndrome as well as the appropriate treatment. We review the important points pertaining to the recognition and treatment of Zollinger-Ellison syndrome in the acute care setting.In 1955, Zollinger and Ellison [1] described the clinical triad of fulminating ulcer diathesis, recurrent ulceration unresponsive to standard medical or surgical therapy, and the presence of non-beta islet cell tumors of the pancreas. The clinical symptoms of Zollinger-Ellison syndrome (ZES) are caused by gastric acid hypersecretion, which results from tumor-released, gastrin-stimulating acid secretion from gastric parietal cells [2,3]. With appropriate use of histamine Hz-receptor antagonists, it is now possible to inhibit gastric acid hypersecretion and to prevent severe, recurrent gastrointestinal ulcerations and their usual complications, such as bleeding and perforation [3][4][5][6][7][8]. Because of the severity of these complications when they are untreated or when the diagnosis is not yet established, patients with ZES will frequently require treatment in an intensive care unit.

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“…Ulcerative or ero sive lesions of the upper gastrointestinal tract were usually found to be healed at fol low-up endoscopies. Recently, Corleto et al [14] reported the efficacy of omeprazole in 9 Zollinger-Ellison patients resistant to high doses (80-400 mg/day) of famotidine. All patients were followed for periods of 6-16 months with a maintenance dose of 40-60 mg omeprazole daily.…”

Section: Efficacy O F Omeprazole On Symptom Reliefmentioning

confidence: 99%

“…This is followed by measurement of BAO 24 h after ingestion allowing tailoring of the following doses. It has been suggested that the dose of omepra zole is related to the previously required dose of histamine H2-receptor antagonists [14].…”

Section: Omeprazole In Zollinger-ellison Syndromementioning

confidence: 99%

Omeprazole in the Treatment of Zollinger-Ellison Syndrome and Histamine H<sub>2</sub>-Antagonist Refractory Ulcers

Meijer

Jansen²,

Lamers³

1989

Digestion

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Omeprazole is a very potent and long-acting inhibitor of gastric acid secretion. These characteristics make the drug very suitable for the management of gastric acid hyper-secretion and symptom relief in patients with the Zollinger-Ellison syndrome, and in the treatment of patients with ulcers resistant to histamine H₂-receptor antagonists. Most patients require only a once-daily dose, whereas in about 30% of patients with Zollinger-Ellison syndrome the dose has to be split. During long-term treatment the required dose of omeprazole is usually rather stable. Up until now neither in patients with Zollinger-Ellison syndrome nor in those with resistant ulcers have convincing reports of resistance to omeprazole been published. However, a relative disadvantage of omeprazole is the observation that symptom-free Zollinger-Ellison syndrome patients are less inclined to undergo the work-up for surgery, which is the only possible curative treatment for these patients. Omeprazole therapy has been well tolerated and no side effects, significant changes in laboratory variables or toxicity have been noted.

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Loss of Efficacy of Famotidine in the Control of Gastric Acid Secretion in Patients with Zollinger-Ellison Syndrome Reversed by Omeprazole

Cited by 5 publications

References 0 publications

Control of gastric acid hypersecretion in the management of patients with Zollinger‐Ellison syndrome

Control of gastric acid hypersecretion in the management of patients with Zollinger‐Ellison syndrome

Zollinger-Ellison Syndrome in the Intensive Care Setting

Omeprazole in the Treatment of Zollinger-Ellison Syndrome and Histamine H<sub>2</sub>-Antagonist Refractory Ulcers

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