Antisecretory medication

The prevalence of hypo- and achlorhydria is high in the elderly population (Bo-Linn et ah, 1984). Furthermore, sufficient food consumption in the elderly is not always possible and in some situations potent gastric antisecretory medications may be prescribed for long-term use in older people (Bo-Lirm et ah, 1984 Evenepoel, 2001). A source of Ca that is more... 

Amyotrophic lateral sclerosis Riluzole, antisecretory medication, supportive care Weakness, drooling... 

H. pylori is a bacterial infection that is treated with a eombination of medications. At least two antibiotics and an antisecretory medication will be ordered. As with all antibiotic prescriptions, the cKent should be taught to take all the medieations as ordered. Resistant strains of H. pylori are being documented in ehents who have not been compKant with the treatment program. 

The purpose of surgical and medical therapy is to lower the rate of acid secretion. Vagotomy is incomplete in 10% of cases, and the effects of antisecretory medication are dose-dependent. 

Another observation of relevance is that lower doses of antisecretory medications appear effective in the management of GERD when H. pylori is... 

Figure 3. Effects of intravenous cimetidine (a), intravenous ranitidine (b) or omeprazole (c) on gastric acid secretion in patients with ZES. a) and b) panels Effect of continuous infusion of either intravenous cimetidine (25 patients) or ranitidine (30 patients) on gastric acid secretion. BAO was determined in all patients at a time when they were not taking any antisecretory medications. The minimum infusion dose to reduce acid output below 10 mEq/h, the accepted level of control, in each patients is shown in parentheses in milligrams/kg/hour. c) Effect of an intravenous bolus dose of omeprazole on gastric acid secretion during the last hour before the next dose of drug in 20 patients with ZES is shown. BAO was determined on a previous occasion in all patients at a time when they were taking no antisecretory medications. The dotted line represents an acid output of 10 mEq/h, the accepted level of control. Figure was drawn from data in studies by Saeed et al. [69] (cimetidine) Vinayek et al. [68] (ranitidine) and Vinayek et al. [67] (omeprazole).

Quadruple therapy regimens (2 antibiotics, bismuth, antisecretory agent) Like triple therapy regimens, these have proven to be effective in H. pylori eradication. The primary disadvantage of these regimens is compliance. In addition, because of the variety and number of medications used, adverse effects are more common in... 

Ericsson C D, Feldman S, Pickering L K et al 1982 Influence of subsalicylate bismuth on absorption of doxycycline. Journal of the American Medical Association 247 2266-2267 Ericsson C D, Tannenbaum C, Charles T T 1990 Antisecretory and antiinflammatory properties of bismuth subsalicylate. Reviews of Infectious Diseases 12 (suppi 1) S16-S20... 

When possible, discontinue medications listed in Table 39-2. Antisecretory drugs may be used to prevent stress-related mucosal bleeding. Octreotide may be tried in severe AP, but its efficacy remains uncertain (see Pig. 39-3). Antibiotics should not be used in the absence of signs of infection except in patients with biliary tract gallstones, or in severe AP when pancreatic necrosis or abscess is... 

In patients with peptic ulcer disease (duodenal ulcers) on medical treatment whose ulcer fails to heal after 12 weeks of treatment. The tests may establish the reason for the failure, e.g. a missed gastrinoma, reveal the need for a higher therapeutic drug dosage, or even establish the need for a switch to a more potent antisecretory drug. 

The second class of agents comprises the reversible K-site antagonists of H, K -ATPase. These compounds have not reached regulatory approval and medical use. They differ from the covalent inhibitors in that they interact reversibly with H, K -ATPase. Therefore, the duration of their antisecretory effect is proportional to their elimination from plasma (Fig. 2). 

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