title: Efficacy of primed infusions with high dose ranitidine and omeprazole to maintain high intragastric pH in patients with peptic ulcer bleeding: a prospective randomised controlled study.
abstract: BACKGROUND
  In healthy subjects, continuous infusions of high dose ranitidine and omeprazole produce high intragastric pH values.
  
  
  OBJECTIVE
  To test the hypothesis that both drugs also maintain high intragastric pH values in patients with bleeding ulcers.
  
  
  METHODS
  In two parallel studies, 20 patients with bleeding duodenal ulcers and 20 patients with bleeding gastric ulcers were randomly assigned to receive either ranitidine (0.25 mg/kg/hour after a bolus of 50 mg) or omeprazole (8 mg/hour after a bolus of 80 mg) for 24 hours. Intragastric pH was continuously recorded with a glass electrode placed 5 cm below the cardia.
  
  
  RESULTS
  Both drugs rapidly raised the intragastric pH above 6. During the second 12 hour period, however, the percentage of time spent below a pH of 6 was 0.15% with omeprazole and 20.1% with ranitidine (p = 0.0015) in patients with duodenal ulcer; in patients with gastric ulcer it was 0.1% with omeprazole and 46.1% with ranitidine (p = 0.002).
  
  
  CONCLUSIONS
  Primed infusions of omeprazole after a bolus produced consistently high intragastric pH values in patients with bleeding peptic ulcers, whereas primed infusions with ranitidine were less effective during the second half of a 24 hour treatment course. This loss of effectiveness may be due to tolerance.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Elisabeth Hospital, Essen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Labenz
authors.forename: U
authors.initials: U
authors.lastname: Peitz
authors.forename: C
authors.initials: C
authors.lastname: Leusing
authors.forename: B
authors.initials: B
authors.lastname: Tillenburg
authors.forename: A L
authors.initials: AL
authors.lastname: Blum
authors.forename: G
authors.initials: G
authors.lastname: Börsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D011446:Prospective Studies; D011899:Ranitidine / Q000008:administration & dosage*; D012044:Regression Analysis; D013276:Stomach Ulcer / Q000150:complications*
chemical_list: D000897:Anti-Ulcer Agents; D011899:Ranitidine; D009853:Omeprazole