Peptic Ulcer disease
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what is the definition of peptic ulcer disease (PUD)?
- group of upper GI disorders
- degrees of erosion of the gut wall
- severe erosion can be complicated by hemorrhage and perforation
what is the cause of PUD?
imbalance between muscosal and aggressive factors
what are the aggressive factors in PUD?
- H pylori
What are the defensive factors in PUD?
- blood flow
what are the goals for drug therapy for PUD?
- alleviate symptoms
- promote healing
- prevent complications
- prevent recurrence
- ** drugs do not alter the disease process, they create conditions conducive to healing
what are the 5 classes of anti ulcer drugs?
- antisecretory agents
- muscosal protectants
- antisecretory agents that enhance muscosal defenses
how do you treat NSAID induced ulcer?
H2 receptor blockers and pPI are preferred method
what is the minimum amount of antibiotics used to treat h pylori?
- it is best to take more than 2 tho
what are the types of antibiotics used to treat H pylori?
- bismuth compounds
what to Histamine 2 (H2) receptor antagonists do?
promote healing by suppressing secretion of gastric acid
what do PPI (proton pump inhibitors) do?
suppress secretion of gastric acid
what does sucralfate do? ***IMPORTANT***
it makes a foam bubble in the stomach so that it creates an artificial mucus
what are the adverse effects of sucralfate?
what is misoprostol contraindicated in?
pregnancy --> teratogen
what do you have to watch out for when using antacids?
people with renal impairments because the Mg builds up in the kidneys which can be dangerous
what do antacids do?
- react with gastric acid to produce neutral salts or salts of low acidity
- decrease destruction of gut wall by neutralizing acid
- may also enhance mucosal protection by stimulating production of prostaglandins
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