In peptic ulcer disease

The sales of antagonists of receptors, eg, diphenhydramine, terfenadine, and astemizole, used in the treatment of allergic diseases, represent 1% of the overall pharmaceutical market, ie, 1.7 biUion (U.S.). antagonists, eg, cimetidine and ranitidine, are effective in peptic ulcer disease and esophageal reflux. Sales represent 3.5% of the world market, ie, 6 biUion (U.S.). agonists or antagonists have not yet found a clear indication. 

Clissold, S. P., Campoli-Richaeds, D. M., Omeprazole. A preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in peptic ulcer disease and Zollinger-Ellison syndrome, Drugs 1986, 32, 15-47. 

Bismuth salts are thought to be effective in peptic ulcer disease because they have bactericidal properties against... 

The answer is d. (Hardman, pp 909-910.) It is now recognized that infection with fi pylon is a major etiologic factor in peptic ulcer disease. Bismuth salts are bactericidal for many organisms but especially for spirochetes. Colloidal bismuth salts such as bismuth subsalicylate also have a coating or cytoprotective action. Antimicrobials and GI antisecretory drugs are also used in combination with bismuth compounds. 

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