Antibiotic which disrupts cell wall synthesis in H. Pylori. Most effective at neutral pH (can work well with antacids);
amoxicillin
Antibiotic which disrupts cell wall in H. pylori causing lysis; inhibits urease activity; prevents H. pylori from adhering to gastric surface ("soap for the stomach"; bacteria do not develop resistance to this drug.
Bismuth (bismuth subsalicylate)
Proton-Pump Inhibitor (PPI); causes irreversible inhibition of H+/K+ ATPase (proton pump); _|_ gastric acid secretion; Effects persist until new enzyme is synthesized;
For treatement of duodenal and gastric ulcers, erosive esophagitis, GERD (short-term treatment); For long-term treatment of hypersecretory problems.
omeprazole [Prilosec]
Antibiotic for treatement of PUD caused by H. pylori. Category D; can cause discoloration in developing teeth.
tetracycline
For treatment and maintenance therapy of duodenal ulcers; Creates a protective barrier against acid and pepsin; No significant side effects
sucralfate [Carafate]
Histamine2 Receptor Antagonist (H2RA)
First choice for gastric and duodenal ulcers (4-12 wks of tx)
Suppresses secretion of gastric acid by binding with H2 receptors in parietal cells
Also relieves symptoms of GERD
Oral, IM, IV admin; antacids can decrease absorption
_|_ Hepatic drug metabolizing enzymes
cimetidine [Tagamet]
Used to prevent prophylactically ulcers in pts taking NSAIDs (e.g. for surgery, etc)