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Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome.
Dig Dis Sci. 1993 Oct; 38(10):1857-65.DD

Abstract

Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome is increasingly required; however, existing methods of determining the required dose are cumbersome and not applicable in all centers. A previous study suggested that the required parenteral dose of histamine H2-receptor antagonists correlated with the previous oral dose. In the present study, in 31 patients with Zollinger-Ellison syndrome we evaluated the hypothesis that an effective parenteral histamine H2-receptor antagonist dose could be predicted from the previous oral dose. Twenty-three patients were taking oral ranitidine (mean 1.3 g/day), six patients famotidine (152 mg/day), and two patients cimetidine (1.8 g/day). Each patient was treated with a continuous intravenous infusion of the equivalent dose of ranitidine (mean dose 1 mg/kg/hr with 35% requiring 0.5 mg/kg/hr, 49% 1 mg/kg/hr, 3% 1.5 mg/kg/hr, 10% 2 mg/kg/hr, and 3% 2.5 mg/kg/hr. This dose of ranitidine acutely controlled acid secretion (< 10 meq/hr) in all patients. To evaluate long-term efficacy and safety, 20 patients were maintained on this dose through the peri- and postoperative periods. Mean duration was 7.1 days with 25% treated 3-5 days, 40% 6-8 days, 30% 8-10 days, and 5% > 10 days. The predicted dose continued to control acid secretion in 95% of patients with one patient requiring one dose adjustment. No biochemical, clinical, or hematological toxicity was seen, although ranitidine was stopped in one patient because of skin rash. These results demonstrate that the parenteral dose of ranitidine required to control acid secretion in patients with Zollinger-Ellison syndrome can be predicted from the oral dose.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8104773

Citation

Vinayek, R, et al. "Parenteral Control of Gastric Acid Hypersecretion in Patients With Zollinger-Ellison Syndrome." Digestive Diseases and Sciences, vol. 38, no. 10, 1993, pp. 1857-65.
Vinayek R, Hahne WF, Euler AR, et al. Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. Dig Dis Sci. 1993;38(10):1857-65.
Vinayek, R., Hahne, W. F., Euler, A. R., Norton, J. A., & Jensen, R. T. (1993). Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. Digestive Diseases and Sciences, 38(10), 1857-65.
Vinayek R, et al. Parenteral Control of Gastric Acid Hypersecretion in Patients With Zollinger-Ellison Syndrome. Dig Dis Sci. 1993;38(10):1857-65. PubMed PMID: 8104773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. AU - Vinayek,R, AU - Hahne,W F, AU - Euler,A R, AU - Norton,J A, AU - Jensen,R T, PY - 1993/10/1/pubmed PY - 1993/10/1/medline PY - 1993/10/1/entrez SP - 1857 EP - 65 JF - Digestive diseases and sciences JO - Dig Dis Sci VL - 38 IS - 10 N2 - Parenteral control of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome is increasingly required; however, existing methods of determining the required dose are cumbersome and not applicable in all centers. A previous study suggested that the required parenteral dose of histamine H2-receptor antagonists correlated with the previous oral dose. In the present study, in 31 patients with Zollinger-Ellison syndrome we evaluated the hypothesis that an effective parenteral histamine H2-receptor antagonist dose could be predicted from the previous oral dose. Twenty-three patients were taking oral ranitidine (mean 1.3 g/day), six patients famotidine (152 mg/day), and two patients cimetidine (1.8 g/day). Each patient was treated with a continuous intravenous infusion of the equivalent dose of ranitidine (mean dose 1 mg/kg/hr with 35% requiring 0.5 mg/kg/hr, 49% 1 mg/kg/hr, 3% 1.5 mg/kg/hr, 10% 2 mg/kg/hr, and 3% 2.5 mg/kg/hr. This dose of ranitidine acutely controlled acid secretion (< 10 meq/hr) in all patients. To evaluate long-term efficacy and safety, 20 patients were maintained on this dose through the peri- and postoperative periods. Mean duration was 7.1 days with 25% treated 3-5 days, 40% 6-8 days, 30% 8-10 days, and 5% > 10 days. The predicted dose continued to control acid secretion in 95% of patients with one patient requiring one dose adjustment. No biochemical, clinical, or hematological toxicity was seen, although ranitidine was stopped in one patient because of skin rash. These results demonstrate that the parenteral dose of ranitidine required to control acid secretion in patients with Zollinger-Ellison syndrome can be predicted from the oral dose.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0163-2116 UR - https://www.unboundmedicine.com/medline/citation/8104773/Parenteral_control_of_gastric_acid_hypersecretion_in_patients_with_Zollinger_Ellison_syndrome_ L2 - http://www.diseaseinfosearch.org/result/7600 DB - PRIME DP - Unbound Medicine ER -