Reply To: Gastroprotectants: Taking the acid out of the suppression
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I have a few questions following the gastroprotectant webinar and was wondering if you could clarify some points.
1. You mentioned giving PPI’s one hour before food. Is this because it’ll limit the acid wave associated with the following meal and therefore it’ll be more effective? Or does the food inhibit the absorption of the drug? If food limits absorption, then would time of administration matter if you were giving it IV? Does it simply take time to work regardless of route of administration?
2. I was recently questioned about not using PPI’s intravenously in cats because the formulary only says per os. Is there actually a contraindication to giving them this way in cats?
3. As the absorption of PPI’s in cats may be affected when given orally. Would it be better to puncture the capsules before giving them, to allow liquid to penetrate them and increase the dissolution of the capsule? Or would the benefit of no capsule offset the decrease in efficacy of being given with food?
4. I appreciate the point of a PPI and sucralfate, not being better than monotherapy with a PPI for gastric ulceration. However, would you consider both in cases of haemorrhagic gastroenteritis where it is presumed to be more distal?
5. Would you consider TXA use in particularly severe HGE cases?
6. Is TXA being used in cats and if so, is it the same dose as per dogs?
Thanks in advance, as I appreciate that I have a lot of questions.