Antiulcer

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Questions and Answers

What is the main cause of the imbalance of digestive fluids in the stomach?

Stress

Insufficient production of anti-H antibodies

Helicobacter pylori infection

Too much acid production (correct)

Which of the following is NOT a type of ulcer?

Cancerous ulcer (correct)

Genital ulcer

Esophageal ulcer

Peptic ulcer

What is the role of Helicobacter pylori in the development of ulcers?

It accelerates the healing process of ulcers

It has no role in the development of ulcers

It contributes to the imbalance of digestive fluids (correct)

It helps in the neutralization of gastric acid

What is the primary location of esophageal ulcers?

Esophagus Signup and view all the answers

What is the consequence of the loss of tissue in the digestive tract?

Development of ulcers Signup and view all the answers

What is the effect of NSAIDs ingestion on the development of ulcers?

It accelerates the development of ulcers Signup and view all the answers

What is the role of stress in the development of ulcers?

It contributes to the imbalance of digestive fluids Signup and view all the answers

What is the primary location of peptic ulcers?

Stomach and duodenum Signup and view all the answers

Which of the following drugs is a proton pump inhibitor?

Omeprazole Signup and view all the answers

What is the main difference between H2 antagonists and proton pump inhibitors?

Proton pump inhibitors are more effective in reducing gastric acid secretion Signup and view all the answers

Which of the following antacids has a high neutralizing capacity?

Sodium bicarbonate Signup and view all the answers

What is the primary mechanism of action of sucralfate?

It polymerizes by cross-linking to form a protective barrier Signup and view all the answers

What is the mechanism of action of antacids?

They neutralize gastric acid in the stomach Signup and view all the answers

Which of the following antacids is associated with constipation as a side effect?

Aluminium hydroxide Signup and view all the answers

Which of the following drugs can cause gynecomastia?

Cimetidine Signup and view all the answers

What is the effect of H2 antagonists on the CNS?

They can cause headache and dizziness Signup and view all the answers

What is the primary mechanism of action of alginates?

It forms a layer of foam on top of gastric contents Signup and view all the answers

Which of the following drugs is a muscarinic antagonist?

Pirenzepine Signup and view all the answers

Which of the following antacids is associated with osteomalacia and encephalopathy as side effects?

Aluminium hydroxide Signup and view all the answers

What is the primary mechanism of action of oxethazine?

It has a surface anesthetic effect Signup and view all the answers

What is the primary mechanism of action of proton pump inhibitors?

They block the proton pump in the stomach Signup and view all the answers

Which of the following drugs can cause osteoporosis?

Omeprazole Signup and view all the answers

Which of the following antacids is associated with hypophosphatemia as a side effect?

Sucralfate Signup and view all the answers

What is the primary use of sucralfate?

To protect the stomach mucosa from acid Signup and view all the answers

What is the primary mechanism of action of simethicone?

It reduces surface tension, preventing bubble formation Signup and view all the answers

Which of the following drugs can cause leucopenia?

Pantoprazole Signup and view all the answers

Which of the following antacids is associated with diarrhea as a side effect?

Magnesium trisilicate Signup and view all the answers

What is the primary mechanism of action of colloidal bismuth?

It coats the ulcer crater, forming a protective barrier Signup and view all the answers

Which of the following proton pump inhibitors has a rapid onset of action?

Rabeprazole Signup and view all the answers

What is the mechanism of action of Pirenzepine?

Blockade of muscarinic receptors Signup and view all the answers

Which of the following drugs is used to prevent NSAID-induced mucosal injury?

Misoprostol Signup and view all the answers

What is the adverse effect of antacids?

Systemic alkalosis Signup and view all the answers

Which of the following proton pump inhibitors has a low affinity for the proton pump?

Pantoprazole Signup and view all the answers

What is the mechanism of action of proton pump inhibitors?

Formation of an enzyme-inhibitor complex Signup and view all the answers

Which of the following drugs is safe for use during pregnancy?

Antacids Signup and view all the answers

What is the effect of muscarinic antagonists on acid production?

Decrease in acid production Signup and view all the answers

Which of the following drugs can cause dry mouth and blurred vision?

Pirenzepine Signup and view all the answers

What is the mechanism of action of Amoxycillin in treating H. pylori infection?

Inhibiting cell wall synthesis Signup and view all the answers

What is the dose of Misoprostol used to prevent NSAID-induced mucosal injury?

200mg 14 times a day Signup and view all the answers

What is the component of quadruple therapy that inhibits bacterial protein synthesis?

