03)
Mucosal damage has been reported to occur during the first 24 hours of hospital admission in 75% to 100% of intensive care Famotidine was the most common H 2 RA prescribed, and 12
Recently, a meta-analysis of 29 RCTs showed that prophylaxis with either proton pump inhibitors (PPIs) or histamine-2-receptor antagonists (H2RAs) was associated with lower risk of overt GI bleeding compared to placebo or no prophylaxis
Comparison with peptic ulcers stress-related mucosal injuries typically occur in the acid-producing areas of the stomach (i
However, the PEPTIC trial (Proton Pump Inhibitors vs Histamine-2 Receptor Blockers for Ulcer Prophylaxis Treatment in the Intensive Care Unit) 18 largely dispelled
Critical illness can disrupt local
More recently, need for prophylaxis and medication of choice have come into question
If confirmed/suspected upper gastrointestinal bleeding:
Pros and Cons Pros • Generally well tolerated with few side effects (when taken short term) • Can take with a quick-acting, acid-lowering medication (like Maalox or Tums) if you need
Purpose: Most intensive care unit (ICU) patients receive stress ulcer prophylaxis
PPIs are absorbed in the proximal small bowel and achieve peak concentrations of approximately 0
Conclusions: We could not show that omeprazole, famotidine, or sucralfate prophylaxis can affect already very low incidence of clinically important stress-related bleeding in high-risk surgical intensive care unit patients
The pathophysiology of stress ulcers in critically ill patients is not fully understood; however, they are believed
Patients who were screened and given PPI prophylaxis had higher compliance with treatment of an ADP-receptor inhibitor like
3 out of 10 from a total of 228 ratings on Drugs
Thus, most patients admitted to the intensive care unit receive stress ulcer prophylaxis
A large randomized adult trial of 3298 patients showed no benefit of using pantoprazole vs
Clinical question What is the role of gastrointestinal bleeding prophylaxis (stress ulcer prophylaxis) in critically ill patients? This guideline was prompted by the publication of a new large randomised controlled trial
H2RA, whereas SUP-ICU compared PPI vs
stress ulcer prophylaxis with sucralfate, antacid, and ranitidine
Best Practice & Research The preferred formulary H2RA is famotidine and it is dosed as follows: Renal Function* Dose CrCl > 50 ml/min Famotidine 20 mg IV/PO** BID prophylaxis: a comparison of pantoprazole vs ranitidine in cardiothoracic surgery patients
Below are common side effects by medication: Cimetidine: headache, diarrhea, and breast growth in men ( gynecomastia) Famotidine: constipation, headache, diarrhea, and dizziness
They are the treatment of choice for several gastrointestinal disorders, such as peptic ulcer disease, esophagitis, gastroesophageal reflux disease, and H
Nosocomial pneumonia risk and stress ulcer prophylaxis: a comparison of pantoprazole vs ranitidine in cardiothoracic surgery patients
Famotidine has an average rating of 4
83% of reviewers reported a positive effect, while 0% reported a negative effect
A headache is the most common side more
The main difference between DVT prophylaxis and SUP is the baseline event rate