[Stress-limiting effect of zantac in duodenal ulcer bleeding]

Two randomized groups of patients with ulcerative gastroduodenal hemorrhage were studied. One group of patients with bleeding-accompanied ulcerative disease of the stomach (n = 11) and the duodenum (n = 22) received the routine therapy, another group, including those of the same diseases (n = 9 and n = 22, respectively) had additionally the histamine H2-receptor blocking agent zontac by the following schedule: intravenously, 50 mg thrice a day within the first 3 days, and orally, 150-mg tablets twice a day within the following 3 weeks. Donors (n = 20) served as a control group for the zontac-treated and untreated patients. The stress-limiting effect of zontac was evaluated by the physicochemical parameters of corticosteroid-binding globulin, serum cortisole and insulin concentrations which were measured on days 1, 3, 7, and 14 following the first hemorrhage. In the zontac-treated group, the association constant of the blood cortisole-corticosteroid-binding globulin increased, while the dissociation constant decreased. At the same time the absolute and relative number of sites for binding of cortisole by means of corticosteroid-binding globulin also dropped to the values seen in the group of donors. Zontac caused a reduction in the cortisole/insulin ratio. This all suggests that zontac produces its stress-limiting effect in patients with ulcerative gastroduodenal hemorrhage. Zontac therapy decreased the need for surgical arrest of bleeding by 50% and the average day/bed.