Clinical Characteristics of Intravenous Pantoprazole Consumption in Cardiac Intensive Care Unit

G. Eslami, Elahe Karimpour Razkenar, Yahya Sharifi, A. Soleimani, E. Salehifar, Parastoo Karimi Aliabadi
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Abstract

Background: Proton Pump Inhibitors (PPIs) are the most common medicine for the treatment and prophylaxis of acid peptic conditions. The inappropriate use of the PPIs, mainly the intravenous form of pantoprazole may lead to excessive cost and unexpected adverse effects.  Objectives: The present study aimed to evaluate the use of intravenous pantoprazole in the International Heart Center in the north of Iran. Methods: The current retrospective study was performed on 215 patients hospitalized in Fatemeh Zahra Hospital in Sari City, Iran. Patients’ demographics, the type and doses of pantoprazole, and other relevant clinical data were recorded from their documentation. The appropriate use of pantoprazole was evaluated according to recommendations provided by Medscape 2020, and UpToDate 2020. Results: Prescribing PPI was appropriate for 53.5% of the examined patients; however, the majority of intravenous prescription cases were inappropriate (76.7%). Oral PPIs could have been used in 93.5% of the cases; however, they received the parenteral form of pantoprazole. The main cause of pantoprazole prescription in the explored hospital was stress ulcer prophylaxis, with the median 4/18 days used, which internal specialists in most of the cases (45.6%) prescribed. Conclusion: In the current study, administrating intravenous pantoprazole was inappropriate in most of the cases. As a result of this improper administration, the extensive cost is exposed to the healthcare system, i.e., likely to be unsafe for patients. Accordingly, risk and indication evaluation for the prescription of pantoprazole should be a priority in each patient. Finally, it seems necessary to determine a protocol for PPI prescription per hospital for the rational use of drugs. 
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心脏重症监护病房静脉注射泮托拉唑的临床特点
背景:质子泵抑制剂(PPIs)是治疗和预防酸性消化性疾病最常用的药物。PPIs(主要是泮托拉唑静脉注射形式)的不当使用可能导致成本过高和意想不到的不良反应。目的:本研究旨在评估伊朗北部国际心脏中心静脉注射泮托拉唑的使用情况。方法:回顾性研究伊朗萨里市Fatemeh Zahra医院住院的215例患者。患者的人口统计资料、泮托拉唑的类型和剂量,以及其他相关的临床数据从他们的文件中记录下来。根据Medscape 2020和UpToDate 2020提供的建议评估泮托拉唑的适当使用。结果:53.5%的患者适合开具PPI;然而,大多数静脉处方不恰当(76.7%)。93.5%的病例可以使用口服质子泵抑制剂;然而,他们接受了注射形式的泮托拉唑。受访医院泮托拉唑处方的主要原因为应激性溃疡预防,中位用药时间为4 ~ 18天,以内科专家为主(45.6%)。结论:在本研究中,大多数病例静脉给予泮托拉唑是不合适的。由于这种不当的管理,大量的成本暴露在医疗保健系统中,也就是说,可能对患者不安全。因此,泮托拉唑处方的风险和适应症评估应该是每个患者的优先事项。最后,为了合理用药,有必要确定每家医院的PPI处方方案。
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