Treatment of gastric hemorrhage by pulverized omeprazole and antacid--concomitant administration via a nasogastric tube.

Abstract

Gastroesophageal reflux (GER) is a common episode in pediatric patients with severe motor and intellectual disabilities (SMID) and occasionally leads to a severe clinical state accompanied with nausea, hematemesis, melena, wheezing, pneumonia, anemia and/or failure to thrive. We report here a case of a 14-year-old male with Lennox syndrome who had been treated with a histamine H2 blocker intravenously or via a nasogastric tube for repeated gastric hemorrhage due to severe GER. Since his gastric hemorrhage became resistant to the H2 blocker, we decided to replace it with a proton pump inhibitor (PPI). Although lansoprazole can be decapsulated for administration via a nasogastric tube, it tends to block fine tubes. The acid-sensitive drug omeprazole, another oral PPI, is commercially available as enteric-coated tablets. Therefore, we pulverized the tablets and administered omeprazole, mixed with a small amount of antacid, via a nasogastric tube. The patient's gastric hemorrhage was dramatically improved. Thus, administration of pulverized omeprazole concomitantly with antacid via a fine nasogastric tube may provide a novel approach for the treatment of chronic GER in pediatric patients with SMID.

• Authors: T Yamaguchi, S Mukai, E Kinoshita, H Ohtani, Y Sawada
• Journal: International journal of clinical pharmacology and therapeutics (Int J Clin Pharmacol Ther) Vol. 42 Issue 11 Pg. 594-6 (Nov 2004) ISSN: 0946-1965 [Print] Germany
• PMID: 15598025 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antacids
• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Cimetidine
• Omeprazole

Topics

• Adolescent
• Antacids (administration & dosage, therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Cimetidine (administration & dosage, therapeutic use)
• Drug Therapy, Combination
• Gastroesophageal Reflux (complications)
• Hemorrhage (drug therapy, etiology)
• Humans
• Intubation, Gastrointestinal
• Male
• Omeprazole (adverse effects, therapeutic use)
• Proton Pump Inhibitors
• Stomach Diseases (drug therapy, etiology)