In order to eradicate H. pylori what drug combination must be achieved? - ANS-2 antibiotics
combined with either an H2 Receptor Blocker OR a Proton Pump Inhibitor.
However, we should know:
amoxicillan (Amoxil) +metronidazole (Flagyl) +bismuth (Pepto)
Drugs that fit into the pharmacological class H2 Receptor Blockers that inhibit gastric acid
secretions. - ANS-"dine"
1. cimetidine (Tagamet)*
2. ranitidine (Zantac)*
3. nizatidine (Axid)
4. famotidine (Pepsid)
CAUTION:
Avoid antacids 1 hr before meds
bleeding abnormalities
some risk of pneumonia with decreased gastric acid in the GI causing bacterial colonization in
stomach and respiratory tract
DO:
increase head of bed (HOB)
inform of bleeding abnormalities
, In addition to the H2 Receptor Blocker CAUTIONS what should we be know about cimetedine
(Tagamet) in particular? - ANS-It causes confusion in the elderly
It inhibits cytP450 enzymes
What are H2 Receptory blockers used for with regard to antiulcer capacity? - ANS-Part of a
multi drug therapy to eradicate H. pylori
decrease symptoms and prevent complications of PUD
prevent NSAID induced ulcers
decrease heartburn
GERD
Zollinger-Ellison syndrome (hypersecretory)
Drugs that fit into the pharmacological class Proton Pump Inhibitors (PPI) and are used to
suppress gastric acid secretion by blocking the enzyme needed for acid formation. -
ANS-"prazole"
RISKS:
fractures, pneumonia, acid rebound, intestinal infection
C. diff leads to diarrhea
long term cancer risk
What are PPI's used for with regard to antiulcer capacity? - ANS-Preferred prophylactic to treat
PUD. In the event these cannot be used then use H2 Receptor Blockers.
GERD
prevent NSAID induced ulcers
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