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. 1988 Apr;29(4):453–457. doi: 10.1136/gut.29.4.453

Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer.

H S Merki 1, L Witzel 1, D Kaufman 1, M Kempf 1, J Neumann 1, J Röhmel 1, R P Walt 1
PMCID: PMC1433542  PMID: 3286384

Abstract

Three double blind crossover studies were carried out to assess the ability of primed infusions of famotidine to raise intragastric pH over 24 hours in 12 duodenal ulcer patients. pH was measured continuously using intragastric electrodes and solid state recording devices. The studies compared the effects of placebo, famotidine 10 mg bolus injection iv followed by continuous infusions of 3.2 mg/h and 4 mg/h in random order. Gastric acidity decreased significantly with both dose regimens (p less than 0.0005) but the effects of either dosage were similar. During fasting median pH rose from 1.35 to 7.1 and 7.05 respectively. During the day, when standard meals were taken, median pH rose from 1.30 to 4.3 and 3.65 respectively. Despite continuous infusions the H2-antagonist was less effective during this time. The latter finding raises questions about gastric secretory control during the day when food is eaten.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Collins R., Langman M. Treatment with histamine H2 antagonists in acute upper gastrointestinal hemorrhage. Implications of randomized trials. N Engl J Med. 1985 Sep 12;313(11):660–666. doi: 10.1056/NEJM198509123131104. [DOI] [PubMed] [Google Scholar]
  2. Crawford J. S. Cimetidine in elective Caesarean section. Anaesthesia. 1981 Jun;36(6):641–642. doi: 10.1111/j.1365-2044.1981.tb10343.x. [DOI] [PubMed] [Google Scholar]
  3. Dawson J., Cockel R. Ranitidine in acute upper gastrointestinal haemorrhage. Br Med J (Clin Res Ed) 1982 Aug 14;285(6340):476–477. doi: 10.1136/bmj.285.6340.476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Etienne A., Fimmel C. J., Bron B. A., Loizeau E., Blum A. L. Evaluation of pirenzepine on gastric acidity in healthy volunteers using ambulatory 24 hour intragastric pH-monitoring. Gut. 1985 Mar;26(3):241–245. doi: 10.1136/gut.26.3.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fimmel C. J., Etienne A., Cilluffo T., von Ritter C., Gasser T., Rey J. P., Caradonna-Moscatelli P., Sabbatini F., Pace F., Bühler H. W. Long-term ambulatory gastric pH monitoring: validation of a new method and effect of H2-antagonists. Gastroenterology. 1985 Jun;88(6):1842–1851. doi: 10.1016/0016-5085(85)90009-5. [DOI] [PubMed] [Google Scholar]
  6. Gledhill T., Buck M., Hunt R. H. Effect of no treatment, cimetidine 1 g/day, cimetidine 2 g/day and cimetidine combined with atropine on nocturnal gastric secretion in cimetidine non-responders. Gut. 1984 Nov;25(11):1211–1216. doi: 10.1136/gut.25.11.1211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Green F. W., Jr, Kaplan M. M., Curtis L. E., Levine P. H. Effect of acid and pepsin on blood coagulation and platelet aggregation. A possible contributor prolonged gastroduodenal mucosal hemorrhage. Gastroenterology. 1978 Jan;74(1):38–43. [PubMed] [Google Scholar]
  8. Hastings P. R., Skillman J. J., Bushnell L. S., Silen W. Antacid titration in the prevention of acute gastrointestinal bleeding: a controlled, randomized trial in 100 critically ill patients. N Engl J Med. 1978 May 11;298(19):1041–1045. doi: 10.1056/NEJM197805112981901. [DOI] [PubMed] [Google Scholar]
  9. Herrmann V., Kaminski D. L. Evaluation of intragastric pH in acutely ill patients. Arch Surg. 1979 Apr;114(4):511–514. doi: 10.1001/archsurg.1979.01370280165027. [DOI] [PubMed] [Google Scholar]
  10. Hoare A. M., Bradby G. V., Hawkins C. F., Kang J. Y., Dykes P. W. Cimetidine in bleeding peptic ulcer. Lancet. 1979 Sep 29;2(8144):671–673. doi: 10.1016/s0140-6736(79)92069-5. [DOI] [PubMed] [Google Scholar]
