Podcast
Questions and Answers
What is a primary goal of therapy for peptic ulcers?
What is a primary goal of therapy for peptic ulcers?
Which type of drug is primarily used to neutralize gastric acid?
Which type of drug is primarily used to neutralize gastric acid?
Which test is used to detect the presence of H.pylori?
Which test is used to detect the presence of H.pylori?
What is a common side effect of H2 blockers such as Cimetidine?
What is a common side effect of H2 blockers such as Cimetidine?
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Which medication is an irreversible inhibitor of H+/K+ ATPase?
Which medication is an irreversible inhibitor of H+/K+ ATPase?
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Which of the following is NOT considered a type of antacid?
Which of the following is NOT considered a type of antacid?
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What therapeutic use is shared by both H2 blockers and proton pump inhibitors?
What therapeutic use is shared by both H2 blockers and proton pump inhibitors?
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What effect do prostaglandins have in the treatment of peptic ulcers?
What effect do prostaglandins have in the treatment of peptic ulcers?
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Study Notes
Peptic Ulcer
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Clinical Features:
- Symptoms and signs: Epigastric pain and tenderness, anorexia, nausea and vomiting, hemorrhage.
- Endoscopy.
- Presence of H. pylori: Diagnosis via endoscopic biopsy, serological tests, and urea breath test.
Goals of Therapy
- Relief of pain.
- Promotion of healing.
- Prevention of recurrence.
Drug Therapy: Antacids
- Mechanism of Action: Neutralization of HCl, relief of pain, elevation of pH decreasing pepsin activity, some increase in prostaglandins and eradication of H. pylori.
Types of Antacids
- Chemical Antacids: Examples include sodium bicarbonate and calcium carbonate.
- Physical Antacids: Act by absorbing HCl and pepsin and have a demulcent effect on the ulcer, e.g., gastric mucin.
Anti-Secretory Drugs
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Mechanism of Action: Inhibit secretion of gastric HCl.
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Types of Anti-Secretory Drugs:
- Anti-Muscarinic Drugs: Examples include pirenzepine and telenzepine (selective M1 blockers) to decrease acidity.
- Gastrin Antagonists: Example is proglumide, a gastrin-receptor blocker.
- Prostaglandins: Example is misoprostol, useful in treatment of NSAID-induced peptic ulcers.
H2 Blockers (e.g., Cimetidine)
- Pharmacodynamics: Selective competitive blocker of histamine H2 receptors, reducing gastric acidity.
- Side Effects: Sudden stop, recurrence of the ulcer, bleeding, GIT upsets, constipation or diarrhea, hypersensitivity reactions (skin rash and itching), affect liver and kidney, decrease hepatic blood flow.
Ranitidine (another H2 blocker)
- Pharmacodynamics: Similar to cimetidine but with longer duration of action and potentially stronger effect (5-10 times).
- Side Effects: Similar to cimetidine but possibly safer.
Proton Pump Inhibitors (e.g., Omeprazole, Lansoprazole, Pantoprazole)
- Mechanism of Action: Activated in the stomach's acidic environment, acting as irreversible inhibitors of H+/K+ ATPase enzyme.
- Therapeutic Uses: Peptic ulcers (drug of choice), gastroesophageal reflux disorder (GERD).
- Side Effects: CNS effects (headache, dizziness, drowsiness), GIT effects (nausea, diarrhea, abdominal colic), skin rash.
Mucosal Protectives (e.g., Prostaglandins)
- Mechanism of Action: Increase mucus secretion, increase bicarbonate secretion, increase blood supply to the mucosa, decrease HCL secretion, promote healing of ulcers, and prevent gastric ulcers induced by analgesics.
- Side Effects: None specified in the provided text.
Contraindications and Additional Side Effects
- Oxytocic effect: Contraindicated in pregnancy (causes abortion).
- Nausea and abdominal pain.
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Description
Test your knowledge on peptic ulcers, their clinical features, and the goals of therapy. This quiz covers drug therapy including antacids and anti-secretory drugs, as well as their mechanisms of action. Ideal for students and professionals in healthcare who want to deepen their understanding of gastrointestinal disorders.
