Use of automatic computerised pump to maintain constant intragastric pH

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Investigation

Background:

• Elevating intragastric pH is crucial for managing acid-related disorders.
• Famotidine is a histamine H2-receptor antagonist used to reduce stomach acid production.
• Optimizing famotidine delivery for sustained acid suppression requires investigation.

Purpose of the Study:

• To evaluate the efficacy of continuous intravenous famotidine infusion in maintaining elevated intragastric pH.
• To compare famotidine infusion with and without an initial bolus dose against a placebo.
• To assess the variability in famotidine dosage requirements for achieving target intragastric pH.

Main Methods:

• Eight healthy volunteers received famotidine via continuous intravenous infusion using a computer-regulated system (GastroJet).
• Intragastric pH was continuously monitored using a glass electrode, with the system programmed to target a pH of 6.0.
• Two famotidine regimens (bolus followed by infusion vs. infusion alone) were compared to placebo.

Main Results:

• Famotidine infusion significantly increased median intragastric pH to 6.5-6.6 compared to placebo (median pH 1.5).
• The time intragastric pH remained below 5.0 was significantly reduced from 98% (placebo) to 16-20% with famotidine.
• While dosage requirements varied (41-126 mg), mean drug use was higher with the bolus regimen, and onset was not faster.

Conclusions:

• Continuous intravenous famotidine infusion effectively maintains a high fasting intragastric pH.
• The use of an initial famotidine bolus may be unnecessary for achieving sustained acid suppression.
• Computer-controlled infusion systems offer precise regulation of famotidine delivery for acid control.