PUD Flashcards
(49 cards)
Classes of drugs to treat PUD (5)
- Antibiotics for H.Pylori
- Anti Secretory:
- Mucosal Protectant:
- Prostaglandin Agent
- Antacid
3 ways drugs work to treat ulcers
- erradicate H pylori
- reduce gastric acidity
- enhance mucosal defenses
Anti ulcer drugs only treat ulcers: true or false
FALSE- also treat gastritis and GERD
What is the regiment for treating H pylori w/ ABX ? how long?
At least 2 antibiotics, preferably 3 abx + PPI or H2 blocker
->14 days
do we give ABX to someone who is asxs but has h pylori ?
nope!
issues w/ treating h pylori?
patient complianc: cost, pill count, SE
3 types of anti secretory agents:
- H2Blockers
- Proton Pump Inhibitors
- Muscarinic antagonist ???
prototype of H2 blockers
- Prototype: cimetidine (Tagamet) –> in the drug book, original H2 blocker
- Also Know: famotidine (Pepcid) –> more commonly used
how fo H2 blockers work?
- Act on H2 receptors on parietal cells
- ->Suppress acid secretion
indication for using H2 blockers
ulcers, GERD, heartburn, aspiration pneumonitis, Zollinger-Ellison syndrome (acid hypersecretion)
Duration of treatment on H2 blockers
4-6 weeks, up to 12
side effects of cimetidine
LOW
◦ Androgen blockade :Gynecomastia, reduced libido, impotence
◦ CNS Effects b/c crosses BB : Elderly (somnolence, seizure)
◦ Pneumonia (all H2 blockers)
‣ Bacterial colonization in the stomach increases with less acid present
• increase risk of aspiration pneumonia
drug drug interactions w/ cimetidine
◦ Warfarin, phenytoin, metformin, glipizide
◦ separate antacids by 1 hr.
route for cimetidine
IV, oral 2x day
side effects of famotidine?
pneumonia risk
prototype for anti secretory: proton pump inhibitor
omeprazole (Prilosec)
how does omeprazole (Prilosec) fxn
Irreversible inhibition of H+,K+ ATPase
most effective drug for acid suppresiion?
omeprazole (Prilosec)
how long does omeprazole (Prilosec) work and when do see effects?
-life of enzyme (1 day) and results w/in 2 hours
indication for using omeprazole (Prilosec)
ulcers, erosive esophagitis, GERD Zollinger-Ellison, stress ulcer prevention–> ICU/Trauma
how long to be on omeprazole (Prilosec)
4-8 weeks
short term vs long term side efffects of omeprazole (Prilosec)
Side Effects: headache, diarrhea, N/V (<1%)
long term side effects: osteoporosis and hip fractures, Cdiff, pneumonia, acid rebound (difficult to come off drug), kidney disease, Mg deficiency
◦ Possible: B12 deficiency, dementia
patient education for omeprazole (Prilosec)
• only want patients on these short term!
–> wean off and put on H2 blocker
ending for ppi’s
prazole
