1 / 54

Omezol Lyo-inj. Omeprazole 40 mg

donelle
Download Presentation

Omezol Lyo-inj. Omeprazole 40 mg

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    6. ?????????

    7. ????????? Endoscopic therapy Pharmacotherapy

    8. ????????? H2RAs (H2-Blockers) Proton pump inhibitors Fibrinolytic inhibitors (tranexamic acid) somatostatin and analoges

    10. Omeprazole is superior to ranitidine in the management of peptic haemorrhage Omeprazole is more effective than ranitidine in the long-term management of complicated reflux oesophagitis A study in patients with peptic stricture and severe erosive oesophagitis has demonstrated that treatment with omeprazole, 20 mg once daily, is superior to ranitidine, 150 mg twice daily, in the long-term management of complicated reflux oesophagitis64. After 6 months of therapy, 90% of patients who received omeprazole were in endoscopic remission, and all these patients were still in remission after 12 months. The few patients who relapsed were successfully managed with higher doses of omeprazole. In contrast, only 28% of patients treated with ranitidine were in remission after 6 months. Moreover, 3.5 dilatations were required per patient treated with omeprazole, compared with 9.0 in those who received ranitidine. These data are consistent with previous studies that have consistently demonstrated the superiority of omeprazole maintenance therapy over the H2-receptor antagonists in keeping patients free of dysphagia with a concomitant reduction in the need for dilatations65, 66. Omeprazole is more effective than ranitidine in the long-term management of complicated reflux oesophagitis A study in patients with peptic stricture and severe erosive oesophagitis has demonstrated that treatment with omeprazole, 20 mg once daily, is superior to ranitidine, 150 mg twice daily, in the long-term management of complicated reflux oesophagitis64. After 6 months of therapy, 90% of patients who received omeprazole were in endoscopic remission, and all these patients were still in remission after 12 months. The few patients who relapsed were successfully managed with higher doses of omeprazole. In contrast, only 28% of patients treated with ranitidine were in remission after 6 months. Moreover, 3.5 dilatations were required per patient treated with omeprazole, compared with 9.0 in those who received ranitidine. These data are consistent with previous studies that have consistently demonstrated the superiority of omeprazole maintenance therapy over the H2-receptor antagonists in keeping patients free of dysphagia with a concomitant reduction in the need for dilatations65, 66.

    11. Omeprazole is superior to ranitidine in the management of peptic haemorrhage Omeprazole is more effective than ranitidine in the long-term management of complicated reflux oesophagitis A study in patients with peptic stricture and severe erosive oesophagitis has demonstrated that treatment with omeprazole, 20 mg once daily, is superior to ranitidine, 150 mg twice daily, in the long-term management of complicated reflux oesophagitis64. After 6 months of therapy, 90% of patients who received omeprazole were in endoscopic remission, and all these patients were still in remission after 12 months. The few patients who relapsed were successfully managed with higher doses of omeprazole. In contrast, only 28% of patients treated with ranitidine were in remission after 6 months. Moreover, 3.5 dilatations were required per patient treated with omeprazole, compared with 9.0 in those who received ranitidine. These data are consistent with previous studies that have consistently demonstrated the superiority of omeprazole maintenance therapy over the H2-receptor antagonists in keeping patients free of dysphagia with a concomitant reduction in the need for dilatations65, 66. Omeprazole is more effective than ranitidine in the long-term management of complicated reflux oesophagitis A study in patients with peptic stricture and severe erosive oesophagitis has demonstrated that treatment with omeprazole, 20 mg once daily, is superior to ranitidine, 150 mg twice daily, in the long-term management of complicated reflux oesophagitis64. After 6 months of therapy, 90% of patients who received omeprazole were in endoscopic remission, and all these patients were still in remission after 12 months. The few patients who relapsed were successfully managed with higher doses of omeprazole. In contrast, only 28% of patients treated with ranitidine were in remission after 6 months. Moreover, 3.5 dilatations were required per patient treated with omeprazole, compared with 9.0 in those who received ranitidine. These data are consistent with previous studies that have consistently demonstrated the superiority of omeprazole maintenance therapy over the H2-receptor antagonists in keeping patients free of dysphagia with a concomitant reduction in the need for dilatations65, 66.

