Gastrointestinal disease peptic ulcers

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

Active upper gastrointestinal disease (peptic ulcers, hiatal hernia, dyspepsia, esophagitis)... 

In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions... 

Gastrointestinal system (inflammatory bowel disease [ulcerative colitis, Crohn s disease], peptic ulcer, pancreatitis, cholecystitis, hepatitis, choledocholithiasis)... 

Important susceptibility factors include age, endogenous coagulation defects, thrombocytopenia, hypertension, cerebrovascular disease, thyroid disease, renal insufficiency, liver disease, tumors, cerebrovascular disease, alcoholism, a history of gastrointestinal bleeding (peptic ulcer disease alone without past bleeding is not associated with an increased risk of bleeding), and an inability to adhere to the regimen. 

Thompson. J. H. Gastrointestinal disorders—peptic ulcer disease, in Rubin. A. A. (ed.). Scorch for New Drugs. Medicinal ResearL ii Senes, vol. 6. New York. Marcel Dekker. 1972. p. M5. 

The salicylates are used cautiously in patients witii hepatic or renal disease, preexisting hypoprotiirombine-mia, or vitamin K deficiency and during lactation. The dragp are also used with caution in patients with gastrointestinal irritation such as peptic ulcers and in patients with mild diabetes or gout. 

The drugp used for gout are contraindicated in patients with known hypersensitivity. Probenecid is contraindicated in patients with blood dyscrasias or uric acid kidney stones and in children younger than 2 years. Sulfinpyrazone is contraindicated in patients with peptic ulcer disease and gastrointestinal inflammation. Colchicine is contraindicated in patients with serious gastrointestinal, renal, hepatic, or cardiac disorders and those with blood dyscrasias. 

These drugp are contraindicated in patients with known hypersensitivity to die drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism. Bethanecol is contraindicated in those with mechanical obstruction of die gastrointestinal or genitourinary tracts. Fhtients with secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye should not use die ophtiialmic cholinergic preparations. 

Previous peptic ulcer disease or upper gastrointestinal bleeding Cardiovascular disease and other comorbid conditions Multiple NSAID use (e.g., low-dose aspirin in conjunction with another NSAID)... 

Patients at increased risk of NSAID-induced gastrointestinal adverse effects (e.g., dyspepsia, peptic ulcer formation, and bleeding) include the elderly, those with peptic ulcer disease, coagulopathy, and patients receiving high doses of concurrent corticosteroids. Nephrotoxicity is more common in the elderly, patients with creatinine clearance values less than 50 mL/minute, and those with volume depletion or on diuretic therapy. NSAIDs should be used with caution in patients with reduced cardiac output due to sodium retention and in patients receiving antihypertensives, warfarin, and lithium. 

Finally be aware of the fact that diseases in the upper part of the gastrointestinal tract are common in the elderly and can cause severe complications and even be fatal. Drugs that are often used in the elderly due to chronic diseases with inflammation and pain are often the cause of gastritis, peptic ulcers and hiatus hernia. The risks of medication side effects as a reason for the problem must be taken into account when treating elderly for peptic ulcers and stomach pain. 

H2 antagonists are clinically used in the treatment of acid-related gastrointestinal conditions. Specifically, these indications may include peptic ulcer disease, gastroesophageal reflux disease, and dyspepsia. 

Bethanechol should not be used in patients with possible mechanical obstruction of the bladder or gastrointestinal tract or when contraction of smooth muscles in these tissues may be harmful (e.g., recent intestinal resection). It is also contraindicated in patients with bronchial asthma, peptic ulcer disease, coronary artery disease, gastrointestinal hypermotility or inflammatory disease, hypotension or marked bradycardia, hyperthyroidism, parkinsonism, or epilepsy. Care should be exercised in administering pilocarpine to elderly patients because it can enter the CNS and affect memory and cognition, even when applied topically to the eye. 

COX-2 specific inhibition good choice for patients with inflammatory conditions who are at high risk of gastrointestinal adverse effects (e.g., older than 60 years history of peptic ulcer disease prolonged, high-dose NSAID therapy concurrent use of corticosteroids or anticoagulants)... 

Peptic ulcer disease NSAIDs, anticoagulants Gastrointestinal hemorrhage... 

Cat s claw has long been used in South America as an anti-inflammatory, antirheumatic, and contraceptive agent. It is also traditionally used to treat gastrointestinal ulcers, tumors, gonorrhea, dysentery, various skin problems, cancers of the female genitourinary tract, and intestinal disorders. Native South Americans use cat s claw to cleanse the kidneys and treat bone pain. Some Europeans report that it is useful in the treatment of AIDS when used in combination with zidovudine (AZT). The purported usefulness of cat s claw tea in the treatment of diverticulitis, hemorrhoids, peptic ulcer disease, colitis, parasites, and leaky bowel syndrome have fueled demand for the bark in the U.S. 

Because the antimuscarinic drugs slow gastric emptying, they may increase symptoms in patients with gastric ulcer. Nonselective antimuscarinic agents should never be used to treat acid-peptic disease (see Chapter 63 Drugs Used in the Treatment of Gastrointestinal Diseases). 

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