Q: What advantage Protonix  (Pantoprazole) drip has over once a day 40 mg IV Protonix - in active GI bleed?

Answer: In active GI bleed, a daily infusion of 40 mg does not increase gastric pH sufficiently to enhance coagulation.  It is recommended to give 80 mg IV bolus, followed by 8 mg/hour infusion. Continuous IV infusion should be done for 72 hours to avoid risk of re-bleeding. 

References.

Brunner G, Luna P, Hartmann M, Wurst W. Optimizing the intragastric pH as a supportive therapy in upper GI bleeding. Yale J Biol Med 1996;69:225-31.

Lau J, Sung J, Lee K, Yung M, Wong S, Wu J, et al. Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. New Engl J Med 2000;343:310-6.