Drug treatments for peptic ulcers

Question 1

Why can’t corticosteroids and NSAIDs be used at the same time?

Answer 1

Causes formation of peptic ulcers, which increase chance of upper GI bleed

Question 2

What is the most common cause of upper GI bleed?

Answer 2

Peptic ulcers

Question 3

How can human error of giving corticosteroids and NSAIDs at same time be avoided?

Answer 3

Check patient’s medical history and ensure that drug history matches to medical conditions

Question 4

What is the therapeutic effect of drugs for peptic ulcers?

Answer 4

Reduce stomach damage

Question 5

What are the 2 targets of drugs to reduce stomach damage when peptic ulcers occur?

Answer 5

Reduce gastric acid

Increase mucus layer lining stomach

Question 6

What is the target of Proton Pump Inhibitors (PPIs) and H2 antagonist drugs?

Answer 6

Reduce gastric acid

Question 7

Give 1 example of an PPI?

Answer 7

Lansoprazole

Question 8

What is mechanism of action of PPIs to treat peptic ulcers?

Answer 8

Irreversibly bind to and inhibit hydrogen-potassium ATPase pump of gastric parietal cell, which normally secretes protons and generates gastric acid

Question 9

What is the mechanism of action of H2 antagonist drugs to treat peptic ulcers?

Answer 9

Reversibly bind to histamine receptors on gastric parietal cell, which decreases gastric acid secretion

Question 10

What is the mechanism of action of Misoprostol to treat peptic ulcers?

Answer 10

Synthetic/analogue prostaglandin that increases gastric mucus

Question 11

What drug class is most favoured for treating peptic ulcers and give 3 reasons why?

Answer 11

PPIs are most favoured:
Most efficacious at increasing pH, so less acidic conditions

Longest duration of action with one daily dose

Highest ulcer healing rate (over 90%)