Peptic Ulcer Treatment Flashcards
(22 cards)
General measures include
Avoid smoking, aspirin and NSAIDs?
No special dietary advice.
Drugs used to treat PUD
-antacids
-proton pump inhibitors
-H2 receptor antagonists
-drugs, which enhance mucosal defense
-Misoprostol
Antacids used are
🟢Aluminum hydroxide
🔴magnesium trisilicate
Proton pump inhibitors include
ام رابي راكبة لينزو وياها عصومي وبنتو
40،40،30،30،20،20 mg
Omeprazole 20mg
Rabiprazole 20mg
Lansoprazole 30mg
Dexlanzoprazole 30mg
Esomeprazole 40mg
Pantoprazole 40mg
How proton pump inhibitors work?
The reversibly inhibit H/K ATPase in parietal cell membrane
The characteristics of PPIs
🟢 the most potent acid inhibitory agents
🔴 efficiency is maximized if they are administrated before meal
What are the H2 receptor antagonists?
Nizatidine
Ranitidine
Cimetidine
Famotidine
How H2 receptor antagonists work
They inhibit the H2 receptor competitively on parietal cells
Side effects of Cimetidine
🔵 anti-androgenic, resulting in reversible gynecomastia and impotence
🟡 confusion
🟣 elevated levels of serum aminotransferase creatinine, and serum prolactin
Which one among H2 receptor antagonists is more potent
Ranitidine, famotidine and nizatidine are more potent than cimetidine
When H2 receptor antagonists are used in the day?and how long
Each can be used once a day at bed time, for 8 weeks for duodenal ulcer, and 8-12 weeks for gastric ulcer
How sucralfate works?
This compound is insoluble in water, and becomes a viscous paste within the stomach and duodenum binding primarily two sites of active ulceration.
What is the standard dose of sucralfate?
1g four times per day
or
2g two times per day
Is sucralfate taken before or after meal?
It should be taken 30-60 min before meals.
what is the dose of Colloidal bismuth compound
125 mg/6h
Is colloidal bismuth compound recommended for maintenance therapy?
No, since it has side effects include blacken tongue, teeth, and feces
What is misoprostol?
A prostaglandin analogue
What are the side effects of Misoprostol?
🟡 diarrhea
🟣 uterine bleeding and uterine contractions
In which group of people misoprostol is contraindicated?
In women of childbearing age
What is the standard therapeutic dose of misoprostol?
200 microgram 4 times per day
What is eradication therapy of H. pylori?
Triple therapy OCLAM
The combination of 2 antibiotics taken simultaneously with PPI twice daily for 10-14 days, eradication rate is 70-85%
PPI+ Clarithromycin 500mg +amoxicillin 1g (or metronidazole 500mg)
Quadruple therapy OBMT
🟢PPI+bismuth+metronidazole 500mg +tetracycline 500mg
🔴PPI+amoxicillin 1g+clarithromycin + nitroimidazole ( or metronidazole or tinidazole )500mg
When H2RAs are substituted for
PPIs and used in high dose ?
If there is allergy or adverse effects due to PPIs
