Canadian Journal of Gastroenterology and Hepatology

Canadian Journal of Gastroenterology and Hepatology / 2004 / Article

Canadian Gastroenterology Elsewhere | Open Access

Volume 18 |Article ID 742140 | https://doi.org/10.1155/2004/742140

Sander Veldhuyzen van Zanten, "Cost-Effectiveness of Intravenous Proton Pump Inhibitors in High-Risk Bleeders", Canadian Journal of Gastroenterology and Hepatology, vol. 18, Article ID 742140, 2 pages, 2004. https://doi.org/10.1155/2004/742140

Cost-Effectiveness of Intravenous Proton Pump Inhibitors in High-Risk Bleeders

Abstract

There is unequivocal evidence that proton pump inhibitors (PPIs) are currently the most effective acid suppressive agents available. Intravenous (IV) formulations have been developed, although only IV pantoprazole is available in Canada. In patients presenting with serious upper gastrointestinal (GI) bleeding due to duodenal or gastric ulcers, it has always been believed that IV administration of acid-lowering agents would improve clinical outcomes. The reason behind this thinking is twofold. First, there is in vitro evidence that formed clots are more stable at or near neutral pH (1). Second, by administering the agent intravenously, suppression of acid production is achieved much more quickly, thereby promoting more rapid healing of the ulcer and reducing the risk of persistent or recurrent bleeding. Interestingly and surprisingly, however, the data for intravenous H2-blockers have been disappointing (2). This failure to demonstrate clinical benefit has never been fully explained.

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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