Therapeutics: PUD 1

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kyleannkelsey
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270387
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Therapeutics: PUD 1
Updated:
2014-04-12 23:21:26
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Therapeutics PUD
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Therapeutics: PUD
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Therapeutics: PUD
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  1. What are the goals of treatment for PUD?
    • Relieve associated pain
    • Heal the ulcer
    • Prevent recurrence
    • Reduce complications
  2. What are the Non-pharmacologic treatments for PUD?
    • Smoking cessation
    • D/C NSAIDs
    • If possible
    • Switch to acetaminophen OR nonacetylated salicylate (e.g. salsalate)
    • Avoid food & beverages that cause dyspepsia
    • Spicy foods, caffeine, alcohol, etc.
    • Reduce psychological stress
    • Surgery
  3. What is the first line treatment for H pylori caused PUD?
    • 3 drug regimen:
    • PPI + Clarithromycin + amoxicillin
  4. If a pt has a PCN allergy, what is the 1st line Tx for PH. Pylori caused PUD?
    PPI + Clarithromycin + Metranidazole
  5. What is Prevepac?
    • Lansoprazole 30 mg BID
    • Clarithromycin 500 mg BID
    • Amoxicillin 1000 mg BID
  6. Which s the Best PPI for a 3 drug regimen to treat H pylori?
    Lansoprazole
  7. How long should H. pylori PUD be treated for with a 3 drug treatment?
    10-14 days (do 14)
  8. How long should H. pylori PUD be treated for with a 4 drug treatment?
    10-14 days (do 14)
  9. A three drug regimen for H pylori treatment of PUD is dosed how many times a day?
    BID
  10. What is the 2nd line treatment for H pylori caused PUD?
    • 4 drug regimen:
    • Antisecretory (PPI)
    • 2 antibiotics
    • Bismuth subsalicylate
  11. What drug combos are used for a 4 drug regimen to treat H pylori caused PUD?
    Pylera and Helidac
  12. What drug combos are used for a 3 drug regimen to treat H pylori caused PUD?
    Prevepac
  13. What is Pylera?
    • Bismuth subcitrate 420 mg QID
    • Tetracycline 375 mg QID
    • Metronidazole 375 mg QID
  14. What is Helidac?
    • Bismuth subcitrate 525 mg QID
    • Tetracycline 500 mg QID
    • Metronidazole 250 mg QID
  15. Helidac and Pylera should be used with what other drug?
    PPI or H2RA
  16. What is the daily dosing regimen for a 4 drug H pylori treatment in PUD?
    QID
  17. What is the 3rd line treatment for H pylori caused PUD?
    • Sequential therapy:
    • Days 1-10: PPI BID
    • Days 1-5: Amoxicillin 1 gram BID
    • Days 6-10: Metronidazole 250 mg BID +Clarithromycin 500 mg BID
  18. What is the daily dosing schedule for a sequential antibiotic regiment to treat H pyloric caused PUD?
    BID
  19. What are the cons to using a sequential antibiotic regimen for H pylori caused PUD?
    Noncompliance/difficult
  20. What are the benefits to using a sequential antibiotic regimen for H pylori caused PUD?
    May reduce resistance
  21. How many days does a sequential antibiotic regimen for H pylori caused PUD last?
    10
  22. What are the considerations for treatment choice of PUD?
    • Compliance
    • Drug interactions
    • Efficacy
    • Cost
    • Resistance
    • Tolerability
  23. What are options for switch a patient off of NSAIDs in NSAID induced PUD?
    • APAP
    • Salsalate
    • COX-2 inhibitors: Celecoxib
    • NSAID + misoprostal
  24. What are the COX-2 inhibitors?
    Celecoxib
  25. What is the 1st line Prevention Tx for NSAID induced PUD if the patient continues to use the NSAID?
    NSAID + PPI
  26. How does treatment with NSAID + PPI compare to NSAID + misoprostal?
    NSAID + PPI is better tolerated
  27. Which PPI is best for a NSAID + PPI Prevention Tx for NSAID induced PUD if the patient continues to use the NSAID?
    All are good
  28. Prevention Tx for NSAID induced PUD of NSAID + PPI is effective for what type of PUD?
    Both gastric and duodenal
  29. When should you counsel a patient to take a PPI?
    30-60 minutes before the 1st meal of the day (or any meal)
  30. Which PPI is Category C (the only one, all others are B)?
    Omerprazole
  31. What is the brand name for Omeprazole?
    Prilosec or Zegerid
  32. What is the Initial and usual dose for Omeprazole (Prilosec or Zegerid) in PUD?
    • 40 mg QD
    • Usual: 20-40
  33. What is the generic name for Prilosec?
    Omeprazole
  34. What is the generic name for Zegerid?
    Omeprazole
  35. What is the Initial and usual dose for Lansoprazole (Prevacid) in PUD?
    • 30 mg QD
    • Usual: 15-30
  36. What is the brand name for Lansoprazole?
    Prevacid
  37. What is the generic name for Prevacid?
    Lansoprazole
  38. What is the Initial and usual dose for Rabeprazole (Aciphex) in PUD?
    • 20 mg QD
    • Usual: 20-40
  39. What is the brand name for Rabeprazole?
    Aciphex
  40. What is the generic name for Aciphex?
    Rabeprazole
  41. What is the brand name for Pantoprazole?
    Protonix
  42. What is the generic name for Protonix?
    Pantoprazole
  43. What is the brand name for Esomoprazole?
    Nexium
  44. What is the generic name for Nexium?
    Esomoprazole
  45. What is the brand name for Dexlansoprazole?
    Dexilant
  46. What is the generic name for Dexilant?
    Dexlansoprazole
  47. What is the Initial and usual dose for Pantoprazole (Protonix) in PUD?
    • 40 mg QD
    • Usual: 40-80
  48. What is the Initial and usual dose for Esomoprazole (Nexium) in PUD?
    • 40 mg QD
    • Usual: 20-40
  49. What is the Initial and usual dose for Dexlansoprazole (Dexilant) in PUD?
    • 30-60 mg QD
    • Usual: 30-60
  50. What is Vimovo?
    • NSAID-induced ulcer prevention combo drug:
    • Naproxen 375mg or 500 mg
    • Esomeprazole 20mg
  51. What does Zegrid have in it that Prilosec does not?
    Sodium bicarbonate
  52. What PPIs are IV?
    Esomaprazole and Pantoprazole
  53. What PPIs come in pellet form?
    • Pantoprazole, Rabeprazole
    • Also Omeprazole

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