[Evaluation of intravenous ranitidine and omeprazole effect on the 24-hour gastric ph-metry in duodenal ulcer hemorrhage].
BACKGROUND
The pharmacotherapy of bleeding peptic ulcer is directed to improve the environment of the bleeding point by keeping the gastric pH above the proteolytic range for pepsin.


OBJECTIVE
To evaluate the best pharmacological approach to inhibit gastric acid secretion with current antisecretory drugs in patients with bleeding duodenal ulcers.


METHODS
Forty-seven patients with bleeding duodenal ulcers were randomized to receive I.V.: I) Omeprazole: an initial bolus of 80 mg + perfusion of 3.3 mg/h; II) Omeprazole: an initial bolus of 80 mg + 40 mg/12 h; III) Omeprazole: 40 mg/8 h; IV) Ranitidine: perfusion of 12.5 mg/h; V) Ranitidine: 50 mg/4 h. Gastric acidity was measured and recorded by 24 h gastric pH monitoring.


RESULTS
All types of treatment with omeprazole were superior to either continuous perfusion or intermittent bolus of ranitidine in increasing the pH for 24 h and reducing the % of time the gastric pH was below 4 and 6, and the number of time the gastric pH was below 4 for more than 5 min. There were no statistical differences between the different regimens of omeprazole, but continuous perfusion of ranitidine was superior to intermittent ranitidine bolus.


CONCLUSIONS
Parenteral omeprazole is better than parenteral ranitidine in keeping the intragastric pH above the proteolytic range for pepsin in patients with bleeding duodenal ulcers.
Artal
A
A
Servicio de Aparato Digestivo, Hospital Clínico Universitario, Zaragoza.
Lanas
A
A
Barrao
M E
ME
Moliner
F J
FJ
Blas
J M
JM
López
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004381:Duodenal Ulcer / Q000150:complications*; D005744:Gastric Acid / Q000378:metabolism; D005745:Gastric Acidity Determination; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D000897:Anti-Ulcer Agents; D011899:Ranitidine; D009853:Omeprazole
Valoración de ranitidina y omeprazol intravenosos por pH-metría gástrica de 24 horas en hemorragia digestiva por úlcera duodenal.