Acid Controlling Drugs Flashcards
Antacids? Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Antacids: aluminum, magnesium salts, calcium salts, sodium bicarbonate
H2RA's (Histamine2 Receptor Antagonists)? Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Histamine 2 Receptor Antagonists (H2RA) : cimetidine 1st Generation, & Ranitidine
Proton Pump Inhibitors? Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Proton Pump Inhibitors/PPI: Omeprazole, “Prazole”
Anti-Ulcer Agents? Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Extra? Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Extra
Simethicone
Bismuth Subsalicylate
Treat:
GERD/Heart burn
ALUMINUM- (Hyperphosphatemia) due to CKD (except magnesium!)
NOT for treating PUD
Many antacid combinations include simethicone to reduce the surface tension of gas bubbles
Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Antacids: aluminum, magnesium salts, calcium salts, sodium bicarbonate
ALUMINUM- (Hyperphosphatemia or Hyperphosphatemia) due to CKD (except pottasium or magnesium!)
Hyperphosphatemia
Magnesium
NOT for treating PUD? Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
(aluminum, magnesium salts, calcium salts, sodium bicarbonate)
Many antacid combinations include ? to reduce the surface tension of gas bubbles? Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
simethicone
Neutralize gastric acid (hydrochloric acid) by producing neutral salts
aluminum
magnesium salts
calcium salts
sodium bicarbonate
aluminum
Antacids: Aluminum Salts
Has constipating effects. Often used with (Pottasium or magnesium) to counteract constipation.
magnesium
Can be used in CKD to treat hyperphosphatemia?
aluminum
magnesium salts
calcium salts
sodium bicarbonate
aluminum
Antacids: Magnesium Salts Commonly cause (Constipation or Diarrhea) with other drugs.
Diarrhea
CONTRA-INDICATION
Dangerous when used with renal failure; the failing kidney cannot excrete extra (pottasium or magnesium) resulting in (Retention or Accumulation)
magnesium
Accumulation
Cause
Constipation, Kidney stones, Milk Alkali Syndrome (don’t give with milk!), Rebound Hypersecretion of Acid
aluminum
magnesium salts
calcium salts
sodium bicarbonate
calcium salts
Long duration of acid action—may cause increased gastric acid secretion (hyperacidity rebound)
aluminum
magnesium salts
calcium salts
sodium bicarbonate
calcium salts
Often advertised as an extra source of dietary calcium (such as Tums®)
aluminum
magnesium salts
calcium salts
sodium bicarbonate
calcium salts
don’t give with milk!
aluminum
magnesium salts
calcium salts
sodium bicarbonate
calcium salts
Antacids: Sodium Bicarbonate
Lowly or Highly soluble
Highly soluble
Buffers the acidic properties of HCl
aluminum
magnesium salts
calcium salts
sodium bicarbonate
sodium bicarbonate
Quick onset but short duration
aluminum
magnesium salts
calcium salts
sodium bicarbonate
sodium bicarbonate
May cause metabolic (alkalosis or acidosis)
aluminum
magnesium salts
calcium salts
sodium bicarbonate
alkalosis
sodium bicarbonate
? content may cause problems in patients with heart failure (HF), hypertension, or renal insufficiency.
aluminum
magnesium salts
calcium salts
sodium bicarbonate
sodium bicarbonate
Constipation:
aluminum
magnesium salts
calcium salts
sodium bicarbonate
Aluminum/Calcium
Diarrhea:
aluminum
magnesium salts
calcium salts
sodium bicarbonate
Magnesium
? is given for CKD (hyperphosphatemia)
aluminum
magnesium salts
calcium salts
sodium bicarbonate
Aluminum
Heart Failure: Avoid any that have ?
aluminum
magnesium salts
calcium salts
sodium bicarbonate
SODIUM (Sodium Bicarb)
Antacids: aluminum, magnesium salts, calcium salts, sodium bicarbonate
Generally ? to ? hours after a meal, bedtime too
Reminder to take other medications before or after if possible to avoid any binding problems or absorption issues (minimum ?-? hour window- both directions)
1 to 3 hours
1-2
If someone is using chronically, we need to investigate!
