Pharmacokinetics and pharmacodynamics of famotidine and ranitidine in critically ill children

Madani, Shailender; Kauffman, Ralph E.; Simpson, Pippa; Lehr, Victoria Tutag; Lai, Mary Lieh; Sarniak, Ashok; Tolia, Vasundhara

doi:10.1002/jcph.219

Cited by 6 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The result interpretation and documentation of the pH were the responsibility of the bedside nurse, which encompassed a large group of health care providers and a potentially greater range of error. 5,6,8,17 Despite this, our results are in concert with these previous studies. Our study reflects the practice of monitoring gastric pH that is common in pediatric intensive care and would likely be used to titrate therapy, as opposed to more invasive monitoring.…”

Section: Figuresupporting

confidence: 89%

“…However, prior pharmacokinetic studies have not shown significant differences in volume of distribution with increasing age. 3,5,6,9 This finding should be noted by clinicians and investigated further to determine the etiology of elevated gastric pH values in older critically ill pediatric patients.…”

Section: Figurementioning

confidence: 85%

“…1 Intravenous ranitidine (IVR) is a commonly used medication for gastric stress ulcer prophylaxis in the pediatric population, and pharmacokinetic data have been generated to identify dosing schemes that will result in acceptable serum concentrations and gastric pH values. [2][3][4][5][6][7][8] Although these data have been useful in guiding dosing, the sample sizes are small, and the studies often fail to account for variables common to the critically ill pediatric patient, such as the use of mechanical ventilation (including oscillatory ventilation or use of inhaled nitric oxide), vasopressor or inotropic medication use, and kidney function. The ability of IVR to maintain a gastric pH ≥4, the goal for prevention of stress-induced bleeding, has been shown to be variable, likely due to myriad potential patient factors that can affect gastric acid production and IVR efficacy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Intravenous Ranitidine on Gastric pH in Critically Ill Pediatric Patients

Moffett¹,

Schmees²,

Gutierrez³

et al. 2019

The Journal of Pediatric Pharmacology and Therapeutics

View full text Add to dashboard Cite

OBJECTIVE To determine the dosing regimen of intravenous ranitidine (IVR) most likely to achieve a gastric pH of ≥4 in critically ill pediatric patients.METHODS A retrospective cohort study was designed and included patients younger than 19 years with gastric pH samples taken from a nasogastric tube within 24 hours after a dose of IVR in an intensive care unit. Data collection included patient demographics, clinical variables, IVR dosing, and gastric pH samples. Descriptive statistical analysis and multivariable logistic regression analysis with clustering of patients was performed to determine variables associated with odds of obtaining a pH of ≥4.RESULTS A total of 628 patients (1356 nasogastric samples) met study criteria (median age 1.3 years [IQR, 0.33, 5.7 years]; 53% male). The IVR dose was 0.90 ± 0.30 mg/kg per dose every 8.1 ± 2.9 hours, and 60.9% of patients (n = 383) had a pH ≥4. Patients with a pH value ≥4 had gastric pH samples taken earlier after a dose of IVR (6.7 ± 5.0 vs. 5.9 ± 4.7 hours, p < 0.001) but had no difference in IVR dose per kilogram (0.88 ± 0.31 vs. 0.88 ± 0.26, p = 0.86) or frequency of dosing (7.9 ± 3.2 vs. 7.9 ± 3.2 hours, p = 0.89). A multivariable logistic regression model identified increasing age, decreased kidney function, and decreased time to pH sample after an IVR dose with significantly greater odds of pH ≥4.CONCLUSIONS The IVR dosing to maintain a gastric pH ≥4 in critically ill pediatric patients should occur more frequently than every 8 hours. Gastric pH evaluation may be necessary to assess IVR efficacy.

show abstract

Section: Figuresupporting

confidence: 89%

Section: Figurementioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Intravenous Ranitidine on Gastric pH in Critically Ill Pediatric Patients

Moffett¹,

Schmees²,

Gutierrez³

et al. 2019

The Journal of Pediatric Pharmacology and Therapeutics

View full text Add to dashboard Cite

show abstract

“…At the present time, among all H2RAs, famotidine is preferred and commonly used because of its effectiveness in reducing stomach acidity [55,56]. However, its effect on human semen quality and sperm function is still undetermined.…”

