[Prevention of acute stress hemorrhages of the upper gastrointestinal tract with pirenzepine and antacids. A controlled comparison between pirenzepine and cimetidine]

Abstract

H2-antagonists, antacids and pirenzepine are effective drugs for prophylaxis of stress ulcer bleeding. Combined medication seems to be superior to single medication, but investigations of the effectiveness of a pirenzepine-antacid prophylaxis have not been carried out. We therefore evaluated the effect of this combination on gastric pH and on prevention of stress bleeding in ICU patients. In a prospective controlled randomized study 33 patients in each group received 50 mg. pirenzepine intravenously as a basic medication and alternatively 2000 mg. cimetidine i.v. or 2-hourly 10 ml. antacid. Gastric pH was determined three times per day. Stress bleeding was defined as bloody gastric juice, haematemesis or melaena. Two stress bleedings could be detected in each group. The pirenzepine-antacid combination proved to be superior to ensure a gastric pH of more than 3.5 than the pirenzepine-cimetidine group. After removal of the nasogastric tube the 2-hourly application of antacids proved to be impracticable.