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Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H + /K + ATPase proton pump . [ 1 ]
An upper GI bleed is more common than lower GI bleed. [2] An upper GI bleed occurs in 50 to 150 per 100,000 adults per year. [8] A lower GI bleed is estimated to occur in 20 to 30 per 100,000 per year. [2] It results in about 300,000 hospital admissions a year in the United States. [1] Risk of death from a GI bleed is between 5% and 30%.
Pantoprazole, sold under the brand name Protonix, among others, is a medication used for the treatment of stomach ulcers, short-term treatment of erosive esophagitis due to gastroesophageal reflux disease (GERD), maintenance of healing of erosive esophagitis, and pathological hypersecretory conditions including Zollinger–Ellison syndrome.
Significant upper gastrointestinal bleeding is considered a medical emergency. Fluid replacement, as well as blood transfusion, may be required. Endoscopy is recommended within 24 hours and bleeding can be stopped by various techniques. [1] Proton pump inhibitors are often used. [2] Tranexamic acid may also be useful. [2]
Dosage and Administration - gives recommended dosage(s); may list more than one for different conditions or different patients (e.g., lower dosages for children) How Supplied - includes the dosage form(s), strength(s), units in which the dosage form(s) are ordinarily available, identifying features of the dosage form(s) such as the National ...
Forrest's classification is instrumental when stratifying patients with upper gastrointestinal hemorrhage into high and low risk categories for mortality.It is also a significant method of prediction of the risk of rebleeding and very often is used for evaluation of the endoscopic intervention modalities. [3]
Omeprazole is a proton-pump inhibitor (PPI) and its effectiveness is similar to that of other PPIs. [9] It can be taken by mouth or by injection into a vein. [1] [10] It is also available in the fixed-dose combination medication omeprazole/sodium bicarbonate as Zegerid [11] [12] and as Konvomep. [13]
Proton-pump inhibitors are named using the suffix "-prazole". There is a purported correlation (but no proven causal link) between the use of PPIs and the risk of dementia. [ 6 ] However, this remain controversial as chronic and co-morbid pathology, and resultant polypharmacy (including increased consumption of PPIs), will probably itself also ...