GERD/PUD drugs

Question 1

Goal of treatment

Answer 1

Decrease stomach acid production or neutralize gastric pH and prevent long term complications such as esophageal adenocarcinoma

Question 2

Major treatments of GERD/PUD

Answer 2

Histamine H2 receptor blockers, proton pump inhibitors, antacids, physical protectors, prostaglandin analogs

Question 3

H2 receptor antagonists

Answer 3

-tidine
Decreases histamine release from enterochromaffin like cells in the stomach
Used for PUD and GERD but less effective than PPI
Has immediate effect
All drugs increase stomach acid pH

Question 4

Proton pump inhibitors

Answer 4

-prazole
Most effective blockers of gastric acid secretion
Irreversible inhibitors of H+/K+ ATPase
Takes 2-5 days to have good effect

Question 5

First line therapy for PUD and GERD

Answer 5

Proton pump inhibitors

Question 6

Chronic use of proton pump inhibitors may cause

Answer 6

Iron and B12 malabsorption and greater risk of respiratory and enteric infections

Question 7

Antacids

Answer 7

Neutralize protons in gut lumen

Short term relief of reflux related symptoms

Question 8

AlOH

Answer 8

Antacid

May cause constipation

Question 9

MgOH

Answer 9

Antacid

May cause diarrhea

Question 10

Sucralate

Answer 10

Cytoprotectant
Requires acidic pH to polymerize and form a sticky gel
Coats ulcer crater and prevents further eradication

Question 11

Bismuth

Answer 11

Similar to sucralate

Used in H Pylori eradication regimen

Question 12

Misoprostol

Answer 12

PGE1 analog
Increases bicarb and mucus production, decreases HCl production
Used for NSAID induced ulcer
Contraindicated in pregnancy

Question 13

Combo therapy for H Pylori

Answer 13

Orneprazole + Clarithromycin + Amoxicillin
Bismuth + metraondiazole + tetracycline
14 day course