Clinical Review
Inappropriate Use of Proton Pump Inhibitors for Stress Ulcer Prophylaxis
Fed Pract. 2011 February;28(2):27
Author and Disclosure Information
Martin Ziska, PharmD, BS; Nicole L. McMaster-Baxter, PharmD, MS, BCPS; and Richard M. Cadle, PharmD, BCPS, FASHP
Dr. Ziska is a clinical pharmacist in geriatrics at the Audie L. Murphy Memorial Veterans Hospital in San Antonio, Texas. At the time of this study, he was a pharmacy practice resident at the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, Texas. Dr. McMaster-Baxter is a clinical pharmacy specialist in internal medicine at the MEDVAMC; an instructor in the section of internal medicine at Baylor College of Medicine (BCM) in Houston, Texas; and a clinical assistant professor at the University of Texas in Austin and the University of Houston in Houston, Texas. Dr. Cadle is the clinical pharmacy manager, pharmacy residency program director, and an infectious disease clinical pharmacy specialist in the MEDVAMC; an assistant professor of medicine in the infectious diseases section at BCM; and a clinical assistant professor at the University of Texas in Austin and the University of Houston.
Stress-related mucosal disease (SRMD) is characterized by acute multiple ulcerations of the upper gastrointestinal submucosa, which may be either diffuse or focal, superficial or deep.(1,2) SRMD can result from any number of factors that increase physiologic demands, though the most common etiology is splanchnic hypoperfusion resulting in gastric mucosal ischemia.(3,4) Patients in intensive care units (ICUs), who are at elevated risk for splanchnic hypoperfusion, are prone to developing stress ulcers and associated gastrointestinal bleeding.