Document Detail


Treating patients with acute gastrointestinal bleeding or rebleeding.
MedLine Citation:
PMID:  14587962     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite advances in medical management, gastrointestinal bleeding remains a substantial cause of morbidity and mortality. At risk are patients with history of the event, those taking nonsteroidal antiinflammatory agents, and those with active peptic ulcer disease. Endoscopy may be performed for diagnosis and treatment. Antisecretory therapy may be employed to control gastric acid secretion, treat active peptic ulcer disease, and control symptoms such as diarrhea and abdominal pain. Options for antisecretory therapy include histamine2-receptor antagonists (H2RAs) that target the histamine pathway, and proton pump inhibitors (PPIs) that target the final step in acid secretion. The H2RAs generally are ineffective at reaching a target pH of 6 in patients with gastrointestinal bleeding because of tachyphylaxis. The PPIs are more effective and do not lead to tachyphylaxis. With the availability of an intravenous PPI, pantoprazole, options for managing hospitalized patients with gastrointestinal bleeding are expanding.
Authors:
Joseph R Pisegna
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  23     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-31     Completed Date:  2004-02-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81S-86S     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology and Hepatology, Veteran Affairs Greater Los Angeles Healthcare System at West Los Angeles, 11301 Wilshire Boulevard, CA 90073, USA. jpisegna@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles
Adult
Anti-Ulcer Agents / therapeutic use*
Benzimidazoles / therapeutic use
Clinical Trials as Topic
Endoscopy, Gastrointestinal
Gastric Acid / physiology,  secretion
Gastrointestinal Hemorrhage / diagnosis,  drug therapy*,  physiopathology
Histamine H2 Antagonists / therapeutic use
Humans
Jehovah's Witnesses
Male
Omeprazole / analogs & derivatives
Proton Pumps / antagonists & inhibitors
Recurrence
Risk Factors
Sulfoxides / therapeutic use
Zollinger-Ellison Syndrome / drug therapy
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Ulcer Agents; 0/Benzimidazoles; 0/Histamine H2 Antagonists; 0/Proton Pumps; 0/Sulfoxides; 102625-70-7/pantoprazole; 73590-58-6/Omeprazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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