Episode 25: Pantoprazole Continuous infusion vs Intermittent Bolus Formulary Nugget by Oscar Santalo

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  • Situation
    • Pantoprazole 80 mg in NS 100 mL drip is being used for GI Bleeds due to ulcers
    • Problem:
      • Evidence not being clear on optimal dosing strategy
    • Opportunity to:
      • Standardize dosing strategies for upper and lower GI bleeds
      • Follow best practice strategies


  • Dosing Strategies for GI Bleeds
  • Bleeding ulcer: Note: For clinically significant upper GI bleeding prior to endoscopy. Optimal IV dosing regimen has not been established;
  • IV: Intermittent dosing:
    • Loading dose of 80 mg, followed by 40 mg every 12 hours
  • IV: Continuous infusion:
    • Loading dose of 80 mg, followed by 8 mg/hour infusion


Pantoprazole 80 mg Drip Utilization8424581,300
Total Costs
($6.02, 3.01 per 40 mg inj median Price)
Report of annualized dispenses of 80 mg in 100 mL drip with savings


  • Remove 80 mg in NS 100 mL order product
  • Pursue intermittent strategy
    • Loading dose of 80 mg, followed by 40 mg every 12 hours
  • Increase medication access in Pyxis
  • Can be prepared on the unit


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Jimmy L. Pruitt III, PharmD, BCPS, BCCCP

The Pharm So Hard Podcast is a show focused primarily on emergency medicine and hospital pharmacy related topics. To empower healthcare providers with the knowledge and skills they need to provide evidence-based, safe care for critically ill patients.

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