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+--- Thread: ulcer - recall (/showthread.php?tid=178773)
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ulcer - recall - ArchivalUser - 04-14-2007
you have a 34 year old patient who has had a motor vehicle accident and is in the ICU with multiple fractures...etc....
the patient is unconsious and on a ventilator.......what is the preferred medication fro the prevention of stress ulcers in this setting:
1...Cimitidine
2....omeprazole
3...sacralfate
4...misoprostol
5 antacid
0 - ArchivalUser - 04-14-2007
5.
0 - ArchivalUser - 04-14-2007
in there any I/v form of antacid ?
0 - ArchivalUser - 04-14-2007
3..
0 - ArchivalUser - 04-15-2007
should be 222222...
0 - ArchivalUser - 04-15-2007
4?
0 - ArchivalUser - 04-15-2007
Based on this ......... Probably 3
3
http://www.brighamandwomens.org/pharmacoepid/Research/EduMaterials/Acid%20suppression%20update%20July%202002.pdf
One large meta-analysis found that sucralfate (1 gm q.i.d.) is as effective as H2 blockers or PPIs in these critically ill patients.
A more recent randomized controlled trial showed decreased incidence of GI bleeding with i.v. ranitidine compared to sucralfate, but no difference in mortality.
Some studies suggest that nosocomial pneumonia may occur less often with use of sucralfate in ventilated patients as compared to H2 blockers (ranitidine 50 mg i.v. t.i.d.).
Intravenous PPIs have not been studied for efficacy in stress ulcer prophylaxis. Their use may be appropriate in the very limited number of patients who cannot be given sucralfate or an i.v. H2 blocker.
0 - ArchivalUser - 04-15-2007
but this patient is unconsious..... how can you give sucralfate PO?
888888 - ArchivalUser - 04-15-2007
can gve thru NG
BUT STILL its far more convenient to gvei/v h2 blockers
as ventilato ris mentioned so i ll go for 3 as well
0 - ArchivalUser - 04-15-2007
sorry i didnt think about the NG
Thank you