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This refers to a pharmacological intervention strategy evaluated by King Saud University to reduce the risk of pulmonary aspiration in adult patients undergoing elective surgery. The strategy involves the administration of two successive oral doses of a proton pump inhibitor (PPI) or a histamine H2-receptor antagonist (H2RA), either alone or in combination with a prokinetic agent. PPIs (such as omeprazole, lansoprazole, esomeprazole, rabeprazole, and pantoprazole) and H2RAs (such as cimetidine, ranitidine, famotidine, nizatidine, and lafutidine) work to increase intragastric pH and reduce gastric acid volume. Prokinetic agents (such as metoclopramide, domperidone, and erythromycin) are included to enhance gastric emptying and further reduce the volume of stomach contents. By optimizing these gastric environment parameters, the multi-drug approach aims to minimize the potential for acid-related lung injury (Mendelson's syndrome) should aspiration occur during the induction of anesthesia.
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