Ch 28 Peptic Ulcer Disease Flashcards
What antibiotics are used to treat peptic ulcer disease
Amoxicillin ( Amoxil) bismuth ( Pepto bismol) Clarithromycin ( Biaxin) Metronidazole ( flagyl) Tetracycline ( achromycin V, Sumycin)
What is the pharmalogical action of antibiotics in the treatment of peptic ulcer disease
Eradication of H pylori bacteria
Therapy should include combination of 2-3 antibiotics for 14 days to increase effectiveness and to mimimize the development of drug resistance.
What are common adverse effects of antibiotics
Nausea
Diarrhea
What are histamine2 receptor antagonists
They suppress the secretion of gastric acid by selectively blocking H2 receptor in parietal cells lining the stomach.
They are used in combinations with antibiotics to treat ulcers caused by H pylori.
Is prescribed for gastric and peptic ulcers, GERD, and hypersecretory conditions such as Zollinger Ellison syndrome.
What are adverse effects of H2 receptor antagonists
Cimetidine may block androgen receptors resulting in decreased libido and impotence. It may also cause CNS effects ( lethargy, depression, confusion.)
What is the prototype drug of histamine 2 receptor antagonists
Ranitidine Hydrochloride ( Zantac)
Cimetidine ( Tagamet)
Famotidine ( Pepcid)
Nizatidine ( Axid) PO use only!!!
What are contraindications and precautions of histamine 2 receptor antagonists
Pregnancy category B
Use in older adults can cause anti adrenergic effects ( impotence) and CNS effects ( confusion)
H2 receptor antagonists decrease gastric acidity, which promotes bacterial colonization of the stomach and secondary of the respiratory tract….uses cautiously in ppl at high risk for pneumonia, such as ppl with COPD.
What are medication interactions of h2 antagonizes
Cimetidine can inhibit medication metabolizing enzymes and thus increases the levels of warfarin, phenytoin, theophylline and lidocaine.
Concurrent use of antacids can decrease absorption of histamine2 receptor antagonists
What is treatment of peptic ulcer disease
Treatment is usually started as an oral dose twice a day until the ulcer is healed, followed by a maintenance dose which is usually given at bedtime.
What is a proton pump inhibitor
They reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid
PPIs reduce basal and stimulated acid production
They are prescribed for gastric and duodenal ulcers, erosive esophagitis, GERD, and hypersecretory conditions such as Zollinger Ellison syndrome.
Name the prototype proton pump inhibitor and other drugs
Omerprazole ( Prilosec) Pantoprazole ( protonix) Lansoprazole ( Prevacid) dexlansoprazolem( Dexilant) Rabeprazole sodium ( AcipHex) Esomeprazole ( Nexium)
Long term use of proton pump inhibitors increase the risk for what
Osteoporosis
What are contraindications and precautions of H2 receptor antagonists and proton pump inhibitor
These meds increase the risks for pneumonia use cautiously in COPD clients
When used concurrently with Omerprazole, what drugs serum levels will be increased
Digoxin
Phenytoin
Warfarin
The absorption of what drugs is decreased significantly when used with proton pump inhibitors
Ketoconazole
Itraconazole ( sporanox)
Atazanavir ( reyataz)
Concurrent use should be avoided if necessary to administer, separate by 2-12 hr.
