The effect of omeprazole on the outcome of endoscopically treated bleeding peptic ulcers: a randomized double-blind placebo-controlled multicentre study

Muckadell, Ove B. Schaffalitzky de; Havelund, Troels; Harling, Henrik; Boesby, S; Snel, P.; Vreeburg, E. M.; Eriksson, S.; Fernström, Paula; Hasselgren, Gunnar

doi:10.1016/0300-2977(96)89555-6

Cited by 55 publications

(131 citation statements)

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“…Two multicenter trials from Scandinavia evaluated the use of an infusion of a high dose of omeprazole in conjunction with endoscopic treatment. 12,13 Both reported clinical benefits with omeprazole.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers

et al. 2000

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Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] Some of the studies did not use endoscopic treatment. 7,8 In some studies the numbers of patients were inadequate or the investigators were aware of the patients' treatment assignments.…”

Section: Discussionmentioning

confidence: 99%

Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers

et al. 2000

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“…The apparent efficacy of this approach has been challenged by studies with inconsistent conclusions in Western Europe and North America [Jensen et al 2006;Hasselgren et al 1997;Schaffalitzky de Muckadell et al 1997]. Moreover, mortality (probably the most important clinical outcome) has never been shown to be affected by the use of IV PPI.…”

Section: Use Of Intravenous Ppi In Peptic Ulcer Diseasementioning

confidence: 99%

Review: A clinical guide to using intravenous proton-pump inhibitors in reflux and peptic ulcers

Pang

Graham

2010

Therap Adv Gastroenterol

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Intravenous (IV) proton-pump inhibitors (PPIs) are potent gastric acid suppressing agents, and their use is popular in clinical practice. Both IV and oral PPIs have similarly short half-lives, and their effects on acid secretion are similar, thus their dosing and dosage intervals appear to be interchangeable. The possible exception is when sustained high pHs are required to promote clot stabilization in bleeding peptic ulcers. Continuous infusion appears to be the only form of administration that reliably achieves these high target pHs. IV PPI is indicated in the treatment of high-risk peptic ulcers, complicated gastroesophageal reflux, stress-induced ulcer prophylaxis, ZollingerEllison syndrome, and whenever it is impossible or impractical to give oral therapy. The widespread use of PPIs has been controversial. IV PPIs have been linked to the development of nosocomial pneumonia in the intensive care setting and to spontaneous bacterial peritonitis in cirrhotic patients. This review discusses the use of IV PPI in different clinical scenarios, its controversies, and issues of appropriate use.

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“…Studies examining the use of intravenous omeprazole doses have had mixed results (75,89,(92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104). However, many of these trials used omeprazole dosing regimens that are thought to be suboptimal and will not be discussed further (75,89,(93)(94)(95)97,100).…”

Section: Drug Interactionsmentioning

confidence: 99%

“…However, many of these trials used omeprazole dosing regimens that are thought to be suboptimal and will not be discussed further (75,89,(93)(94)(95)97,100). Three other randomized, controlled trials assessed the use of higher doses of omeprazole, namely an 80 mg bolus followed by 6.7 to 8 mg/h continuous infusion in the treatment of high risk patients with either actively bleeding ulcers or nonbleeding visible vessels (96,98,99). Previously published studies demonstrated that these dosing regimens achieved an intragastric pH of greater than 6.0 for more than 80% of a 24 h period, with a median 24 h pH of 6.5 to 7.5 (90,105,106).…”

Section: Drug Interactionsmentioning

confidence: 99%

Intravenous Pantoprazole: A New Tool for Acutely Ill Patients Who Require Acid Suppression

Trépanier¹

1999

Canadian Journal of Gastroenterology and Hepatology

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. Until now, oral proton pump inhibitors have not been available as parenteral therapy in the acute care setting. Pantoprazole is the first parenteral proton pump inhibitor to become available in Canada. This agent is superior to the parenteral histamine2 receptor antagonists with respect to acid suppressive effects and is not associated with tolerance development. Another advantage over the histamine2 receptor antagonists is that pantoprazole does not require dosage adjustment in patients with renal impairment. Dosage adjustments are also not required for elderly patients or those with hepatic impairment when the drug is used at the usual dose for a limited period of time. Contrary to intravenous cimetidine and ranitidine, which have negative inotropic and chronotropic effects, intravenous pantoprazole is well tolerated and has no significant effect on heart rate, contractility or blood pressure. The lack of drug interactions for this agent also simplifies its use, especially in patients who may require multiple drugs during hospitalization. Parenteral pantoprazole is effective in the treatment of reflux esophagitis. It is also promising for the treatment of upper gastrointestinal bleeding and in the perioperative care of patients with Zollinger-Ellison syndrome, but further research in these areas is necessary. Once the patient is able to tolerate oral medications, parenteral therapy can be easily converted to oral therapy using an oral dose that was equivalent to the parenteral dose (ie, 40 mg given intravenously is equivalent to 40 mg given orally).

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The effect of omeprazole on the outcome of endoscopically treated bleeding peptic ulcers: a randomized double-blind placebo-controlled multicentre study

Cited by 55 publications

References 0 publications

Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers

Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers

Review: A clinical guide to using intravenous proton-pump inhibitors in reflux and peptic ulcers

Intravenous Pantoprazole: A New Tool for Acutely Ill Patients Who Require Acid Suppression

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