Repeated intravenous bolus injections of omeprazole: effects on 24-hour intragastric pH, serum gastrin, and serum pepsinogen A and C.
We determined the effect of four times daily dosing with intravenous omeprazole on 24-h intragastric acidity, serum gastrin, and serum pepsinogen A and C in 10 fasting subjects (median age, 23.5 years). Two dose regimens (80-20-20-20 mg and 80-40-40-40 mg) were compared in a randomized placebo-controlled crossover study. Intragastric pH was continuously monitored during 24 h, using combined glass electrodes, and blood samples were taken every 6 h. Repeated boluses of omeprazole every 6 h significantly increased (p less than 0.01) the median 24-h intragastric pH compared with placebo (median pH, 3.7 (140 mg/day), 4.3 (200 mg/day), and 1.4 (placebo)) but failed to continuously raise pH levels above 4.0 in 8 (140 mg/day) or 9 (200 mg/day) of 10 subjects. No advantage of the 200-mg dose over the 140-mg dose was demonstrated. A cumulative effect of intravenous omeprazole was shown after repeated boluses but also a marked interindividual variation in response, which was correlated with the omeprazole area under the plasma concentration time curve. A significant elevation of serum gastrin coincided with the increased pH levels, which was followed after 12-18 h by a significant increase of both serum pepsinogens.
Baak
L C
LC
Dept. of Gastroenterology and Hepatology, University Hospital, Leiden, The Netherlands.
Biemond
I
I
Jansen
J B
JB
Lamers
C B
CB
D000328:Adult; D004334:Drug Administration Schedule; D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005745:Gastric Acidity Determination; D005755:Gastrins / Q000097:blood / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009853:Omeprazole / Q000008:administration & dosage* / Q000493:pharmacokinetics; D010435:Pepsinogens / Q000097:blood / Q000187:drug effects*; D013270:Stomach / Q000187:drug effects* / Q000201:enzymology / Q000503:physiopathology; D013997:Time Factors
D005755:Gastrins; D010435:Pepsinogens; D009853:Omeprazole