Proton-pump inhibitors as a protective treatment for high-risk patients receiving treatment with NSAIDs

2007 ◽  
Vol 3 (12) ◽  
pp. 694-695 ◽  
Author(s):  
Francis KL Chan
Keyword(s):  
High Risk ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
High Risk Patients ◽  
Risk Patients ◽  
Protective Treatment

COX-2 inhibitor compared with proton pump inhibitor in the prevention of recurrent ulcer complications in high-risk patients taking NSAIDs

2001 ◽  
Vol 120 (5) ◽  
pp. A104 ◽  
Author(s):  
Kam-Chuen Lai ◽  
Kent-Man Chu ◽  
Wai-Mo Hui ◽  
Chun-Yu Wong ◽  
Wayne Hu ◽  
...  
Keyword(s):  
High Risk ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Recurrent Ulcer ◽  
High Risk Patients ◽  
Risk Patients ◽  
Ulcer Complications ◽  
Cox 2

scholarly journals SMERNICE ZA PREPREČEVANJE IN ZDRAVLJENJE NEŽELENIH UČINKOV NESTEROIDNIH PROTIVNETNIH IN ANTIAGREGACIJSKIH UČINKOVIN NA PREBAVILA

2015 ◽  
Vol 84 (1) ◽  
Author(s):  
Borut Štabuc ◽  
Bojan Tepeš ◽  
Pavel Skok ◽  
Miroslav Vujasinović ◽  
Aleš Blinc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
High Risk ◽  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Risk Patients ◽  
Upper Gastrointestinal

Adverse effects of nonsteroidal antiinflammatory drugs and antiaggregants on gastrointestinal tract can be prevented or reduced by rational prescribing, use of proton pump inhibitors and Helicobacter pylori eradication.Nonsteroidal antiinflammatory drugs should not be used to treat patients with high risk for serious adverse effects on either upper gastrointestinal or cardiovascular system. Proton pump inhibitors in standard oral dosages are used for treatment of dyspepsia or gastric and duodenal erosions and ulcers, caused by nonsteroidal antiinflammatory drug or antiaggregant use. Peptic ulcer hemorrhage is treated with endoscopic hemostasis and proton pump inhibitors (72-hour continuous infusion followed by 4 – 8 week standard dose oral treatment).Patients can be stratified into three groups based on risk for upper gastrointestinal system adverse effects associated with nonsteroidal antiinflammatory drugs or antiaggregants use. Absence of risk factors denotes low-risk patient population, one or two risk factors are associated with medium risk; high-risk patients harbor either three or more risk factors or history of complicated peptic ulcer disease.  Helicobacter pylori should be eradicated (if present) in all medium and high-risk patients prior to introduction of nonsteroidal antiinflammatory drugs or antiaggregants and proton pump inhibitors in standard daily dose should be prescribed for the duration of the treatment.Risk of gastrointestinal hemorrhage should be considered when planning invasive cardiovascular procedures or introduction of antiaggregant or anticoagulant treatment. In the context of acute gastrointestinal hemorrhage, antiaggregants should not be discontinued for longer than 7 days and oral anticoagulant therapy should be stopped and converted to low-molecular-weight heparin after complete hemostasis.

scholarly journals LO25: Use of Glasgow Blatchford Score, time to endoscopy, and proton pump inhibitor use in patients presenting with upper gastrointestinal bleeding to the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S16
Author(s):  
S. Sandha ◽  
J. Stach ◽  
M. Bullard ◽  
B. Halloran ◽  
H. Blain ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Proton Pump Inhibitor ◽  
Gastrointestinal Bleeding ◽  
Proton Pump ◽  
Upper Gastrointestinal Bleeding ◽  
Low Risk ◽  
High Risk Patients ◽  
Risk Patients ◽  
Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding (UGIB) is a common presentation to the emergency department (ED). Early endoscopy within 24 hours has been shown to reduce re-bleeding rates and lower mortality. However, low-risk patients can often be managed through outpatient follow-up. The aim of this study was to compare the timing and appropriateness of endoscopy and proton pump inhibitor (PPI) use in a tertiary care ED setting for low- and high-risk patients determined using the Glasgow Blatchford Score (GBS). Methods: Retrospective chart review was conducted to examine the management of patients presenting with an UGIB in 2016 to the University of Alberta Hospital ED. TANDEM and Emergency Department Information System (EDIS) databases were used to identify patients using specific ICD-10 codes and the CEDIS presenting complaints of vomiting blood or blood in stool/melena. Patients with GBS 0-3 were categorized as low-risk and those with GBS > 3 were considered high-risk with appropriateness of and time to endoscopy, disposition of patient at 24 hours, and use of PPIs determined for each group. Results: A total of 400 patients were included. A total of 319/400 patients (80%) underwent esophagogastroduodenoscopy (EGD). EGD was performed within 24 hours in 37% of patients (29/78) with GBS 0 to 3 and in 77% (248/322) with GBS greater than 3. Of the remaining high-risk patients, 11% (36/322) underwent EGD after 24 hours and 12% (38/322) did not undergo EGD. The endoscopic diagnoses were peptic ulcer disease (PUD) in 41% of patients (130/319), esophagitis in 18% (56/319), and varices in 14% (45/319). PPIs (data available 375/400) were administered (mainly intravenously) to 93% (279/300) of high-risk and 79% (59/75) of low-risk patients. Data on patient disposition showed 60/322 (19%) high-risk patients were discharged from the ED within 24 hours and only 31/60 (52%) of these underwent EGD before discharge. Of 29 low-risk patients undergoing EGD within 24 hours, 9 (31%) were admitted, 17 (59%) were discharged from ED, and 3 (10%) were kept for observation in the ED greater than 24 hours. Of low-risk patients, 76% (59/78) were discharged from the ED within 24 hours. Conclusion: A majority of patients presenting with UGIB appropriately received endoscopy within 24 hours. 19% of high-risk patients were discharged from the ED. Earlier discharge for low-risk patients can be improved as only 76% of low-risk patients were discharged from the ED within 24 hours. As expected, PPI use was high in these patients.

Combination of norfloxacin and cisapride in prevention of SBP in high risk patients: A new approach

2001 ◽  
Vol 120 (5) ◽  
pp. A376-A376
Author(s):  
B JEETSANDHU ◽  
R JAIN ◽  
J SINGH ◽  
M JAIN ◽  
J SHARMA ◽  
...  
Keyword(s):  
High Risk ◽  
New Approach ◽  
High Risk Patients ◽  
Risk Patients
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