The use of histamine2-receptor antagonists could be beneficial in critically ill patients for protection against stress-induced gastrointestinal bleeding. Famotidine, similar to cimetidine and ranitidine, is stable when mixed in dextrose 5% injection and NaCl 0.9% injection at a concentration of 200 μg/mL and stored in polyvinyl chloride bags at 4 °C for 14 days or when frozen for 28 days and subsequently refrigerated for 14 days. Furthermore, famotidine, also like cimetidine and ranitidine, is stable when added to most common total parenteral nutrition (TPN) solutions. Famotidine in concentrations of 20 mg/L and 40 mg/L is stable in crystalline amino acid solutions (20 g/L and 42.5 g/L) when refrigerated for 24 hours, then held at room temperature for 24 hours, at room temperature for 48 hours, or refrigerated for seven days. The concentration of amino acids in the TPN solutions containing 42.5 g/L also is not affected by the addition of famotidine 40 mg/L when stored under conditions similar to those stated above for 48 hours. TPN solutions remain clear and free of turbidity.
KS-3 There is no definitive consensus between muscle and protein/amino acid delivery for critically ill patients