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Antacids: aluminum, magnesium salts, calcium salts, sodium bicarbonate
MECHANISM OF ACTION
Antagonizes H2 receptors in gut; Decreases acid production; Increases pH in stomach, decreases damage
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Histamine 2 Receptor Antagonists (H2RA) : cimetidine 1st Generation, ranitidine and famotidine
Treat: Peptic Ulcer Disease (PUD) GERD Stress Ulcer Prophylaxis (SUP) Immune responses (histamine blockade)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Cimetidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Histamine 2 Receptor Antagonists (H2RA) : cimetidine 1st Generation, ranitidine and famotidine
1st Generation
Famotidine
Cimetidine
Ranitidine
Cimetidine
2nd Generation
Famotidine
Cimetidine
Ranitidine
Famotidine
Ranitidine
Anti-Androgen
Famotidine
Cimetidine
Ranitidine
Cimetidine
Liver Enzyme Inhibition
Famotidine
Cimetidine
Ranitidine
Cimetidine
Cleaned up version (no androgen/liver issues)
Famotidine
Cimetidine
Ranitidine
Ranitidine
Famotidine
Can accumulate in renal impairment (geriatrics)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Cimetidine
Ranitidine
Famotidine
Change pH in the gut- High risk for Pneumonia & C Diff? Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Cimetidine
Ranitidine/ Famotidine
KIDNEY DISEASE/GERIATRICS: Can take at night b/c of drownesness. Cns - confusion, hallucinations and disorientation.
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Cimetidine
Ranitidine/ Famotidine
PH CHANGE IN GI TRACT- Pneumonia & C Diff, notify prescriber of foul smelling/greenish diarrhea.
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Cimetidine
Ranitidine/ Famotidine
ANTI-ANDROGEN: ? may induce impotence and gynecomastia. ? blocks androgen, educate patients to monitor for libido changes, gynecomastia, impotence
Cimetidine
Ranitidine/ Famotidine
Cimetidine
Renal impairment (begins to act like Benadryl-H1RA)
Cimetidine
Ranitidine/ Famotidine
Cimetidine
Thrombocytopenia and Hepatotoxicity have been reported- rare
Cimetidine
Ranitidine/ Famotidine
ranitidine and famotidine
Cimetidine
Ranitidine/ Famotidine
Intended Use
Intended Outcome: Reduced heartburn/dyspepsia/healing of ulcers•NOTE: USUAL DURATION is ?-? weeks for Ulcer healing. •
4-8 weeks
Cimetidine
Ranitidine/ Famotidine
Long term use is indicated for (hypersecretory or hyposecretory) conditions
hypersecretory
? interacts with many drugs- caution with other drugs
Cimetidine
Ranitidine/ Famotidine
Cimetidine
Cimetidine Ranitidine/ Famotidine Administration H2RAs and antacids should be administered at least ?-? hours apart Can administer at bedtime or with meals
1-2 hours apart
Can administer at bedtime or with meals
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Cimetidine
Ranitidine/ Famotidine
Treat:
G.I. Bleed, Peptic Ulcer Disease (PUD), GERD, Stress Ulcer Prophylaxis (SUP)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
MECHANISM OF ACTION
Inhibits H+ / K+ ATPase in parietal cells Decreases acid production; irreversible inhibition
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
ADVERSE EFFECTS
Change in gut pH
Increased risk for pneumonia and Clostridium difficile
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Rare antifungals/antivirals may not absorb
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Avoid “vir” or “azole”
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Change in absorption of electrolytes
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Long term –hypomagnesemia
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Long term- hypocalcemia◦Fractures and Osteoporosis (due to hypocalcemia)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Drug to Drug
Other drugs may not absorb efficiently
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Omeprazole (Prilosec)
Intened outcome
Intended Outcome: Reduced heart burn/dyspepsia/healing of ulcers•NOTE: USUAL DURATION is ?-? weeks for Ulcer healing.
