INTRAVENOUS HISTAMINE H-2-RECEPTOR ANTAGONISTS AND PARENTERAL-NUTRITION - PATTERNS OF USE

Patterns of use of i.v. histamine H-2-receptor antagonists (H(2)RAs) a nd parenteral nutrient solutions in patients receiving both given sepa rately or as admixtures were studied. Consecutive adult patients at a university teaching hospital were placed in an ''admixed group,'' cons isting of all those who received an i.v. H(2)RA as a parenteral nutrie nt solution additive, or a ''nonadmixed group,'' consisting of all tho se who received an i.v. H(2)RA and a parenteral nutrient solution as s eparate infusions. Data were collected for many variables, including i nterruptions in therapy, route and method of administration, indicatio n for use, total daily dose of H(2)RA, patient demographic data, and a ny additional anti-ulcer drugs prescribed. A total of 128 patients rec eived 158 regimens of therapy, 60 regimens in the admixed group and 98 in the nonadmixed group. There was at least one interruption in i.v. H(2)RA therapy for 32% of the admired-group regimens and 33% of the no nadmixed-group regimens. When an interruption occurred, patients in th e admired group missed an average of 40% of their daily H(2)RA dose, c ompared with 53% for the nonadmixed group. No alternative anti-ulcer d rug was given on 10 (23%) of the 42 days when intensive care patients had an interruption in H(2)RA therapy, versus 33 (55%) of the 60 days of H(2)RA interruption for non-intensive-care patients. Interruptions in i.v. H(2)RA therapy occurred more frequently when the H(2)RA was a component of the nutrient solution than when it was given as a separat e infusion. Supplemental anti-ulcer therapy was typically not provided during interruptions in H(2)RA therapy, regardless of the method of a dministration.