Proton pump inhibitor formulary considerations in the acutely Ill

Part 1 - Pharmacology, pharmacodynamics, and available formulations

John W. Devlin, Lynda S. Welage, Keith Melvin Olsen

Research output: Contribution to journalReview article

30 Citations (Scopus)

Abstract

OBJECTIVE: To review important proton pump inhibitor (PPI) pharmacologic, pharmacokinetic, and pharmacodynamic principles in acutely ill patients, compare PPI formulation options for patients unable to swallow a tablet or capsule, and provide clinicians with guidance when making hospital formulary decisions with this class of agents. DATA SOURCES: MEDLINE (1966-May 2005) and the Cochrane Library databases were searched using the key words proton pump inhibitor, acid suppression, peptic ulcer disease, gastrointestinal bleeding, stress ulcer prophylaxis, and critical illness. Bibliographies of cited references were reviewed, and a manual search of abstracts from recent gastroenterology, critical care, and surgery scientific meetings was completed. STUDY SELECTION AND DATA EXTRACTION: All articles identified from the data sources were evaluated, and all information deemed relevant was included for this review. DATA SYNTHESIS: PPIs have become a mainstay for acute acid suppression in hospitalized patients over other therapeutic options. Various commercially available PPI products are available for administration, either enterally or parenterally, to patients unable to swallow a tablet or capsule. Newer oral PPI formulations offer numerous advantages over older products. The results of studies comparing the pharmacokinetics and pharmacodynamics of different PPI dosage forms and routes of administration are among the factors to consider when making formulary decisions. CONCLUSIONS: While the introduction of new PPI products has expanded the therapeutic options for acid suppression in acutely ill patients, a number of unresolved questions remain surrounding the interchangeability of these products, the clinical significance of one PPI formulation over the other, and how oral/enteral PPI therapy should be used as step-down therapy after parenteral PPI therapy.

Original languageEnglish (US)
Pages (from-to)1667-1677
Number of pages11
JournalAnnals of Pharmacotherapy
Volume39
Issue number10
DOIs
StatePublished - Oct 1 2005

Fingerprint

Formularies
Proton Pump Inhibitors
Pharmacology
Information Storage and Retrieval
Deglutition
Tablets
Acids
Capsules
Hospital Formularies
Pharmacokinetics
Therapeutics
Gastrointestinal Diseases
Dosage Forms
Bibliography
Gastroenterology
Critical Care
Peptic Ulcer
Critical Illness
MEDLINE
Libraries

Keywords

  • Critical care
  • Decision-making
  • Proton pump inhibitors

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Proton pump inhibitor formulary considerations in the acutely Ill : Part 1 - Pharmacology, pharmacodynamics, and available formulations. / Devlin, John W.; Welage, Lynda S.; Olsen, Keith Melvin.

In: Annals of Pharmacotherapy, Vol. 39, No. 10, 01.10.2005, p. 1667-1677.

Research output: Contribution to journalReview article

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