The use of subcutaneous omeprazole in the treatment of dyspepsia in palliative care patients

Agar, Meera; Lacey, Judith; Donovan, Brian; Walker, Amanda

doi:10.1016/j.jpainsymman.2004.10.005

Cited by 27 publications

(23 citation statements)

References 6 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regarding the allowable pH range for subcutaneous infusions, both acidic agents (ondansetron at pH 3.5, morphine sulfate at pH 2.5-6.5) and alkaline agents (sodium phenobarbitone at pH 9.2-10.3) are being administered successfully subcutaneously without inducing skin irritation (9). However, in this previous study, successful administration without skin irritation was assessed physiologically and was not based on patients' complaints.…”

Section: Discussionmentioning

confidence: 97%

Extravasation of Hydroxymethylene Diphosphonate–Induced Subcutaneous Inflammation, Histologically Demonstrated in BALB/c Mice: FIGURE 1.

Lim

Kang²,

Myung³

et al. 2010

J Nucl Med

View full text Add to dashboard Cite

We encountered local reactions at injection sites in 7 patients after an intravenous injection of 99m Tc-hydroxymethylene diphosphonate ( 99m Tc-HDP). Archived bone scans showed radiopharmaceutical extravasation at injection sites in all patients. To identify the mechanism underlying these local reactions, we challenged BALB/c mice with an 99m Tc-HDP injection and investigated the mechanism involved. Methods: Seven solutions were prepared: 0.1 M acetic acid, 0.1 M NaOH, 2.1 mM 99m Tc-HDP, 4.7 mM 99m Tc-methylene diphosphonate ( 99m Tc-MDP), 1.05 mM 99m Tc-HDP diluted with normal saline, 37 MBq of 99m Tc-pertechnetate, and normal saline. Six female BALB/c mice were subcutaneously injected in their backs with 0.04 mL of each solution. Backs were observed, and skin and subcutaneous tissues were acquired on days 5, 7, and 19 after injection. Two pathologists interpreted the histologic specimens. Results: The pH values of the 0.1 M acetic acid, 0.1 M NaOH, 2.1 mM 99m Tc-HDP, 4.7 mM 99m Tc-MDP, 1.05 mM 99m Tc-HDP diluted with normal saline, 37 MBq 99m Tc-pertechnetate, and normal saline were 3. 28, 14.3, 4.79, 6.45, 6.16, 6.85, and 6.53, respectively. A slight redness was observed at 99m Tc-HDP injection sites on day 5 after injection, and many inflammatory cells, such as neutrophils, were found to infiltrate subcutaneous tissues by light microscopy, suggesting active inflammation. However, no abnormality was found at 99m Tc-MDP injection sites. On day 19, 99m Tc-HDP injection sites appeared to have recovered and showed healed scars and almost-normal microscopic features. Conclusion: Our results indicate that the local reaction induced by extravasation of 99m Tc-HDP is probably caused by high acidity, and 99m Tc-HDP should be administered carefully to avoid adverse reactions. Di phosphonate is a widely used radiopharmaceutical for bone scanning, and no significant toxic effects have been reported to date (1). Regarding adverse reactions, only 0.5 were reported for every 100,000 administrations in 1984 (2).We started to use 99m Tc-hydroxymethylene diphosphonate ( 99m Tc-HDP) as a bone scanning agent instead of 99m Tc-methylene diphosphonate ( 99m Tc-MDP) at the Seoul National University Hospital in January 2008 because 99m Tc-HDP has better physiochemical and biologic characteristics than 99m Tc-MDP (3). After this change, 7 of 2,700 patients (0.26%) complained of a sharp pain at the injection site immediately after 99m Tc-HDP administration and continued to experience pain and inflammation at injection sites 2 wk later. Retained bone scans showed radiopharmaceutical extravasation in all patients. The reported adverse reactions to diphosphonate included typical drug reactions such as rash, headache, dizziness, nausea, myalgia, and fever (4). However, we have not encountered adverse reactions of pain or inflammation over more than 30 y of 99m Tc-MDP use, and we infer that these 99m Tc-HDP reactions are not systemic but local because patient responses were immediate and the pain was localized.No previous study has been c...

show abstract

Section: Discussionmentioning

confidence: 97%

Extravasation of Hydroxymethylene Diphosphonate–Induced Subcutaneous Inflammation, Histologically Demonstrated in BALB/c Mice: FIGURE 1.

Lim

Kang²,

Myung³

et al. 2010

J Nucl Med

View full text Add to dashboard Cite

show abstract

“…Moreover, esomeprazole has demonstrated greater antisecretory activity than other PPIs 7 . To the authors' knowledge, this is the first case report of well‐tolerated esomeprazole administrations through subcutaneous infusion and the second report of subcutaneous PPI administration 8 …”

Section: Casementioning

confidence: 81%

Subcutaneous Infusion of Esomeprazole in Elderly Patients in Palliative Care: A Report of Two Cases

Desmidt

Constans

2009

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…With a bowel obstruction secondary to malignancy, medications would generally be administered parenterally. Ranitidine and PPIs may be administered orally or parenterally without dilution thereby allowing its administration subcutaneously [19].…”

Section: Limitationsmentioning

confidence: 99%

Reducing gastric secretions—a role for histamine 2 antagonists or proton pump inhibitors in malignant bowel obstruction?

Clark

Lam

Currow

2009

Support Care Cancer

View full text Add to dashboard Cite

show abstract

The use of subcutaneous omeprazole in the treatment of dyspepsia in palliative care patients

Cited by 27 publications

References 6 publications

Extravasation of Hydroxymethylene Diphosphonate–Induced Subcutaneous Inflammation, Histologically Demonstrated in BALB/c Mice: FIGURE 1.

Extravasation of Hydroxymethylene Diphosphonate–Induced Subcutaneous Inflammation, Histologically Demonstrated in BALB/c Mice: FIGURE 1.

Subcutaneous Infusion of Esomeprazole in Elderly Patients in Palliative Care: A Report of Two Cases

Reducing gastric secretions—a role for histamine 2 antagonists or proton pump inhibitors in malignant bowel obstruction?

Contact Info

Product

Resources

About