  11. Londong W., Londong V., Ruthe C., Weizert P. Complete inhibition of food-stimulated gastric acid secretion by combined application of pirenzepine and ranitidine. Gut. 1981 Jul;22(7):542–548. doi: 10.1136/gut.22.7.542. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Merki H. S., Witzel L., Walt R. P., Neumann J., Scheurle E., Kaufmann D., Mappes A., Heim J., Röhmel J. Comparison of ranitidine 300 mg twice daily, 300 mg at night and placebo on 24-hour intragastric acidity of duodenal ulcer patients. Aliment Pharmacol Ther. 1987 Jun;1(3):217–223. doi: 10.1111/j.1365-2036.1987.tb00621.x. [DOI] [PubMed] [Google Scholar]
  13. Merki H., Witzel L., Harre K., Scheurle E., Neumann J., Röhmel J. Single dose treatment with H2 receptor antagonists: is bedtime administration too late? Gut. 1987 Apr;28(4):451–454. doi: 10.1136/gut.28.4.451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morgan D. J., Uccellini D. A., Raymond K., Mihaly G. W., Jones D. B., Smallwood R. A. The influence of duration of intravenous infusion of an acute dose on plasma concentrations of cimetidine. Eur J Clin Pharmacol. 1983;25(1):29–34. doi: 10.1007/BF00544010. [DOI] [PubMed] [Google Scholar]
  15. Ostro M. J., Russell J. A., Soldin S. J., Mahon W. A., Jeejeebhoy K. N. Control of gastric pH with cimetidine: boluses versus primed infusions. Gastroenterology. 1985 Sep;89(3):532–537. doi: 10.1016/0016-5085(85)90447-0. [DOI] [PubMed] [Google Scholar]
  16. Peden N. R., Saunders J. H., Wormsley K. G. Inhibition of pentagastrin-stimulated and nocturnal gastric secretion by ranitidine. A new H2-receptor antagonist. Lancet. 1979 Mar 31;1(8118):690–692. doi: 10.1016/s0140-6736(79)91146-2. [DOI] [PubMed] [Google Scholar]
  17. Peterson W. L., Richardson C. T. Sustained fasting achlorhydria: a comparison of medical regimens. Gastroenterology. 1985 Mar;88(3):666–669. doi: 10.1016/0016-5085(85)90134-9. [DOI] [PubMed] [Google Scholar]
  18. Peura D. A., Johnson L. F. Cimetidine for prevention and treatment of gastroduodenal mucosal lesions in patients in an intensive care unit. Ann Intern Med. 1985 Aug;103(2):173–177. doi: 10.7326/0003-4819-103-2-173. [DOI] [PubMed] [Google Scholar]
  19. Pounder R. E., Williams J. G., Milton-Thompson G. J., Misiewicz J. J. 24-hour control of intragastric acidity by cimetidine in duodenal-ulcer patients. Lancet. 1975 Nov 29;2(7944):1069–1072. doi: 10.1016/s0140-6736(75)90434-1. [DOI] [PubMed] [Google Scholar]
  20. Priebe H. J., Skillman J. J., Bushnell L. S., Long P. C., Silen W. Antacid versus cimetidine in preventing acute gastrointestinal bleeding. A randomized trial in 75 critically ill patients. N Engl J Med. 1980 Feb 21;302(8):426–430. doi: 10.1056/NEJM198002213020802. [DOI] [PubMed] [Google Scholar]
  21. Reynolds J. R., Walt R. P., Clark A. G., Hardcastle J. D., Langman M. J. Intragastric pH monitoring in acute upper gastrointestinal bleeding and the effect of intravenous cimetidine and ranitidine. Aliment Pharmacol Ther. 1987 Feb;1(1):23–30. doi: 10.1111/j.1365-2036.1987.tb00602.x. [DOI] [PubMed] [Google Scholar]
  22. Walt R. P., Male P. J., Rawlings J., Hunt R. H., Milton-Thompson G. J., Misiewicz J. J. Comparison of the effects of ranitidine, cimetidine and placebo on the 24 hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer. Gut. 1981 Jan;22(1):49–54. doi: 10.1136/gut.22.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Walt R. P., Reynolds J. R., Langman M. J., Smart H. L., Kitchingman G., Somerville K. W., Hawkey C. J. Intravenous omeprazole rapidly raises intragastric pH. Gut. 1985 Sep;26(9):902–906. doi: 10.1136/gut.26.9.902. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Zinner M. J., Zuidema G. D., Smith P[L, Mignosa M. The prevention of upper gastrointestinal tract bleeding in patients in an intensive care unit. Surg Gynecol Obstet. 1981 Aug;153(2):214–220. [PubMed] [Google Scholar]

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