7. Pharmacological basis of treatment of peptic ulcer and H. Pylori

Question 1

What were the 3 surgical methods for treating duodenal ulcers?

Answer 1

Vagotomy
Subtotal gastrectomy
Antrectomy

Question 2

What are the two acid lowering drugs used in the treatment of peptic ulcers and what one is more effective?

Answer 2

H2 antagonists

Proton pump inhibitors (PPIs) - most effective

Question 3

What are the limitations of the medical advances in treating peptic ulcers (H2 antagonists and PPIs)

Answer 3

Expensive

Control but do not cure

Question 4

What two drugs were found to heal peptic ulcers without lowering the acid?

Answer 4

Bismuth salt and sucralfate

Question 5

What is the first line treatment of H. Pylori infection?

Answer 5

Omeprazole
Metronidazole
Amoxycillin
(two PPIs and one antibiotic)

Question 6

What is the second line treatment of H. Pylori infection?

Answer 6

Omeprazole
Clarithromycin
Amoxycillin

Question 7

How are peptic ulcers treated if the patient is allergic to penicillin?

Answer 7

Omeprazole
Metronidazole
Clarithromycin

Question 8

How do you treat a patient with simple dyspepsia when H. Pylori isn’t present?

Answer 8

Endoscopy is very unlikely unless for oesophagitis

Treat symptomatically

Question 9

How do you treat a patient with simple dyspepsia when H. Pylori is present?

Answer 9

10-15% will have ulcer disease which will be cured with eradication therapy
Treat all with eradication therapy

Question 10

What are the less controversial methods to reducing gastric cancer than general population screening?

Answer 10

Non-invasive H. Pylori testing
Treating dyspeptics
Reducing H. Pylori prevalence by improving living conditions