Acid suppression therapy is frequently prescribed in the intensive care unit (ICU) to prevent stress-related mucosal bleeding and peptic ulcer rebleeding. Proton pump inhibitors (PPIs) with their potent acid suppressive effect, lack of tolerance, clean safety profile and availability in a number of different dosage formulations have potential advantages over histamine-2 receptor antagonists (H₂RAs). Although the literature evidence to support the use of PPIs for acid suppression in the ICU is ever increasing, a number of questions surrounding PPI use remain unanswered including the interchangeability of individual agents, the optimal dosage regimen for a given patient and the cost-effectiveness of PPI therapy.

This program will provide pharmacists with the knowledge to optimize stress ulcer prophylaxis therapy and acid suppressive therapy following nonvariceal upper gastrointestinal bleeding. Speakers will review the pharmacology of PPIs and discuss the important factors affecting both intravenous and enteral PPI pharmacodynamic response. Using a case-based approach, pharmacists will be provided with the current literature evidence surrounding the use of PPIs for stress ulcer prophylaxis and nonvariceal upper GI bleeding as well as strategies to optimize acid suppressive therapy in this population. Lastly, with the number of PPI formulations ever increasing, the key drug, patient and economic factors that need to be considered when making PPI formulary decisions will be reviewed.

Target Audience

This symposium was planned to meet the needs of pharmacy technicians and pharmacists in a variety of health systems, including large and small hospitals, managed care facilities, inpatient facilities, outpatient clinics, and home care settings, as well as the pharmaceutical industry and academia. The program would be beneficial for those who treat, instruct, or otherwise participate in the care of critically ill patients in need of acid suppression therapy.