4-8 weeks
Omeprazole (Prilosec)
Long term use is indicated for (hypersecretory or hyposecretory) conditions
hypersecretory
Monitor
For long term treatment complications:
Osteoporosis (Vitamin D + Calcium intake)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Pneumonia/C.Diff (patients monitor S/S)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Magnesium (monitor for muscle cramps, more dangerously- seizures)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Taper off if you can, sudden stoppage can cause rebound hypersecretion of stomach acid
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Omeprazole (Prilosec)
Omeprazole (Prilosec)
Administration
Patients should take first thing in the morning, ? minutes before their first meal
30
Treat:
Peptic Ulcer Disease
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Composed of aluminum hydroxide and sulfated sucrose. When ingested, creates a protective barrier/gel at active ulcer sites for up to 6 hours
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Anti-Ulcer: Sucralfate
Composed of aluminum hydroxide and sulfated sucrose. When ingested, creates a protective barrier/gel at active ulcer sites for up to ? hours?
6 hours
BAND AID BARRIER
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Drug to drug
May bind other drugs
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Anti-Ulcer: Sucralfate
ADVERSE EFFECTS
Diarrhea or Constipation
Constipation
Nursing Considerations
Patients may develop constipation- encourage fiber intake
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Remember, it works for several hours at a time.
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Anti-Ulcer: Sucralfate
Anti-Ulcer: Sucralfate
Administration
Administer on ? stomach for best mechanism, ideally ? hour before meals and at bedtime (make a protective barrier in stomach BEFORE you eat!)
Separate administration of other drugs (? hours before/after)
empty
1
2
Treat:
Ulcers Promotes Cervical Ripening (Labor Induction)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Treat Postpartum Hemorrhage
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Can be used for termination of Pregnancy
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
MECHANISM OF ACTION
Prostaglandin analog- suppress stomach acid
promote secretion of bicarbonate and mucus
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Promotes Cervical Ripening (cervix becomes thinner- facilitates labor)
Can be used for termination of Pregnancy– stimulates uterine contractions
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
ADVERSE EFFECTS
Diarrhea (up to 40%) and abdominal pain (up to 20%)
Spotting, dysmenorrhea
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Pregnancy Category X
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Nursing Considerations
If using the drug, must have negative serum pregnancy test prior to use and be educated about risks.
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Avoid touching this medication with hands (precautions for nurses!)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Educate patients they may have dysmenorrhea, spotting
Educate patients that diarrhea is fairly common
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Administration
Give with meals (reduce GI upset)
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Prostaglandin Analog: Misoprostol
Treat:
Gas Pain
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Simethicone
MECHANISM OF ACTION
Decreases the surface tension of gas bubbles, gas bubbles become smaller, easier to leave
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Simethicone
Commonly given with antacids because they can produce gas
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Simethicone
Administration
Comes in chewable tablets/liquids
Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Cimetidine Ranitidine/ Famotidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Simethicone
Treat:
Diarrhea (traveler’s diarrhea)
Indigestion/Heartburn
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
Bismuth Subsalicylate
MECHANISM OF ACTION
? component has bactericidal properties
? component may act as anti-inflammatory
Bismuth
Subsalicylate
Bismuth
Salicylate
ADVERSE EFFECTS
May stain tongue, bowel movements green/black
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
Bismuth Subsalicylate
Avoid in children (especially if they have a virus > risk for Reye’s Syndrome)
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
Bismuth Subsalicylate
Chronic use could accumulate (risk for salicylism)
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
Bismuth Subsalicylate
Drug to Drug
Can bind to antibiotics/other drugs
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
Bismuth Subsalicylate
Treat:
Minimum of two antibiotics prescribed (up to three may be used) to reduce risk of resistance developing FOR ?WEEKS (? days)
Amoxicillin, Clarithromycin, Bismuth compounds, Tetracycline, Metronidazole
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
2
14
H. pylori Treatment
Nursing Considerations
None is effective aloneIf these drugs are used alone, the risk of resistance developing increases
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
Administration
OAC (Omeprazole, amoxicillin, clarithromycin)
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
BMT (Bismuth Subsalicylate, Metronidazole, Tetracycline)
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
LAC (Lansoprazole, Amoxicillin, Clarithromycin)
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
TIP: These are used to treat H.pylori induced PUD
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
PUD- three letters, needs three drugs!14 days
Simethicone
H. pylori Treatment
Bismuth Subsalicylate
H. pylori Treatment
Prostaglandin Analog
Cimetidine Omeprazole (Prilosec) (aluminum, magnesium salts, calcium salts, sodium bicarbonate) Ranitidine Sucralfate (Carafate) Simethicone Bismuth subsalicylate Misoprostol
Misoprostol