COMPARISON OF THE NEUROLOGICAL ADVERSE EVENTS AND CHANGES IN ELECTROLYTES LEVELS BETWEEN PANTOPRAZOLE AND FAMOTIDINE: A PROSPECTIVE OBSERVATIONAL STUDY
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Date
2023-06-13
Authors
A'mer Nawwaf Zidan
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Abstract
Abstract
Background: Proton-pump inhibitors (PPIs) have recently become more commonly used in patients with functional gastrointestinal illnesses or for primary prophylaxis of drug-related gastro duodenal damage, despite the fact that their benefits for those conditions have not been thoroughly confirmed. In a few studies, significant acute neurological symptoms related to PPI-induced hypomagnesemia have been observed; and histamine-2 Receptor Antagonist (H2RAs) are more strongly associated with increased delirium than PPIs. However, severe hypomagnesaemia has not been linked to usage of H2RAs.
Aim: The study aim was to compare the effects of Pantoprazole (Proton pump inhibitor) and Famotidine (histamine-2 Receptor Antagonist) on electrolytes disturbances and other neurological adverse events among critically ill patients.
Method: A prospective observational study was conducted between August 2022 and December 2022 included 100 critically ill patients in intensive and cardiac care units of Al- Watani Hospital. The response rate was 91.75%. The data sheet consisted of several sections, including sociodemographic data, health information, data about administration of Pantoprazole and Famotidine, clinical outcomes, neurological complications including delirium degree.
Results: The highest age group for the total participants was over 60 years old (60%), and more than half of the total participants were male (57.0%). The findings pointed out that the percentage of Acute Kidney Injury was higher in Pantoprazole compared with Famotidine (38% vs. 10%, respectively). The results also showed that the blood urea nitrogen was significantly higher in Pantoprazole group compared to Famotidine group (40.0±29.6 vs. 27.8±24.3 mg/dl; P < 0.05). Similarly, creatinine was significantly higher in Pantoprazole group compared to Famotidine group (2.2±2.0 vs. 1.5±1.5 mg/dl; P < 0.05). In contrast, the average albumin in Pantoprazole group were significantly lower than that in Famotidine group (2.8±0.5 vs. 3.1±0.6 g/dl; P < 0.05). The Mean±SD of serum Magnesium (2.0±0.3 mg/dl in Pantoprazole vs. 2.1±0.2 mg/dl in Famotidine; P > 0.05). The results pointed out that the percentages of neurological complication among Pantoprazole group compared to Famotidine were agitation (12% vs. 24%, P=0.118), hallucinations (10% vs. 4%, P=0.24), dizziness (4% vs. 6%, P=0.646), nausea (4% vs. 4%, P=1.000), vomiting (2% vs. 2%, P=1.000), numbness (2% vs. 2%, P=1.000), muscle spasms (2% vs. 0%, P=0.315), seizures (0% vs. 2%, P=0.315), convulsions (2% vs. 0%, P=0.315), however, nobody has loss of consciousness, death, tetany, and tremors.
Conclusion: There was no significant association between patients who were treated by Pantoprazole and who were treated by Famotidine with regards to serum magnesium level, occurrence of neurological complications, and mean delirium degree. But the Pantoprazole group were associated with elevated levels of creatinine and blood urea nitrogen, and lower levels of albumin and hematocrit compared to Famotidine group.
Keywords: Pantoprazole; Famotidine; electrolytes; neurological adverse events.