Drugs for Peptic Ulcer Disease

Question 1

Causes of Peptic Ulcer Disease

Answer 1

H. pylori
NSAIDs
Stress
Zollinger-Ellison Syndrome

Question 2

H2 Blockers

Answer 2

Cimetidine - Weak antiandrogen, enzyme inh.
Ranitidine
Famotidine - Most potent
Nizatidine - 100% B.A

Question 3

Proton Pump Inhibitors

Answer 3

Omeprazole
Esomeprazole
Pantoprazole
Rabeprazole

PREFERRED DRUGS OF TREATING PUD

Question 4

MOA of PPIs

Answer 4

Inhibit H-K ATPase pump

Question 5

S/E of PPIs

Answer 5

Diarrhea
Vit B12 Deficiency
Gastric Infection
Dec. Magnesium levels
Inc. risk of osteoporosis
GI Problems (Enterocolitis)

Question 6

Antacids

Chemical antagonist - neutralizers of HCl

Answer 6

Systemic Antacids:
NaHCO3

A/E: Edema, Metabolic Alkalosis, Rebound hyperacidity

Non-Systemic:
Al(OH)3
Mg(OH2)
CaCO3

A/E: Constipation, Diarrhea, Milk-alkali syndrome

Question 7

Mucosal Protectants / Cytoprotectant

Answer 7

1. Sucralfate
2. Misoprostol - synthetic prostaglandin
3. Colloidal Bismuth Subcitrate

Question 8

Cytoprotectants

Answer 8

Forms a protective barrier between the acidic environment of the stomach the epithelium by lining the stomach wall

Question 9

Polymer of sulfated sucrose / sucrose octasulfate and Al(OH)3

Answer 9

Sucralfate
Used in patients who cannot tolerate H2 Blockers or PPI

Question 10

PGE-1 Analog used for prevention of NSAID-induced ulcer

Answer 10

Misoprostol

Inc. uterine contraction - abortifacient

Question 11

Triple Drug Therapy to Eradicate H. Pylori

Answer 11

PPI (Omeprazole)
Amoxicillin/Metronidazole
Clarithromycin

Question 12

Quadruple Therapy

Answer 12

Non-Bismuth Therapy
Rabeprazole + Amoxicillin + Clarithromycin + Metronidazole

Bismuth-Based Therapy
PPI + Metronidazole + Tetracycline + Bismuth subsalicylate