The Journal of Informed Pharmacotherapy 2004;15:403.
Mandeep K. Saran, B.Sc.(Pharm) , Peter S. Loewen, B.Sc.(Pharm), Pharm.D., Peter J. Zed, B.Sc., B.Sc.(Pharm), Pharm.D.
Pharmaceutical Sciences Clinical Services Unit, Vancouver Hospital & Health Sciences Centre, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 2003.
To determine the epidemiology and management of acute upper gastrointestinal bleeding (AGIB) in subjects presenting with signs suspicious of AGIB and receiving intravenous (IV) pantoprazole.
A major Canadian tertiary adult acute care teaching hospital.
Retrospective chart review of subjects receiving IV pantoprazole for suspected or confirmed AGIB was conducted at two teaching hospitals from January 1, 2000 to November 7, 2002.
Of 175 subjects enrolled, 38% had an endoscopically confirmed high-risk bleed. The median time to endoscopy was 18.5 hours and the median time to start pantoprazole was 6.9 hours. Twenty-one percent of the population did not receive the appropriate pantoprazole dose of 80 mg bolus followed by 8 mg/h infusion and 33% of the high-risk subjects received less than 60 hours of IV pantoprazole. The median duration of pantoprazole following endoscopy for low-risk subjects was 21.1 hours. In the high-risk population, clinical event rates were 19% for rebleeding, 6% for surgery and 3% for death during the initial hospitalization.
Although IV pantoprazole is initiated quickly, the appropriate dose and duration is not always used in high-risk patients. Pantoprazole infusion is continued longer than necessary in low-risk patients. Further strategies are required at our institutions to ensure optimal use of IV pantoprazole for AGIB.
Copyright © 2003 by the Journal of Informed Pharmacotherapy. All rights reserved.