PUD w H pylori (vivien) Flashcards
At what conditions do H pylori grow best?
Grow best in neutral pH
but still can survive in acidity
H pylori treatment
1.
2.
- Antibiotics: clarithromycin + amoxicillin
2. Acid suppressing agent: esomeprazole
Frequency of antibiotics dose
2x a day
What do we need to monitor after administering the antibiotics?
- I/O for diarrhoea and vomiting
- rash
- anaphylaxis (severe allergic rxn eg. decrease in BP)
Why do we also need to monitor ECG after clarithromycin?
the drug may cause QTc interval prolongation in certain patients (arrhythmia can lead to sudden cardiac death)
Class of esomeprazole
proton pump inhibitor
Frequency of esomeprazole
2x daily
Role of esomeprazole
increases pH, making gastric conditions more alkaline → H pylori can multiply at increased pH → antibiotics work best when H pylori is multiplying → reduces PUD symptoms and ulcer healing
What do we need to monitor after administering the esomeprazole?
- flatulence
- dry mouth
- rash
- anaphylaxis
When do we administer esomeprazole?
30mins-1h before food (on empty stomach)
Can esomeprazole be crushed?
NO
What is antisecretory therapy?
the standard long-term treatment for patients with bleeding ulcers to prevent recurrent bleeding
Duration of antisecretory therapy
- Duodenal ulcers
- Gastric ulcers
- 4-8 wks
2. 8-12 wks
Desc post-op plan: pain relief
Step 1 (mild pain) :
2 (mod pain) :
3 (severe pain) :
- NSAIDs, paracetamol or aspirin
- mild opioids (eg. codeine, tramadol)
- strong opioids (eg. morphine, fentanyl)
Role of IV antibiotics as a post-op plan and eg.
Prevent skin & soft tissue infections that arise from an incision
eg. IV cefazolin, amoxicillin
