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New Drug Eases Ulcers in Critically Ill Patients

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New Drug Eases Ulcers in Critically Ill Patients

Critically ill patients with stress ulcers often can't swallow medications because of their underlying critical condition. As a result, doctors trying to stem stress-related upper gastrointestinal bleeding must rely on liquid drugs administered by feeding tube or intravenous medicines.

But this too presents problems, says Jeffrey Phillips, research associate professor and director of research in MU's Department of Surgery. The I.V. form of the most potent medications, known as PPIs, is not very rapid in it's action. Oral forms work more quickly, but are available only as granules or tablets that must be ground up. This destroys the enteric coating these PPIs need to withstand acid already built up in the stomach, thus thus neutralizing their ability to inhibit further acid production. Phillips recently proposed a novel solution: Why not administer a single dose of sodium bicarbonate as an acid buffer, then wash crushed PPI granules down with an additional buffer? He reasoned that if even some of the drug were absorbed it would benefit the patient.

The result far surpassed these modest expectations. Not only did the buffer protect the drug in the stomach, but it substantially increased the speed at which the PPI entered a patient's blood stream. Following publication of his discovery, Phillips and OTSP teamed up with Santarus Inc. -- a California company, to take a product based on Phillips' work through human clinical trials. If approved by the U.S. Food and Drug Administration the treatment could reach the marketplace by the end of this year.

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