30 Questions
What is the main aim of drug therapy for peptic ulcer?
Promote healing
Which of the following is NOT considered an aggressive factor in the pathophysiology of peptic ulcer diseases?
Mucus
What is the main function of Antacids in drug therapy for peptic ulcer?
Neutralize secreted acid
What is the primary cause of Peptic Ulcer Disease (PUD) according to the text?
Genetics
Which of the following is a common symptom of peptic ulcer disease?
Dark stool indicating bleeding
What is the role of prostaglandins in the pathophysiology of peptic ulcer diseases?
Protect the stomach lining
What is the mechanism of action of antacids?
Neutralize free acid in the stomach
How is infection with H. pylori typically treated?
With antibiotics plus antisecretory drugs
What is the therapeutic use of antacids?
Offering symptomatic relief for PUD or GERD
Which drug category is used to treat inadequate mucosal defense against HCl?
Mucosal Protectives
What is the role of antibiotics in the treatment of peptic ulcers?
Treat infection with H. pylori
When should antacids be dosed in relation to other medications?
3 hours before taking other medications
What is a common side effect associated with aluminum salts?
Constipation
Which drug class can lead to gynecomastia and galactorrhea as side effects?
H2 receptor antagonists
How can most drug interactions be avoided when taking antacids?
Taking antacids 2 hours before or after other drugs
Which H2 receptor antagonist is known to be the most potent?
Famotidine
What is the mechanism of action of H2 receptor antagonists on parietal cells?
Competitive blocker of Histamine H2-receptors
What is the mechanism of action of Proton Pump Inhibitors (PPIs)?
Bind covalently to proton pumps
Which drug class inhibits the fasting secretion of HC1 by 60-70% during the daytime and 90% during the nighttime?
H2 receptor antagonists
Which side effect is associated with PPIs use?
Increased risk of osteoporosis
What is the role of Mucosal Protective Agents like Bismuth subsalicylate?
Form a protective layer over ulcer base
How do Proton Pump Inhibitors affect vitamin B12 absorption?
Decrease absorption by inhibiting intrinsic factor
Why do Proton Pump Inhibitors (PPIs) take 24 hours to start working effectively?
PPIs bind covalently to proton pumps, which requires time for new pump synthesis
Which drug interaction can be expected with Omeprazole and Esomeprazole?
Reduced bioavailability of drugs requiring acidity for absorption
What is the main mechanism of action of Misoprostol?
Stimulates local prostaglandin production
Which drug is contraindicated in pregnancy due to its potential to induce labor?
Misoprostol
How does Sucralfate work in the treatment of ulcers?
Binds to negatively charged proteins in the ulcer base
What is a common side effect of Bismuth therapy?
Blackening of the tongue and feces
Which agent is used for the prevention of stress ulcers?
Sucralfate
Which antibiotics are effective against H. pylori in combination therapy?
Metronidazole and Amoxicillin
Study Notes
Peptic Ulcer Disease
- Peptic ulcer disease results from an imbalance between aggressive and defensive mechanisms in the gastric and duodenal mucosa.
Secretion of HCl
- Parietal cells produce HCl, which is stimulated by acetylcholine, histamine, and gastrin.
- H+/K+ ATPase, a proton pump, is responsible for secreting H+ ions into the gastric lumen.
Pathophysiology of Peptic Ulcer
- Aggressive factors: acid, pepsin, H. pylori, and NSAIDs.
- Defensive factors: mucus, bicarbonate, prostaglandins, and mucosal blood flow.
Clinical Features and Complications
- Epigastric pain, nausea, vomiting, heartburn, loss of appetite, and dark stools.
- Bleeding, perforation, gastric outlet obstruction, and gastric cancer are complications.
Drug Therapy of Peptic Ulcer
- Four main approaches:
- Reduction of gastric acid secretion (anti-secretory drugs).
- Mucosal protective agents.
- Antimicrobial treatment for eradication of H. pylori.
- Neutralization of secreted acid (antacids).
Anti-Secretory Drugs
- Proton pump inhibitors (PPIs): omeprazole, pantoprazole.
- H2 blockers: cimetidine, ranitidine.
- Mechanism of action: competitive blocker of histamine H2-receptors on parietal cells.
Antacids
- Mechanism of action: neutralize free acid in the stomach.
- Examples: aluminum hydroxide, calcium carbonate.
- Side effects: constipation vs. diarrhea.
Mucosal Protective Agents
- Examples: misoprostol, sucralfate, bismuth subsalicylate.
- Mechanism of action: stimulate mucus and bicarbonate secretion, enhance mucosal blood flow.
- Indications: prevention of mucosal injury, reduction of inflammation, and healing existing ulcers.
Antimicrobial Treatment for Eradication of H. pylori
- Triple therapy: one PPI + two antibiotics (e.g., metronidazole, amoxicillin, clarithromycin).
- Treatment duration: 14 days.
Test your knowledge on antacids and anti-secretory drugs including aluminum salts, magnesium salts, drug interactions, and H2 receptor antagonists. Learn about their mechanisms of action and common side effects.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