    15. Comparison about acute bleeding management

    16. Sources of extra costs associated with failure to prevent rebleeding 6.6 additional hematology tests 10.8 units of blood products 23.6 days of anti-ulcer medication 11.4 more days in ICU for surviving p’t Increased number of endoscopies and surgeries Adapted with permission from Heyland et al 1995

    18. Total Cost for Acute Ulcer bleeding management with Pharmacological therapy*

    19. PPIs for Stress ulcer Prophylaxis Omeprazole : 20-80mg , I.V. QD Pantoprazole : 40mg,I.V. QD

    20. Proton Pump Inhibitors

    21. Ome- Panto- Lanso- Rabe- T.R* (ug · h/mL) 0.2-1.2 (6X) 2-5 (2.5X) 2.7-5 (~2X) 0.8-1.5(~2X) Tmax (h) 0.5-3 2-4 1.3-2.2 3.1 t1/2 (h) 0.6-1 0.9-1.9 0.9-1.6 1 Protein binding (%) 95 98 97-99 95-98 Dose linearity non-linear linear linear linear

    22. Pharmacokinetic parameters

    23. Summary They are all potent acid suppressants with good safety profile. Omeprazole is especially. Rabeprazole and Omeprazole have faster onset Pantoprazole and Rabeprazole have least drug interaction Esomeprazole have the best acid suppression potency, Increase acid suppression may be relevant to the treatment of gastric ulcer and GERD

    24. Which one is better … Infusion ( Losec ) Injection ( Pantolac, Omezol )

    25. We could discuss ….. Pharmaceutics Pharmacokinetics Clinical Application

    27. Pharmacokinetics of injection

    28. Pharmacokinetics of infusion

    29. Clinical Application Active peptic ulcer bleeding with a visible vessel carry a high risk rebleeding and need aggressive treatment………, most clinicians hope for a simple, safe and effective medical therapy might prevent rebleeding and improve prognoses. Hwai-Jeng Lin…etc ( VGH-TP ) Arch Intern Med. 1998; 158:54-58 Chin Med J (Taipei) 1996;57:139-45

    30. Omezol Lyo.- injection Pharmaceutics Pharmacokinetics Clinical Application

    31. Losec infusion ? Omezol injection ???? ? AstraZeneca ?

    34. Omezol® injection???,??? : ??????????,???infusion,?Push ????????(bag)?,????(<20 ml)?? ??(< 5 min.),???????????? Omezol® injection ? Losec® infusion ????? : Omezol® Injection ????????(Push,Bolus)???(??<20 min.), ????????????????????????,????????? ?Losec® ???????????????”??”??,????? Omezol® injection ??? Losec® iv infusion???????????, ?????pH?,????????,??????????????? ???????????????????????

    36. Adverse Reactions Headache, diarrhea, rash, nausea, constipation : 1-3% similar to all PPIs Reported cases of AST & ALT elevation Hepatitis case reports for Omeprazole & Lansoprazole High dose IV Omeprazole ass. with visual disturbance? 2-10x elevation of gastrin

    39. Conclusion ?? ?? ?? ??

    40. ?? !! Thanks for your attention .

    41. Plasma Volume Replacement Gelofusine® Tom Cheng ??? B.Braun Taiwan

    44. ?????????,??? ”Omezol? Lyo-Injection” ? ”Losec? Infusion” ??????????????pH????? ??????????????? : ???158? ??????? ??? ?? ??????? ??? ???

    45. ? ? ? ? ? ? ???? : ????????????????????? ???? : ??????????? ???? : ??????????? ?????? : ??????????? ???????? : ?????? ???? ???????? : Omezol? lyophilized injection 40mg/10ml/vial ????: ??????? ???? : 30 ?

    46. ? ? ? ? ?????pH??6.0??,??fibrinogen ??? fibrin,???????,?????????,?????????,?????????????,??pH>6?????????????pH???6?????????????...?,?????????????????????? On-set, Fraction Time (FT), Duration, Adverse events

    47. ? ? ? ? ”Standard” Omezol? Lyo-Injection(40mg/vial) 40 mg, IV bolus for 3 ~10 min. each 12 hours ” AstraZeneca” Losec? Infusion(40mg/vial) 40mg, IV infusion for >20 min. each 12 hours

    48. ? ? ? ? ??????: ????pH?>6.0??? ??????: ????pH?>6.0??? ??????? :????????????

    49. ? ? ? ? ?????????????,????????????,????????????????,??? 30 ???,???? 24 ???????,???????? 2 ????pH??

    50. ? ? ? ? ? ?

    51. ? ? ? ? (1)

    53. ? ? ? ? (3)

    54. Result (3) : Intragastric acid suppression

    55. ? ? ? ? ????????????,“Omezol? Lyo-Injection”?“Losec? Infusion”??????????????,????????,??Omezol? ??????????????????????????

More Related