Anti Ulcer Drugs Fitz Flashcards
What is the most effective drug for preventing and treating peptic ulcer disease?
ANTIMICROBIALS because the eradicate H. pylori
Why is amoxicillin the best drug in its class?
Broad spectrum- treats gram neg
Good oral bioavailability
Acid Stable
Why is clarithromycin the best macrolide choice to treat H. pylori?
It has a substantially LOWER MIC90!!! (you want it to be low NOT high!!!)
More acid stable, and fewer SE
Why is should you NOT give antacids with tetracycline?
Significantly decreases antibiotic efficacy due to chelation
What is the most effective agents for reducing intragastric acidity? Why?
PPIs
the IRREVERSIBLY inhibit the final common pathway in acid secretion: H/K ATPase
Which H2 receptor blocker has the most side effects?
Cimetidine
How to H2 receptors work?
Decrease all forms of gastric acid secretion (esp nocturnal)
How do antacids work in general?
They are weak bases used to buffer stomach acid
Which drugs are useful for intermittent dyspepsia?
Antacids
Rapid onset short duration
No prevention of ulcer recurrence
What is the drug of choice for Zollinger-Ellison Syndrome, GERD, and ulcer treatment?
PPIs
Slow onset
Long duration
Excellent Prevention of ulcers
Sucralfate
Attaches to BM of ulcer, stimulates PG and HCO3 secretion, recruits growth factors for repair
**requires acid environment to be active (don’t give with PPI, H2 blocker, etc)
Two MOAs for Bismuth Subsalicylate?
Direct antimicrobial against H. pylori (disrupts cell wall, prevents adhesion, inhibits urease)
Protects ulcer surface- coats to protect and stimulates PG
What is the drug of choice for treatment of ulcers induced by NSAIDS?
MISOPROSTOL (PGE1)
Omperazole Esomerprazole Lansoprazole Pantoprazole Raberprazole
PPIs
Atropine
Pirenzipine
Antimuscarinics