BACKGROUND: Severity of aspiration pneumonitis is associated with acidity and volume of aspirated gastric contents. Volume and acidity of gastric contents are influenced by food, drugs, and patient factors. However, most studies were performed without controlling these factors. The objectives of this study were to determine the effects of a 20 mg intravenous famotidine injection on gastric content volume and acidity, 1 to 2 hours prior to general anesthesia after controlling the last intake of food. METHODS: One hundred twenty three healthy patients were randomly assigned to famotidine and control groups. All patients were requested to drink 200 ml of milk the night before surgery in order to control food related factors and fasting time. After induction of general anesthesia, volume and acidity of aspirated gastric contents were measured. RESULTS: There were no significant differences in acidity of aspirated gastric contents between the two groups. However, the famotidine group showed a significant aspirated gastric volume reduction compared with that of the control group. CONCLUSIONS: Famotidine premedication by intravenous injection 1 to 2 hours prior to general anesthesia may be effective to prevent aspiration pneumonitis by reducing gastric content volume.
Anesthesia, General* ; Famotidine* ; Fasting ; Humans ; Injections, Intravenous ; Milk ; Pneumonia ; Premedication*

The aim of the investigation was to study the efficacy and safety of Famotidine (Gaster), a new, potent, histamine H-receptor antagonist. The Famotidine (40 mg p.o.h.s) was administered to 22 patients with 33 peptic ulcers for 4 weeks. Follow up checking was done at 2 week and 4 week by endoscopy and physical examination. All patients were carefully evaluated at regular intervals for adverse drugh reactions by clinical and laboratory examinations. By the end of study, 97% of the ulcers were healed by endoscopically and rapid and complete relief of epigastric pain was observed in all patients. Famotidine treatment was well tolerated and no alterations in laboratory tests were noted. Therfore, Famotidine was proved effective in the treatment of peptic ulcers (especially multiple ulcers) and was well tolerted on the short-term basis.
Endoscopy ; Famotidine* ; Follow-Up Studies ; Histamine ; Humans ; Peptic Ulcer* ; Physical Examination ; Ulcer

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

BACKGROUND: To identify the gastric pH of gastric carcinoma patients after more than 8 hours of fasting and ascertain the antisecretory effects of H2-receptor antagonists, the gastric volume and pH of 41 gastric carcinoma patients was checked immediately after the induction of inhalational general anesthesia (endotracheal intubation). METHODS: The patients were divided randomly into two groups: the control received IV normal saline as a placebo and the famotidine group received IV famotidine as a premedicant 1 to 2 hours before the induction of anesthesia. Immediately after the induction of anesthesia, the gastric contents were aspirated blindly with a 60 ml syringe. Fisher's exact test was used to compare the percentage of patients 'at risk' between the two groups in relation to their pH and volumes. RESULTS: The percentage of patients 'at risk' (volume > 0.4 ml/kg and pH < 2.5) of acid aspiration pneumonitis in the control and famotidine groups was 8.7% and 5.6%, respectively, which was 30 77% lower than for patients with no premedication, as observed in other studies. In the present study, the difference in percentage of patients 'at risk' between the two groups was not statistically significant. CONCLUSIONS: The gastric carcinoma patients exhibited a higher gastric pH when fasting and a lower risk of acid aspiration pneumonitis relative to their gastric contents. The effect of famotidine on lowering gastric acidity and volume in gastric carcinoma patients was rather weak. Accordingly, the routine use of H2-receptor antagonists to decrease gastric secretion in gastric carcinoma patients should be reevaluated.
Anesthesia ; Anesthesia, General ; Famotidine* ; Fasting ; Gastric Acid* ; Humans ; Hydrogen-Ion Concentration ; Pneumonia ; Premedication ; Syringes

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) currently serves as the minimally invasive treatment of choice for early gastric cancer and premalignant lesions of the stomach. There have been few studies addressing whether a proton pump inhibitor or a histamine 2-receptor antagonist is the most effective treatment for iatrogenic ulcers after EMR. We compared the effectiveness of pantoprazole and famotidine in treating iatrogenic ulcers and preventing bleeding after EMR without endoscopic submucosal dissection. METHODS: Between March 2006 and April 2007, we retrospectively analyzed the effect of famotidine (40 mg/day) and pantoprazole (40 mg/day) on the healing of iatrogenic ulcers and control of bleeding after EMR. RESULTS: During the study period, 126 patients underwent EMR. Eighty-one received famotidine, and 45 received pantoprazole. The mean duration of drug therapy was 44 days in each group. The stages of ulcers at 1 to 3 months after EMR were mostly scar stage, and there was no specific difference between the groups. Delayed bleeding was seen after EMR in one patient (1.2%) from the famotidine group and in one patient (2.2%) from the pantoprazole group. There were no other major complications after EMR. CONCLUSIONS: Famotidine was no different than pantoprazole in its effectiveness toward preventing delayed bleeding and promoting healing of iatrogenic ulcers after EMR.
2-Pyridinylmethylsulfinylbenzimidazoles ; Cicatrix ; Famotidine ; Hemorrhage ; Histamine ; Humans ; Proton Pumps ; Retrospective Studies ; Stomach ; Stomach Neoplasms ; Ulcer

