PUD Flashcards
What are the nun pharmacological treatment for PUD
Reduce : Stress , cergarette smoking , NSAID use and Aspirin
Can use Acetaminophen for pain
No need to adjust diet patient should avoid irritants ( spicy food caffeine alcohol )
Surgery may require for bleeding or obstruction
What are the drug regimen to eradicate Helicobacter pylori positive PUD
First choice
PPI
Omeprazole ( Prilosec ) 20 mg + Clarithromycin 500 mg bd + Amoxicillin 1g bd or metronidazole 500 mg bd
All for 10 - 14 days
Patient X was diagnosed with PUD Hpylori positive and after 14 days of triple therapy treatment patient start having an reaction to amoxicillin , what should be the second best option :
Bismuth based quadruple therapy
PPI
Omiprazole 20mg od or bd +
Bismuth subsalicylate 525 mg 4 times daily +
metronidazole 250 -500 mg 4 times daily +
tetracycline 500mg 4 times daily
All for 14 days
All except PPI should be taken with meal and at bed time
How do you treat a patient that has peptic ulcer induced by NSAID that HP negative
PPI OR Misoprostol
Or switch to selective COX 2 inhibitor
Prilosec
Omeprazole
Lanzaprazole
Aciphex
Nexium
Esomeprazole
Sucralfate
Carafate
What are your monitoring parameter
Side effects of drugs
Drug and drug reaction eg Omiprazole
Resolution of pain
Cytotec
Misoprostol
Celecoxib
Celibrex
Clarithromycin
Karicid
Metronidazole
Flagyl
Augment
Amoxicillin and clavulanic acid
Sequential therapy 10 day therapy
Pp1 10 days
Amoxicillin 1g bd * 5/7 first 5 days
Clairicid 500mg and Flagyl 500mg bd for the next 5 days
