Peptic Ulcers: Definition and Causes

Definition

• A peptic ulcer is a sore on the lining of the stomach or duodenum (first part of the small intestine)
• Caused by damage to the mucosal lining, leading to inflammation and ulceration

Types of Peptic Ulcers

• Gastric ulcer: occurs in the stomach
• Duodenal ulcer: occurs in the duodenum (first part of the small intestine)

Causes

• Helicobacter pylori (H. pylori) infection: a type of bacteria that can cause stomach inflammation and ulcers
• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs): such as aspirin, ibuprofen, and naproxen
• Zollinger-Ellison syndrome: a rare condition that causes the stomach to produce too much acid
• Stress: physical or emotional stress can contribute to the development of peptic ulcers

Symptoms

• Abdominal pain: usually in the upper middle part of the abdomen, and can be worse at night
• Nausea and vomiting
• Loss of appetite
• Weight loss
• Bleeding: vomiting blood or black tarry stools

Diagnosis

• Endoscopy: a flexible tube with a camera is used to examine the inside of the stomach and duodenum
• Upper GI series: a type of X-ray that uses a contrast agent to visualize the stomach and duodenum
• Blood tests: to check for H. pylori infection

Treatment

• Antibiotics: to treat H. pylori infection
• Acid-reducing medications: to reduce acid production in the stomach
• Antacids: to neutralize stomach acid
• Proton pump inhibitors (PPIs): to block the production of stomach acid
• ** Lifestyle changes**: avoiding NSAIDs, managing stress, and avoiding spicy or fatty foods

Definition and Types

• Peptic ulcer: a sore on the lining of the stomach or duodenum, caused by mucosal lining damage, leading to inflammation and ulceration
• Gastric ulcer: occurs in the stomach
• Duodenal ulcer: occurs in the duodenum (first part of the small intestine)

Causes of Peptic Ulcers

• Helicobacter pylori (H. pylori) infection: a bacterial infection causing stomach inflammation and ulcers
• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs): aspirin, ibuprofen, and naproxen can cause ulcers
• Zollinger-Ellison syndrome: a rare condition causing excessive stomach acid production
• Stress: physical or emotional stress contributing to ulcer development

Symptoms of Peptic Ulcers

• Abdominal pain: usually in the upper middle abdomen, worsened at night
• Nausea and vomiting
• Loss of appetite
• Weight loss
• Bleeding: vomiting blood or black tarry stools

Diagnosis of Peptic Ulcers

• Endoscopy: a flexible tube with a camera examines the stomach and duodenum
• Upper GI series: a type of X-ray using a contrast agent to visualize the stomach and duodenum
• Blood tests: checking for H. pylori infection

Treatment of Peptic Ulcers

• Antibiotics: treating H. pylori infection
• Acid-reducing medications: reducing stomach acid production
• Antacids: neutralizing stomach acid
• Proton pump inhibitors (PPIs): blocking stomach acid production
• Lifestyle changes: avoiding NSAIDs, managing stress, and avoiding spicy or fatty foods

Cough Medicine

Cough Suppressants

• Block the cough reflex to relieve coughing
• Examples: dextromethorphan, codeine
• Used for dry, non-productive coughs, causing side effects like drowsiness, dizziness, and stomach upset

Expectorants

• Loosen and thin mucus in the airways, making it easier to cough up
• Examples: guaifenesin, acetylcysteine
• Used to relieve congestion, making cough more productive, with side effects like stomach upset, diarrhea, and headache

Bronchodilators

• Relax airway muscles, opening up airways
• Examples: albuterol, ipratropium
• Used to relieve wheezing, shortness of breath, and coughing, causing side effects like nervousness, tremors, and rapid heartbeat

Mucolytics

• Break down mucus, making it easier to cough up
• Examples: acetylcysteine, dornase alfa
• Used to relieve thick, sticky mucus in conditions like cystic fibrosis, causing side effects like stomach upset, diarrhea, and allergic reactions

Anxiolytics

• Used to treat anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety disorder
• Enhance the activity of the neurotransmitter GABA, which has a calming effect on the brain
• Examples include benzodiazepines (alprazolam, diazepam, clonazepam) and non-benzodiazepines (buspirone, zolpidem)

Antipsychotics

• Used to treat psychotic disorders such as schizophrenia, bipolar disorder, and schizoaffective disorder
• Block the action of dopamine and other neurotransmitters in the brain
• Typical antipsychotics include haloperidol and chlorpromazine
• Atypical antipsychotics include olanzapine, risperidone, and quetiapine
• Side effects include extrapyramidal symptoms (tremors, rigidity, dystonia) and metabolic changes (weight gain, hyperglycemia, dyslipidemia)

Antiemetics

• Used to treat nausea and vomiting associated with chemotherapy, surgery, or motion sickness
• Act on the brain's vomiting center, blocking the release of serotonin and other neurotransmitters
• Examples include dopamine antagonists (metoclopramide, domperidone), serotonin antagonists (ondansetron, granisetron), and NK1 receptor antagonists (aprepitant)

Antiarrhythmics

• Used to treat abnormal heart rhythms such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation
• Affect the heart's electrical conduction system, slowing or regulating the heart rate
• Classes include Class I (sodium channel blockers: quinidine, procainamide), Class II (beta blockers: propranolol, esmolol), Class III (potassium channel blockers: amiodarone, sotalol), and Class IV (calcium channel blockers: verapamil, diltiazem)

Vasodilators

• Used to treat conditions such as hypertension, heart failure, and peripheral artery disease
• Relax smooth muscle in blood vessels, reducing blood pressure and improving perfusion
• Examples include calcium channel blockers (nifedipine, amlodipine), ACE inhibitors (enalapril, lisinopril), nitrovasodilators (nitroglycerin, isosorbide mononitrate), and alpha-adrenergic blockers (prazosin, doxazosin)