Peptic ulcer disease

Question 1

Gastric / Duodenal ulcer tx

Answer 1

~ PPIs
~ H2 antagonists
~ Misoprostol
~ Sucralfate

Question 2

Misoprostol

Answer 2

used IN GASTRIC/DUODENAL ULCERS
synthetic prostaglandin analogue
~ teratogenic
~ colic/diarrhoea = dose limiting SEs

Question 3

Sucralfate

Answer 3

USED IN GASTRIC / DUODENAL ULCERS
chelates and complexes
~ BEZOAR formation
~ take 1h before meals / 1h gap between enteral feeds

Question 4

H.pylori ulcers tx

Answer 4

7 days of PPI (BD dose), + 2 ABX (Amoxi, Clarithromycin, Metronidazole)

Question 5

NSIAD induced ulcers tx

Answer 5

~ withdraw NSAID
~ PPI (or H2 antagonist/Misoprostol)
~ Test for H.pylori on healing, if positive; eradication therapy

Question 6

NSAID induced ulcers prophylaxis

Answer 6

~ high risk patient = 65+, Hx, liver/kidney/heart/diabetes
at risk = PPI
3 or more risk factors = PPI + COX-2 selective NSAID