Recently, several studies have shown that the H2-receptor blockers can cause inhibition of cholinesstrase and neuromuscular blockade which suggest involvement of ion-chennel block in relatively large experimental dose. We investigated the effect of three H2-receptor blockers cimetidine, ranitidine, and famotidine on antagonism of vecuronium neuromuscular blockade. Forty ASA class 1 or 2 adult patients were studied. All patients were premedicated with hydroxyzine 1.5mg/kg and glycopyrrolat 0.2mg IM, 1hour before induction. Anesthesia was induced with thiopental sodium 5~6 mg/kg, succinylcholine 1mg/kg and was maintained with 02-N20(50%)-enflurane. Intraoperative muscle relaxation was maintained below 5% of control twitch height on TOF stimulation by combined bolus IV(0.08mg/kg) and contino=uous infusion(0.08mg/kg/hour) of vecuronium. Patients were divided into four groups according to use of H2-receptor blocker just after stop of vecuronium infusion as follows: Control group (n=10): no use of H2-receptor blocker, Cimetidine group (n=10): cimetidine 200mg IV, Rantitidine group (n=10): rantidine 50 mg IV, Famotidine group (n=10): famotidine 50 mg IV. Reversal of neuromuscular blockade with neostigmine(0.04mg/kg) was performed at 10% recovery of first twitch height (T1) in all cases. The recovery of T1 and T4 ratio after reversal was measured at 1min, interval for 20 min. The results were as follows: 1) The recovery of twitch height after administration of neostigmine was prolonged in all three H2-receptor blocker groups as compared to control group, but statistical significance was noted only in Famotidine group (p<0.05). 2) The changes of heart rate and mean arterial pressure after administration of neostigmine were similar in all groups.
Adult ; Anesthesia ; Arterial Pressure ; Cimetidine ; Famotidine ; Heart Rate ; Humans ; Hydroxyzine ; Muscle Relaxation ; Neostigmine ; Neuromuscular Blockade* ; Ranitidine ; Succinylcholine ; Thiopental ; Vecuronium Bromide*

The purpose of this study is to design push-pull osmotic pump (PPOP) tablets of famotidine using the expert system for the formulation design of osmotic pump of poor water-soluble drug which had been established by the authors. Firstly, the parameters which were requisite of the system input were obtained from literatures and experimental tests. Then the parameters were input into the system, and the program was run. The system displayed the designed formulations sequential. Finally, famotidine PPOP was prepared according to the designed formulations and the in vitro dissolution was carried out. It was found out that the target formulation of famotidine PPOP which could release for 24 hours was obtained in a very short period. Meanwhile, the practicability of the established expert system was proved.
Delayed-Action Preparations ; Drug Delivery Systems ; methods ; Excipients ; chemistry ; Expert Systems ; Famotidine ; administration & dosage ; chemistry ; Osmosis ; Solubility ; Tablets ; Water

Child ; Famotidine ; adverse effects ; therapeutic use ; Gastrointestinal Hemorrhage ; drug therapy ; Histamine H2 Antagonists ; adverse effects ; therapeutic use ; Humans

Cimetidine, and H2-receptor blocker, is associated with a direct inhibition of liver microsomal enzymes and a decrease in liver blood flow which results in a variety of clinically significant drug interactions, but its effects on the action of muscle relaxants have not been established. Recently, Kambam et al(1987) reported that the duraion of action of succinylcholine was prolonged 2~2.5 times by cimetidine. The effects of cimetidine, ranitidine, and famotidine, on duration of action of succinylcholine and vecuronium were studied. Sixty ASA class 1 or 2 patients scheduled for elective exploratory laprotomies were randomly divided into two groups as follows: Succinylcholine Group(n=40, 1mg/kg) control group(n=10), cimetidine group(n=10): 300mg ph hs & 1 hour before induction, ranitidine group(n=10): 150mg po hs & 1 hour before induction, famotidine group(n=10) : 40mg po hs only. Vecuronimu Group(n=20, 0.08mg/kg) control group(n=10), famotidine group(n=10): 40 mg po hs only. All patients were premedicated with hydroxyzine(1.5mg/kg) and Robinul 0.2mg IM, 1 hour before anesthesia. Anesthesia was induced with thiopental sodium 5~6mg/kg and succinylcholine 1mg/kg or vecuronium 0.08mg/kg. Tracheal intubation was performed at 75~!00% block as monitored by train-of-four stimulation of the ulnar nerve at 2Hz, 20 seconds apart(ABM, Datex). Anesthesis was maintained with 50% nitrous oxide, oxygen, and 2% enflurane. The duration of action of the muscle relaxants was measured from injection of muscle relaxant to the time of 25% recovery of first twitch height on train-of-four stimulation. The results were as follows: 1) The duration of succinylcholine was prolonged significantly by the H2-receptor blockers, 8.3+/-1.49 minutes with cimetidine, 9.8+/-1.98 minutes with ranitidine, and 10.3+/-2.48 minutes in the famotidine group as compared to 6.9+/-1.43 minutes in the control(p<0.05). 2) The duration of action of vecuronium was not affected significantly by the H2-receptor blocker, 26.5+/-4.72 minutes in the famotidine group as compared to 23.6+/-4.52 minutes in the control(p>0.05).
Anesthesia ; Cimetidine ; Drug Interactions ; Enflurane ; Famotidine ; Humans ; Hydrogen-Ion Concentration ; Intubation ; Liver ; Nitrous Oxide ; Oxygen ; Ranitidine ; Succinylcholine* ; Thiopental ; Ulnar Nerve ; Vecuronium Bromide*