Protonix use

[laughingtoe]

Hi all. I'm a long time lurker but infrequent poster here on AN. I have a question for all you experienced nurses out there. I'm a fairly new grad & I've noticed that about 90% of my patients are prescribed protonix on admission to the hospital. I've looked up this medication in the drug books & I found it's often prescribed for GERD, but I've noticed it's prescribed for my patients that don't have GERD. I've also noticed it's often started once it's found a patient may have a GI bleed. So my question is, why are so many patients receiving this med if they don't have GERD?

[ChristineN, BSN, RN]

Doctors routinely prescribe it on pts that are GI stable and don't have GERD to help decrease the risk of a stomach ulcer while in the hospital. Stress, medications, etc can all be very hard on the stomach, so we try to reduce that risk.

[NeoPediRN]

Patients are prone to stress ulcers in the hospital. They are usually less mobile, and laying in bed makes you more susceptible to reflux.

[TigerGalLE, BSN, RN]

Research has shown that being in the hospital puts patients at risk for stress related stomach ulcers. Protonix is ordered as a prevention. GI prophylaxis.

[NeoPediRN]

Also, it's a proton pump inhibitor which helps turn off the acid in the stomach that can lead to the things mentioned above.

[laughingtoe]

Thanks for the replies!

[Tait, MSN, RN]

We used to give omeprazole every morning like candy, until the warnings came out for the interactions between Omep and Plavix (heavy cardiac floor at the time).

[Roy Fokker, BSN, RN]

Also - how many admitted pts. are kept NPO?

cheers,

[anotherone, BSN, RN]

I read an article in a nursing magazine recently (maybe nrusing spectrum). that ppis given as prophylaxis outside of the ICU may not be doing any good. did any one else read this ? or know more about it ? I can't remember the source now.

[ZippyGBR, BSN, RN]

Also - how many admitted pts. are kept NPO?

cheers,

as few as possible for as short a period as is safe

[mama_d, BSN, RN]

We used to give omeprazole every morning like candy, until the warnings came out for the interactions between Omep and Plavix (heavy cardiac floor at the time).

We switched to Protonix for this reason...it's the only PPI which does not interact with Plavix.

[ckh23, BSN, RN]

It is used for gastric ulcer prevention while hospitalized. However there was an article recently in one of the critical care magazines that show some evidence that giving GI prophylaxis outside of the ICU created more problems and showed no reduction in ulcers or GI bleeds. I'll have to look around to see if I can find the article.

Edit: I couldn't find the exact article but here is a link to something similar

http://onlinelibrary.wiley.com/doi/10.1002/jhm.10/full