Comparison of the enteral and intravenous lansoprazole pharmacodynamic responses in critically ill patients

K. M. Olsen, J. W. Devlin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background While proton pump inhibitors are frequently administered in the intensive care unit, the pharmacodynamic response of acid suppression between the enteral and intravenous (IV) route is unknown. Aim To compare the pharmacodynamic response between enteral and IV lan- soprazole in intensive care unit patients requiring stress ulcer prophylaxis therapy. Methods Adult mechanically ventilated patients were randomized to receive 72 h of daily enteral [lansoprazole oral disintegrating tablet (LODT) 30 mg mixed in 10 mL of water via a nasal gastric tube] or IV lansoprazole (30 mg over 30 min) therapy. Serial blood samples were collected after the first and third dose and analysed for pharmacokinetic parameters. Pharmacodynamic determination of intragastric pHmetry began prior to the first dose and continued for 72 h using a single channel pH micro- electrode. Results Nineteen intensive care unit patients were randomized [LODT (n = 10); IV-L (n = 9)]. LODT bioavailability was 76%. LODT maintained gastric pH > 4 longer than IV-L at both 24 h (7.4 vs. 5.9 h; P = 0.039) and 72 h (10.4 and 8.9 h; P = 0.046) and resulted in a greater average pH over the first 24 h (3.67 vs. 2.89; P = 0.03). Conclusion Despite a lower bioavailability, enteral lansoprazole suppresses acid in intensive care unit patients to a greater extent than IV lansoprazole.

Original languageEnglish (US)
Pages (from-to)326-333
Number of pages8
JournalAlimentary Pharmacology and Therapeutics
Volume28
Issue number3
DOIs
StatePublished - Aug 1 2008

Fingerprint

Lansoprazole
Critical Illness
Small Intestine
Tablets
Intensive Care Units
Biological Availability
Stomach
Acids
Proton Pump Inhibitors
Nose
Ulcer
Electrodes
Pharmacokinetics
Water

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Comparison of the enteral and intravenous lansoprazole pharmacodynamic responses in critically ill patients. / Olsen, K. M.; Devlin, J. W.

In: Alimentary Pharmacology and Therapeutics, Vol. 28, No. 3, 01.08.2008, p. 326-333.

Research output: Contribution to journalArticle

@article{1bf739cbe4e94774959f0819f9d94fdc,
title = "Comparison of the enteral and intravenous lansoprazole pharmacodynamic responses in critically ill patients",
abstract = "Background While proton pump inhibitors are frequently administered in the intensive care unit, the pharmacodynamic response of acid suppression between the enteral and intravenous (IV) route is unknown. Aim To compare the pharmacodynamic response between enteral and IV lan- soprazole in intensive care unit patients requiring stress ulcer prophylaxis therapy. Methods Adult mechanically ventilated patients were randomized to receive 72 h of daily enteral [lansoprazole oral disintegrating tablet (LODT) 30 mg mixed in 10 mL of water via a nasal gastric tube] or IV lansoprazole (30 mg over 30 min) therapy. Serial blood samples were collected after the first and third dose and analysed for pharmacokinetic parameters. Pharmacodynamic determination of intragastric pHmetry began prior to the first dose and continued for 72 h using a single channel pH micro- electrode. Results Nineteen intensive care unit patients were randomized [LODT (n = 10); IV-L (n = 9)]. LODT bioavailability was 76{\%}. LODT maintained gastric pH > 4 longer than IV-L at both 24 h (7.4 vs. 5.9 h; P = 0.039) and 72 h (10.4 and 8.9 h; P = 0.046) and resulted in a greater average pH over the first 24 h (3.67 vs. 2.89; P = 0.03). Conclusion Despite a lower bioavailability, enteral lansoprazole suppresses acid in intensive care unit patients to a greater extent than IV lansoprazole.",
author = "Olsen, {K. M.} and Devlin, {J. W.}",
year = "2008",
month = "8",
day = "1",
doi = "10.1111/j.1365-2036.2008.03728.x",
language = "English (US)",
volume = "28",
pages = "326--333",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Comparison of the enteral and intravenous lansoprazole pharmacodynamic responses in critically ill patients

AU - Olsen, K. M.

AU - Devlin, J. W.

PY - 2008/8/1

Y1 - 2008/8/1

N2 - Background While proton pump inhibitors are frequently administered in the intensive care unit, the pharmacodynamic response of acid suppression between the enteral and intravenous (IV) route is unknown. Aim To compare the pharmacodynamic response between enteral and IV lan- soprazole in intensive care unit patients requiring stress ulcer prophylaxis therapy. Methods Adult mechanically ventilated patients were randomized to receive 72 h of daily enteral [lansoprazole oral disintegrating tablet (LODT) 30 mg mixed in 10 mL of water via a nasal gastric tube] or IV lansoprazole (30 mg over 30 min) therapy. Serial blood samples were collected after the first and third dose and analysed for pharmacokinetic parameters. Pharmacodynamic determination of intragastric pHmetry began prior to the first dose and continued for 72 h using a single channel pH micro- electrode. Results Nineteen intensive care unit patients were randomized [LODT (n = 10); IV-L (n = 9)]. LODT bioavailability was 76%. LODT maintained gastric pH > 4 longer than IV-L at both 24 h (7.4 vs. 5.9 h; P = 0.039) and 72 h (10.4 and 8.9 h; P = 0.046) and resulted in a greater average pH over the first 24 h (3.67 vs. 2.89; P = 0.03). Conclusion Despite a lower bioavailability, enteral lansoprazole suppresses acid in intensive care unit patients to a greater extent than IV lansoprazole.

AB - Background While proton pump inhibitors are frequently administered in the intensive care unit, the pharmacodynamic response of acid suppression between the enteral and intravenous (IV) route is unknown. Aim To compare the pharmacodynamic response between enteral and IV lan- soprazole in intensive care unit patients requiring stress ulcer prophylaxis therapy. Methods Adult mechanically ventilated patients were randomized to receive 72 h of daily enteral [lansoprazole oral disintegrating tablet (LODT) 30 mg mixed in 10 mL of water via a nasal gastric tube] or IV lansoprazole (30 mg over 30 min) therapy. Serial blood samples were collected after the first and third dose and analysed for pharmacokinetic parameters. Pharmacodynamic determination of intragastric pHmetry began prior to the first dose and continued for 72 h using a single channel pH micro- electrode. Results Nineteen intensive care unit patients were randomized [LODT (n = 10); IV-L (n = 9)]. LODT bioavailability was 76%. LODT maintained gastric pH > 4 longer than IV-L at both 24 h (7.4 vs. 5.9 h; P = 0.039) and 72 h (10.4 and 8.9 h; P = 0.046) and resulted in a greater average pH over the first 24 h (3.67 vs. 2.89; P = 0.03). Conclusion Despite a lower bioavailability, enteral lansoprazole suppresses acid in intensive care unit patients to a greater extent than IV lansoprazole.

UR - http://www.scopus.com/inward/record.url?scp=63449109451&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63449109451&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2008.03728.x

DO - 10.1111/j.1365-2036.2008.03728.x

M3 - Article

C2 - 19086331

AN - SCOPUS:63449109451

VL - 28

SP - 326

EP - 333

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 3

ER -