Drugs for Peptic Ulcer Disease

Question 1

PUD

Answer 1

erosion of gut wall; imbalance of defensive factors and aggressive factors

Question 2

defensive factors of gut

Answer 2

Mucus-protective barrier
Bicarbonate-neutralizes acid
Blood flow-maintain mucosal integrity
Prostaglandins-stimulate secretion of mucus and bicarb, enhance blood flow

Question 3

Common causes/Aggressive factors: PUD

Answer 3

H. Pylori infection-bacteria-most common
NSAIDs
Gastric acids
Pepsin
Smoking

Question 4

peptic ulcer

Answer 4

an ulcer occurring in the esophagus, stomach, or duodenum; occur from hypersecretion of hydrochloric acid and pepsin

Question 5

Treatment Options for Peptic Ulcer Disease

Answer 5

Nonpharmacologic measures
Antibiotics
Antisecretory Agents
Mucosal Protectants
Antisecretory Agents
Antacids

Question 6

PUD non-drug therapy

Answer 6

in addition to drugs; Diet (small meals) Smoking cessation, avoid NSAIDs

Question 7

Treatment Options for Peptic Ulcer Disease: antibiotics

Answer 7

Clarithromycin
Amoxicillin
Bismuth (Pepto Bismol)-OTC
Metronidazole
Tetracycline

Question 8

Treatment for PUD-H2 Receptor Antagonists

Answer 8

suppressing the secretion of gastric acid; 
Cimetidine
Ranitidine
Famotidine
Nizatidine

Question 9

Cimetidine

Answer 9

on empty stomach
CNS depression/stimulation/ reduced libido
duo 4-6 weeks/gas 8-12
antacids an hour apart

Question 10

Treatment for PUD-Proton Pump Inhibitors

Answer 10

most effective for suppressing gastric acid; lowest dose for shortest time-limited 4-8 weeks;

omeprazole

Question 11

Omeprazole (enteric coated)

Answer 11

N/V, diarrhea
Increase risk for fractures (osteoporosis)
Pneumonia
Acid rebound
Intestinal infection (C-diff)
Hypomagnesemia
Lots of drug interactions
(CAN BE LONG TERM HYPERSECRETORY)

EMPTY STOMACH IN AM

Question 12

Treatment for PUD-Antiulcer Drugs

Answer 12

ulcer healing by creating a protective barrier; no acid-neutralizing capacity and does not decrease acid secretions

Sulcrafate

Question 13

Sulcrafate

Answer 13

sulfated sucrose and aluminum hydroxide

Side effects (very minimal):
Constipation
Lacks significant drug interactions

empty stomach at least 30 min to 2 hours from food or drugs.

Can impede the absorption of phenytoin, theophylline, digoxin, warfarin, Cipro

Question 14

Treatment for PUD-Antacids

Answer 14

neutralize stomach acid; PUD & GERD; drug interactions, take at least 1 hour spaced apart;

Aluminum hydroxide
Magnesium hydroxide
Calcium carbonate

Question 15

Aluminum hydroxide
Magnesium hydroxide
Calcium carbonate

side effects

Answer 15

Constipation (aluminum hydroxide)
Diarrhea (magnesium hydroxide)
Hypertension

Question 16

Calcium carbonate (Tums)

Answer 16

safest choice of antacid in

patients with renal failure as it is not systemically absorbed