Duodenal ulcers, treatment

DUODENAL ULCERS Treatment of Histamine2 (Hj) Receptor Antagonists... 

Tripotassium dicitratobismuthate [57644-54-9] (bismuth subcitrate), De-Nol is a buffered aqueous suspension of a poorly defined, water-insoluble bismuth compound. It is said to very effective for the treatment of gastric and duodenal ulcers (180,184). There have not yet been any reports of bismuth encephalopathy following the use of this dmg. 

These drug are used for the medical treatment of agastric or duodenal ulcer, gastric hypersecretory (excessive gastric secretion of hydrochloric acid) conditions, and GERD. These drug may also be used as prophylaxis of stress-related ulcers and acute upper GI bleeding in critically ill patients. 

The proton pump inhibitors are particularly important in the treatment of Helicobacter pylori in patients with active duodenal ulcers. Helicobacter pylori (H. pylori) has been implicated as a causative organism in a type of chronic gastritis and in a large number of cases of peptic and duodenal ulcers. 

The proton pump inhibitors are used for treatment or symptomatic relief of various gastric disorders, including gastric and duodenal ulcers, GERD, or pathological hypersecretory conditions. Painful, persistent heartburn 2 or more days a week may indicate acid reflux disease which can erode the delicate lining of the esophagus,... 

Bismudi subsalicylate is used in combination witii otiier dru > to treat gastric and duodenal ulcers caused by H. pylori bacteria Mesalamine is used in the treatment of chronic inflammatoiy bowel disease Misoprostol is used to prevent gastric ulcers in those taking aspirin or nonsteroidal anti-inflammatory dragp in high doses for a prolonged time Olsalazine is used in the treatment of ulcerative colitis in those allergic to sulfasalazine. Sulfasalazine is used in the treatment of Crohn s disease and ulcerative colitis. Sucralfate is used in the treatment of duodenal ulcer. 

The primary health care provider has prescribed cime-tidine for the treatment of a duodenal ulcer in Mr. Talley, who is 68 years old. A drug history by the nurse reveals that Mr. Talley is also taking the following drugs Lanoxin 0.5 mg orally each day and a daily aspirin tablet. Analyze this situation. Discuss what you would tell Mr. Talley. 

DeAngelis, Catherine D. and Phil B. Fontanarosa, Conflicts over Conflicts of Interest , Journal of the American Medical Association (2009) http / /jama, ama-assn.org/misc/jed900i2pap Ei E3.pdf de Craen, Anton J. M., D. E. Moerman, S. H. Heisterkamp, G. N. J. Tytgat, J. G. Tijssen andj. Kleijnen, Placebo Effect in the Treatment of Duodenal Ulcer , British Journal of Clinical Pharmacology 48 (1999) 853-60... 

Helicobacter pylori to human gastric epithelium.26 Clinical studies have identified H. pylori as a causative agent in gastric and duodenal ulcers.27 Considerable evidence exists to suggest that carbohydrate-based treatments could be an effective means to combat infection.28 Since bacterial attachment is a prerequisite to infection,29 soluble Leb oligosaccharides may serve as therapeutic alternatives to broad-spectrum antibiotics. 

Gastric secretion. Stimulation of gastric acid production by vagal impulses involves an M-cholinoceptor subtype (M -receptor), probably associated with enterochromaffin cells. Pirenzepine (p. 106) displays a preferential affinity for this receptor subtype. Remarkably, the HCl-secreting parietal cells possess only Ma-receptors. Mi-receptors have also been demonstrated in the brain however, these cannot be reached by pirenzepine because its lipophilicity is too low to permit penetration of the blood-brain barrier. Pirenzepine was formerly used in the treatment of gastric and duodenal ulcers (p. 166). 

Arthritis patients at high risk of w/cers Treatment of the signs and symptoms of osteoarthritis or rheumatoid arthritis in patients at high risk of developing NSAID-induced gastric and duodenal ulcers and their complications. 

Duodenai nicer Short-term treatment (up to 8 weeks) of active duodenal ulcer. Maintenance therapy (tabiets oniy) Duodenal ulcer patients at reduced dosage after healing of acute ulcers. 

Ulcer recurrence Duodenal ulcer is a chronic recurrent disease. While short-term treatment can completely heal the ulcer, do not expect a successful course to alter posthealing frequency or severity of duodenal ulceration. 

Short-term treatment of active duodenal ulcer 800 mg at bedtime. Alternate regimens are 300 mg 4 times/day with meals and at bedtime, or 400 mg twice/day. 

Short-term treatment of active duodenal ulcer 150 mg orally twice daily. An alternate dosage of 300 mg once daily at bedtime can be used for patients in whom dosing convenience is important. 

Duodenal ulcer associated with H. pylori infection For treatment of patients with H. pylori infection and duodenal ulcer to eradicate H. pylori. 

Helicobacter pylori H. pylori is found in approximately 100% of chronic active antral gastritis cases, 90% to 95% of duodenal ulcer patients, and 50% to 80% of gastric ulcer patients. The treatment of documented H. pylori infection in patients with confirmed peptic ulcer on first presentation or recurrence has been recommended by the National Institutes for Health in a 1994 Consensus Conference. Once H. py/on eradication has been achieved, reinfection rates are less than 0.5% per year, and ulcer recurrence rates are dramatically reduced. 

Vondracek TG. Ranitidine bismuth citrate in the treatment of Helicobacter pylori infection and duodenal ulcer. Ann Pharmacother 1998 32(6) 672-9. 

Sucrose octasulfate (23, Structures 6) bound to FGF and was able to induce, like heparin, a conformational change in the peptide, but showed very low mitogenic activity for an F32 cell line. The basic aluminium salt of sucrose octasulfate, which is used as a drug (Sucralfate, Carafate) for the treatment of duodenal ulcers was claimed to exert part of its activity through the stabilization of FGF... 

Acute treatment of duodenal and gastric ulcers PO 40 mg/day at bedtime Duodenal ulcer maintenance PO 20 mg/day at bedtime Gastroesophageal reflux disease PO 20 mg twice a day Esophagitis PO 2-40 mg twice a day. 

Unlabeled Uses Treatment of bacterial vaginosis, grade 111-lV decubitus ulcers with anaerobic infection, Flelicobacler pytori-associated gastritis and duodenal ulcer, inflammatory bowel disease topical treatment of acne rosacea... 

Prevention of NSMD-induced gastric ulcer PO 100-200 meg 4 times/day with food. Unlabeled Uses Treatment of duodenal ulcer... 

Erosive esophagitis, poorly responsive gastroesophageal reflux disease, active duodenal ulcer, prevention and treatment of NSMD-induced ulcers PO 20 mg/day To maintain healing of erosive esophagitis PO 20 mg/day. 

Unlabeled Uses H. pytori-associated duodenal ulcer (wifh amoxicillin and clarilhro-mycin), prevenfion and treatment of NSAID-induced ulcers, frealmenf of acfive benign gastric ulcers... 

H2 Antagonists and the Treatment of Peptic Ulcers. Treatment of peptic ulcers is a complicated and multilevel therapy in which Hj antagonists are very successful and widely used (and abused). Peptic ulcers may affect either the stomach (gastric ulcers, less common overall but more common in people with iatrogenic [i.e., physician-induced] ulcers from the use of nonsteroidal anti-inflammatory drugs [NSAIDs]) or the duodenum (duodenal ulcers). The lining of the stomach or duodenum is attacked by the digestive juices to such an extent that the protective mucous layer on the surface has... 

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