Peptic Ulcer Flashcards
High risk NSAIDS induces Peptic Ulcer:
Piroxicam or ketorolac
Moderaterisk of NSAIDS induces Peptic Ulcer:
naproxen
Low risk of NSAIDS induces Peptic Ulcer:
Ibuprofen, diclofenac, and nabumetone
Diagnostic tests for peptic ulcer are two types:
Endoscopic (EGD)
Non-Endoscopic
Non-Endoscopic tests are;
Serologic
Stool antigen
Urea breath
-if patient has history of ulcer before so use :
PPI + need NSAIDs so start paracetamol
-if no history of ulcer but he has something appear or symptoms , the principle is useing:
prostaglandin analogue (misoprostol)
if no cardiac risk so use:
COX2 inhibitor and PPI
if there is cardiac risk use:
naproxen with PPI
What are the first line therapy for H.Pylori Eradication Therapy Regimens;
Bismuth quadruple
Concomitant
What is the Bimuth quadrable terapy:
When it is used?
Bismuth subsalicylate 300 mg QID or Bismuth subcitrate 120-300 mg QID + metronidazole 250 QID or 500 mg TID-QID + tetracycline 500 mg QID + PPI BID
For 10-14 days
It is used when the pateint has allergy toward pencillin
What is the conconitant therapy:
PPI (standard dose) BID +clarithromycin 500 mg BID + amoxicillin 1000 mg BID + metronidazole or tinidazole 500 mg BID
For 10-14 days
What is Deuxis:
H2RA and NSAID Combination product
Famotidine+Ibuprofen
Side effect of PPI long term :
AKI STROKE HYPOCALCEMIA leading to fractures HYPOMAGNESEMIA Community-acquired pneumonia Clostridium difficile– associated diarrhea
Adverse efects of misoprostol (PG analogue):
contraindicated in pregnancy ( because induce abortion ) and contraindicated in bronchial asthma ( because of bronchoconstriction )