Section: Effect Of Famotidinementioning

confidence: 99%

Histamine‐2 Receptor Antagonists and Semen Quality

Banihani

2015

Basic Clin Pharma Tox

View full text Add to dashboard Cite

Histamine-2 receptor antagonists are a class of drugs used to treat the acid-related gastrointestinal diseases such as ulcer and gastro-oesophageal reflux disease. Although such drugs, especially ranitidine and famotidine, are still widely used, their effects on semen quality, and hence on male infertility, is still unclear. This MiniReview systematically addresses and summarizes the effect of histamine-2 receptor antagonists (cimetidine, ranitidine, nizatidine and famotidine) on semen quality, particularly, on sperm function. Cimetidine appears to have adverse effects on semen quality. While the effects of ranitidine and nizatidine on semen quality are still controversial, famotidine does not appear to change semen quality. Therefore, additional studies will be required to clarify whether histamine-2 receptor-independent effects of these drugs play a role in semen quality as well as further clinical studies including direct comparison of the histamine-2 receptor antagonists.The histamine-2 (H2) receptors are widely expressed and can be found in gastric mucosal cells, heart, central nervous system, immune cells, smooth muscles of the airway, vasculature and uterus [1]. They are positively coupled to adenylate cyclase via Gs alpha subunit [2,3]. The activation of histamine-2 receptors by histamine alters the activity of Gs and therefore enhances the intracellular cyclic AMP (cAMP) production [3]. cAMP activates protein kinase A, which phosphorylates the cytoskeletal proteins, leading to the transport of the H + /K + ATPase (proton pump) from the cytoplasm to the plasma membrane of parietal cells [3,4]. H2 receptor activation stimulates hydrochloric acid secretion from the acidsecreting parietal cells of the gastric mucosa, leads to smooth muscle relaxation in the vasculature and airways, increases cardiac rate and contractility, and mediates some of the immunomodulatory effects of histamine [1]. Histamine-2 receptor antagonists (H2RAs), also called H 2 -blockers (e.g. cimetidine, ranitidine, nizatidine and famotidine), are the medications used to reduce the amount of hydrochloric acid produced by the stomach [5][6][7]. Mechanistically, these drugs are competitive antagonists of histamine-2 receptors [6,7]. In view of that, H2RAs are used to treat the acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [8,9], dyspepsia [10-12], Zollinger-Ellison syndrome [13,14] and ulcer [15][16][17].Various studies have shown that proton pump inhibitors (e.g. omeprazole, lansoprazole, esomeprazole), another class of acid reducers with long-lasting reduction of gastric acid production [18,19], are more effective than H2RAs in treating acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [20][21][22][23], ulcer [21,24], dyspepsia [25] and Zollinger-Ellison syndrome [26]; however, H2RAs are still widely used in the treatment of acid-related gastrointestinal diseases. One reason for this is that proton pump inhibitors therapy is more expensive and less cost-effective, ...

show abstract

“…The ease of dosing, superior safety profile and less probability for drug-drug interaction has provided ranitidine an edge over its counterpart cimetidine 6 . Ranitidine is indicatedin GERD, gastric ulcers, Zollinger-Ellison syndrome and hyper-secretory states 7 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Prokinetic Activity of Ranitidine and Neostigmine Alone and in Combination- An in Vitro Study

Butt

Khan

Mazhar

et al. 2021

PAFMJ

View full text Add to dashboard Cite

Objective: To explore the prokinetic effect of Ranitidine, to compare it with the prokinetic effect of Neostigmineand to observe the potentiating prokinetic effect of Ranitidine and Neostigmine in combination. Study Design: Randomised controlled trial (experimental study). Place and Duration of Study: Multi disciplinary centre, Army Medical College, Rawalpindi, from Jan to Dec 2015. Methodology: Experiments were performed on three groups of rabbits (n=6) and Cumulative dose responsecurves were plotted using isolated duodenal tissue on power lab (USA). In the first two groups of experiments,cumulative concentrations of Neostigmine and Ranitidine were studied separately with neostigmine acting as acontrol and in the third group the potentiating effect of a fixed dose of ranitidine on neostigmine was evaluated. Results: Neostigmine’s response was taken as 100 percent and Ranitidine’s response when compared to it came out to be 197 percent. The dose response curve of Neostigmine was shifted to the left and upwards in the presence of Ranitidine. The percent response with Neostigmine alone was taken as 100 percent and increased to 212 percent when the tissue was pre-treated with Ranitidine. Conclusion: Our study has indicated that Ranitidine has marked prokinetic effect which is found to be greaterthan Neostigmine. It is also inferred that Ranitidine can potentiate the prokinetic effect of Neostigmine.

show abstract

Pharmacokinetics and pharmacodynamics of famotidine and ranitidine in critically ill children

Cited by 6 publications

References 20 publications

Evaluation of Intravenous Ranitidine on Gastric pH in Critically Ill Pediatric Patients

Evaluation of Intravenous Ranitidine on Gastric pH in Critically Ill Pediatric Patients

Histamine‐2 Receptor Antagonists and Semen Quality

Comparison of Prokinetic Activity of Ranitidine and Neostigmine Alone and in Combination- An in Vitro Study

Contact Info

Product

Resources

About