Ch 28 Peptic Ulcer Disease

Question 0

What antibiotics are used to treat peptic ulcer disease

Answer 0

Amoxicillin ( Amoxil)
bismuth ( Pepto bismol)
Clarithromycin ( Biaxin)
Metronidazole ( flagyl)
Tetracycline ( achromycin V, Sumycin)

Question 1

What groups of medications is used to treat peptic ulcer disease

Answer 1

Antibiotics
Anti secretory agents ( H2 receptor antagonists and PPI)
Mucosal protectants
Antacids

Question 2

What is the pharmalogical action of antibiotics in the treatment of peptic ulcer disease

Answer 2

Eradication of H pylori bacteria
Therapy should include combination of 2-3 antibiotics for 14 days to increase effectiveness and to mimimize the development of drug resistance.

Question 3

What are common adverse effects of antibiotics

Answer 3

Nausea

Diarrhea

Question 4

What are histamine2 receptor antagonists

Answer 4

They suppress the secretion of gastric acid by selectively blocking H2 receptor in parietal cells lining the stomach.
They are used in combinations with antibiotics to treat ulcers caused by H pylori.
Is prescribed for gastric and peptic ulcers, GERD, and hypersecretory conditions such as Zollinger Ellison syndrome.

Question 5

What are adverse effects of H2 receptor antagonists

Answer 5

Cimetidine may block androgen receptors resulting in decreased libido and impotence. It may also cause CNS effects ( lethargy, depression, confusion.)

Question 6

What is the prototype drug of histamine 2 receptor antagonists

Answer 6

Ranitidine Hydrochloride ( Zantac)
Cimetidine ( Tagamet)
Famotidine ( Pepcid)
Nizatidine ( Axid) PO use only!!!

Question 7

What are contraindications and precautions of histamine 2 receptor antagonists

Answer 7

Pregnancy category B
Use in older adults can cause anti adrenergic effects ( impotence) and CNS effects ( confusion)
H2 receptor antagonists decrease gastric acidity, which promotes bacterial colonization of the stomach and secondary of the respiratory tract….uses cautiously in ppl at high risk for pneumonia, such as ppl with COPD.

Question 8

What are medication interactions of h2 antagonizes

Answer 8

Cimetidine can inhibit medication metabolizing enzymes and thus increases the levels of warfarin, phenytoin, theophylline and lidocaine.
Concurrent use of antacids can decrease absorption of histamine2 receptor antagonists

Question 9

What is treatment of peptic ulcer disease

Answer 9

Treatment is usually started as an oral dose twice a day until the ulcer is healed, followed by a maintenance dose which is usually given at bedtime.

Question 10

What is a proton pump inhibitor

Answer 10

They reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid
PPIs reduce basal and stimulated acid production

They are prescribed for gastric and duodenal ulcers, erosive esophagitis, GERD, and hypersecretory conditions such as Zollinger Ellison syndrome.

Question 11

Name the prototype proton pump inhibitor and other drugs

Answer 11

Omerprazole ( Prilosec)
Pantoprazole ( protonix)
Lansoprazole ( Prevacid) dexlansoprazolem( Dexilant)
Rabeprazole sodium ( AcipHex)
Esomeprazole  ( Nexium)

Question 12

Long term use of proton pump inhibitors increase the risk for what

Answer 12

Osteoporosis

Question 13

What are contraindications and precautions of H2 receptor antagonists and proton pump inhibitor

Answer 13

These meds increase the risks for pneumonia use cautiously in COPD clients

Question 14

When used concurrently with Omerprazole, what drugs serum levels will be increased

Answer 14

Digoxin
Phenytoin
Warfarin

Question 15

The absorption of what drugs is decreased significantly when used with proton pump inhibitors

Answer 15

Ketoconazole
Itraconazole ( sporanox)
Atazanavir ( reyataz)

Concurrent use should be avoided if necessary to administer, separate by 2-12 hr.

Question 16

What time of the day should Omerprazole be administered

Answer 16

Once a day in the morning prior to eating

Question 17

What proton pump inhibitor can be administered orally

Answer 17

Pantoprazole ( protonix)