An Ounce of Prevention: Pantoprazole in the Intensive Care Unit and Aspirin for Primary Prevention in Diabetes

Christopher Giuliano, clinical pharmacist, is hosting this week’s episode of The Rounds Table with Claudia Hanni, an Internal Medicine clinical pharmacist.  Together they are covering pantoprazole for gastrointestinal bleeding in the intensive care unit and aspirin for primary prevention in patients with diabetes.

In the intensive care unit, many patients receive pantoprazole for prevention of gastrointestinal stress ulceration.  The risks and benefits of this are unclear.  Chris discusses a trial performed to assess patients in the intensive care unit with a high bleeding risk and whether intravenous pantoprazole 40 mg or placebo have an effect on mortality.  Other secondary outcomes, such as clinically important gastrointestinal bleeding, were also reported by researchers.

It is known that diabetes mellitus is associated with an increased risk of cardiovascular events.  Claudia reviews the ASCEND trial, comparing aspirin to placebo for primary prevention in patients with diabetes with no known cardiovascular disease.  The outcomes in terms of bleeding risk are also discussed.

Next, The Good Stuff segment.  Chris tells listeners about an article on dietary supplementation and the common reasons for use, and Claudia discusses an article on the major causes of death in children and adolescents in the United States.

For this month’s special segment, Sheliza Halani interviews Dr. James Downar, Head of the Division of Palliative Care for the University of Ottawa, on medical assistance in dying and how this is related to end-of-life care and treatment options.

Like what you hear?  Rate us on iTunes!  Chat with us on Twitter at @roundstable and tweet at Chris Giuliano @ChristopherGiu9, Claudia Hanni @ClaudiaMHanni, Wayne State University @wsueacphs, James Downar @jamesdownar, and Sheliza Halani @sheliza_halani.

Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.

The Papers

1. Pantoprazole for ICU GI bleeds: https://www.nejm.org/doi/full/1056/NEJMoa1714919

2. ASCEND: https://www.nejm.org/doi/full/1056/NEJMoa1804988

Good Stuff

1. Dietary Supplements:https://www.medscape.com/viewarticle/903925

2. Major Causes of Death in the US: https://www.nejm.org/doi/full/10.1056/NEJMsr1804754

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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