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Effective treatments for these conditions stemmed from our increased understanding of the gastric acid secretory pathway and target pH values. The late 1970s saw the introduction of histamine<jats:sub>2<\/jats:sub>\u2010receptor antagonists (H<jats:sub>2<\/jats:sub>RAs), which partially suppress basal and meal\u2010stimulated acid secretion. Some of these agents can induce an intragastric pH greater than 3, lasting for approximately 10 hours\/day when given twice\/day at recommended doses. This level of acid suppression can facilitate healing of duodenal ulcers but has limited efficacy for other indications (e.g., gastrointestinal bleed). In the late 1980s a more potent class of acid\u2010suppressing agents was developed, proton pump inhibitors (PPIs). The PPIs can induce an intragastric pH above 3 lasting for approximately 17 hours\/day, and an intragastric pH above 5 for approximately 9 hours\/day after once\u2010daily oral administration of recommended doses. It is possible to attain even higher target pH values with large doses and with continuous intravenous infusion. Thus, PPIs are agents of choice for treatment of many acid\u2010related disorders including peptic ulcer disease and moderate\u2010to\u2010severe gastroesophageal reflux disease, and for prevention of rebleeding in patients with upper gastrointestinal bleeding. Availability of an intravenous formulation, pantoprazole, enables hospitalized patients for whom oral administration is not feasible to benefit from the superior potency of PPIs. Preliminary data suggest that intravenous PPIs may be more effective than H<jats:sub>2<\/jats:sub>RA prophylaxis against stress\u2010related ulcer bleeding for intensive care patients and should facilitate healing in those with bleeding ulcers of the upper gastrointestinal tract.<\/jats:p>","DOI":"10.1592\/phco.23.13.56s.31932","type":"journal-article","created":{"date-parts":[[2004,5,10]],"date-time":"2004-05-10T08:38:04Z","timestamp":1084178284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["History of Acid Suppression: Focus on the Hospital Setting"],"prefix":"10.1002","volume":"23","author":[{"given":"William 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