Why is everyone on Protonix

  1. 0 The title pretty much speaks for itself as far as my question. I've had too many patients who were on Protonix with no hx of ulcers, GERD, anything. So why?!
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  3. Visit  mediatix8} profile page

    About mediatix8

    From 'Chicago, IL'; 34 Years Old; Joined Nov '04; Posts: 194; Likes: 101.

    20 Comments so far...

  4. Visit  ArmyWife,RN} profile page
    0
    Depending on the length of the hospital stay and the agressiveness of the doc (in treating the pt), stress ulcers born from the hospitalization/illness/dz process would be the reason.

    A.W.
  5. Visit  Tweety} profile page
    0
    Quote from ArmyWife,RN
    Depending on the length of the hospital stay and the agressiveness of the doc (in treating the pt), stress ulcers born from the hospitalization/illness/dz process would be the reason.

    A.W.

    Our trauma docs here give pepcid for the same reason.

    I've noticed a lot of medical patients getting protonix though.
  6. Visit  MamaTheNurse} profile page
    0
    our ICU is part of a statewide safety initiative to prevent pneumonia in ventilator patients and we round 3 times a week on vent patients to make sure they are being treated appropriately to prevent complications - they have to have their HOB up at least 30 degrees (if they can tolerate), have some sort of DVT prophylaxis (minimum SCD's, if not heparin or Lovenox), some sort of PUD prophylaxis (we mostly use IV Pepcid), have their blood sugars monitored and treated appropriately, have their skin closely monitored and aggressively treated if breakdown occurs, have a daily wake-up if they are sedated, daily attempts at weaning off the vent (if appropriate) - I think there are a few more but I can't remember off hand - the PUD prophylaxis is to prevent ulcers and also minimize damage if aspiration occurs

    I think all hospitals in Michigan are part of this program, tailored to your institution
  7. Visit  suebird3} profile page
    0
    One of our local hospitals put people on Protonix because they get kick backs. They couldn't care less if the patient is on anything else, with good results. We end up switching OFF Protonix, cuz PA doesn't pay for it.
  8. Visit  litepath} profile page
    0
    All of theses answers while correct do miss an important point; HCL in the stomach is there to kill bugs via low pH. These inhibitors nix the low pH and thereby give rise to bug growth. Sucralfate will bind with HCl, preventing the stress ulcers w/o raising the pH to unsafe( for the patients protection) levels.

    Read "The ICU Book" by Paul Marino
  9. Visit  MamaTheNurse} profile page
    0
    Quote from litepath
    All of theses answers while correct do miss an important point; HCL in the stomach is there to kill bugs via low pH. These inhibitors nix the low pH and thereby give rise to bug growth. Sucralfate will bind with HCl, preventing the stress ulcers w/o raising the pH to unsafe( for the patients protection) levels.

    Read "The ICU Book" by Paul Marino
    that's very interesting - I'll have to check that out - isn't sucralfate "Carafate"? I don't think I've seen that given at all in our ICU for anything.......thanks for the info
  10. Visit  nesher} profile page
    0
    In stem cell transplant land we give protonix over zantac due to cost. Our pt's (98%) are on TPN and not eatting so they suffer from heartburn type issues which of course may well be mucositis...
  11. Visit  lsyorke} profile page
    1
    Interesting article here about this very subject. As a nurse of 20 years I can't remember a patient developing ulcers as a result of being hospitalized. Kind of makes you go Hmmmmm, as to why we are spending the money on expensive preventative therapy for something that doesn't occur frequently.

    http://www.brighamandwomens.org/phar...uly%202002.pdf
    Tooimpatient likes this.
  12. Visit  Tweety} profile page
    0
    Quote from litepath
    All of theses answers while correct do miss an important point; HCL in the stomach is there to kill bugs via low pH. These inhibitors nix the low pH and thereby give rise to bug growth. Sucralfate will bind with HCl, preventing the stress ulcers w/o raising the pH to unsafe( for the patients protection) levels.

    Read "The ICU Book" by Paul Marino

    Beside that it's for digestion of protein, calcium and other minerals. Many people actually suffer from low levels of HCL. When I was reading a diet plan called "The Fast Track Detox" Ann Louise Gittlemen, talked of this and even encouraged supplementation, to help with detox and weight loss. Here's another article: http://altmedicine.about.com/cs/dige...s/a/LowHCL.htm

    Off topic.
  13. Visit  Nurseboy1} profile page
    0
    Quote from litepath
    All of theses answers while correct do miss an important point; HCL in the stomach is there to kill bugs via low pH. These inhibitors nix the low pH and thereby give rise to bug growth. Sucralfate will bind with HCl, preventing the stress ulcers w/o raising the pH to unsafe( for the patients protection) levels.

    Read "The ICU Book" by Paul Marino
    While that is true, sucralfate does bind to many drugs preventing absorption which can make a dosing schedule problematic since the sucralfate is typically taken qid while protonix is taken daily or q12H.
    Last edit by Nurseboy1 on Oct 9, '05 : Reason: clarification
  14. Visit  lsyorke} profile page
    0
    But why are we treating something that doesn't exist?? This seems to be a trend in medicine today. I can understand prophalaxsis in some things, like DVT prevention, since there is a physiological risk with limited activity. But when did the whole inpatient population start having excess gastric acid production? Just because someone is on an antibiotic doesn't mean that they need protonix. Now if you have a GI diagnosis that is caused by increased acid I can see using these drugs, but everyone??? Am I missing something here????
  15. Visit  Nurseboy1} profile page
    0
    Quote from lsyorke
    But why are we treating something that doesn't exist?? This seems to be a trend in medicine today. I can understand prophalaxsis in some things, like DVT prevention, since there is a physiological risk with limited activity. But when did the whole inpatient population start having excess gastric acid production? Just because someone is on an antibiotic doesn't mean that they need protonix. Now if you have a GI diagnosis that is caused by increased acid I can see using these drugs, but everyone??? Am I missing something here????
    According to my med-surg textbook, stress ulcers have some known causes such as trauma, burns, head injuries, sepsis, respiratory failure. Stress ulcers also arise from unknown etiology. It is therefore easier to prevent the ulcer from occuring then to treat a resulting ulcer and its potential complications (infection, bleeding, hypovolemia, perforation). Once the patient is discharged usually the use of the PPI is discontinued.


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