Tetracycline Signup and view all the answers

What is the combination of antibiotics used in triple therapy for H. pylori infection?

Amoxycillin + Clarithromycin + Omeprazole/Lansoprazole Signup and view all the answers

What is the role of Omeprazole/Lansoprazole in triple therapy for H. pylori infection?

Reducing acid secretion in the stomach Signup and view all the answers

What is the benefit of using Bismuth subalycilate in quadruple therapy for H. pylori infection?

It has antibacterial properties and helps to create an environment conducive to the elimination of H. pylori Signup and view all the answers

What is the mechanism of action of Metronidazole in treating H. pylori infection?

Inhibiting bacterial DNA replication Signup and view all the answers

Study Notes

Ulcers

Ulcers are open sores or wounds on the skin or lining of the digestive tract, caused by loss of tissue due to various factors.

Types of Ulcers

Peptic ulcer: found in the stomach, duodenum (first part of the small intestine), or esophagus
Genital ulcer: found in the genital area
Esophageal ulcer: found in the esophagus
Pressure ulcer: found in individuals who are confined to bed

Factors Contributing to Ulcers

Imbalance of digestive fluids (HCl, pepsin)
Infection with Helicobacter pylori
Ingestion of NSAIDs (non-steroidal anti-inflammatory drugs)
Stress

Treatment of Ulcers

H2 receptor blockers (e.g. cimetidine, ranitidine)
Proton pump inhibitors (e.g. omeprazole, pantoprazole, lansoprazole)
Muscarinic antagonists (e.g. pirenzepine)
Antacids (e.g. sodium bicarbonate, magnesium hydroxide)
Prostaglandin analogues (e.g. misoprostol)

H2 Receptor Blockers

Mechanism of action: competitively block histamine receptors, reducing acid secretion
Adverse effects: headache, dry mouth, confusion, bradycardia, cardiac arrest

Proton Pump Inhibitors

Mechanism of action: inhibit the proton pump, reducing acid secretion
Adverse effects: nausea, diarrhea, headache, muscle pain, rashes

Muscarinic Antagonists

Mechanism of action: block muscarinic receptors, reducing acid secretion
Adverse effects: dry mouth, blurred vision, anticholinergic effects

Prostaglandin Analogues

Mechanism of action: increase production of mucus and bicarbonate, protecting the mucosa
Adverse effects: diarrhea, uterine bleeding, inflammatory bowel disease

Antacids

Mechanism of action: neutralize acid, inhibit pepsin
Adverse effects: systemic alkalosis, discomfort, bloating### Antacids
Sodium Bicarbonate has potent neutralizing capacity and is used to treat heartburn.
It can raise pH above 7, which may decrease the effect of certain medications.

Systemic vs Non-Systemic Antacids

Systemic antacids (e.g. Sodium Bicarbonate) can be absorbed into the bloodstream and may cause side effects.
Non-systemic antacids (e.g. Aluminum Hydroxide, Magnesium Hydroxide) are not absorbed and are less likely to cause side effects.

Magnesium-Based Antacids

Magnesium Hydroxide reacts with HCl to form MgO and water, which can cause constipation and osteomalacia.
Magnesium Trisilicate reacts with HCl to form MgCl and water, which can cause osmotic diarrhea.

Aluminium-Based Antacids

Aluminium Hydroxide can cause constipation, osteomalacia, and aluminum toxicity, which can lead to encephalopathy.

Miscellaneous Antacids

Simethicone reduces surface tension and prevents bubble formation, which can help prevent reflux.
Alginates form a layer of foam on top of gastric contents, reducing reflux.
Oxethazine is a surface anesthetic that can help reduce pain.

Sucralfate

Sucralfate polymerizes by cross-linking to form a sticky substance that adheres to ulcer craters, providing a physical barrier.
It can cause constipation and hypophosphatemia.

Colloidal Bismuth

Colloidal Bismuth coats the ulcer crater with a layer of mucus, providing a protective barrier.
It can cause the tongue, stools, and dentures to turn black.

Subcitrate (CBS)

Subcitrate is a mucous bicarbonate that can help protect the ulcer crater.
It can cause osteodystrophy and encephalopathy.

Antibiotics/Eradication of H.pylori

Triple therapy involves using 2 antibiotics and 1 acid-reducing agent to eradicate H.pylori.
The best triple therapy regimen is Omeprazole/Lansoprazole + Clarithromycin + Amoxycillin/Metronidazole.
Quadruple therapy involves using 4 medications to eradicate H.pylori.

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Description

Learn about the definition and characteristics of ulcers, including open sores on the skin and digestive tract lining.