Ulcer , peptic

Gelatin can be a source of essential amino acids when used as a diet supplement and therapeutic agent. As such, it has been widely used in muscular disorders, peptic ulcers, and infant feeding, and to spur nail growth. Gelatin is not a complete protein for mammalian nutrition, however, since it is lacking in the essential amino acid tryptophan [73-22-3] and is deficient in sulfur-containing amino acids. 

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. 

Bismuth subsahcylate [14882-18-9] Pepto-Bismol, is a basic salt of varying composition, corresponding approximately to i9-H0CgH4C02(Bi0). Like a number of other insoluble bismuth preparations, it is not currentiy approved in the United States for the treatment of peptic ulcer disease but is under active investigation for this purpose (180). It does appear to be effective for the rehef of mild diarrhea and for the prevention of travelers diarrhea (181). The ready availabiUty of this dmg, however, may lead to its ovemse and result in toxic effects caused by both the saUcylate and bismuth components. It has been suggested that bismuth subsahcylate is somewhat effective in the symptomatic treatment of isosporiasis, a disease caused by the intracellular parasite Isospora belli (182). 

Hydroxy-A, A -bis(hydroxymethyl)-A -methylmethanaminium salts and related types of compounds 19 for prevention and treatment of peptic ulcers and... 

A great many organic quaternary bases can inhibit the action of acetyl choline in organ systems activated by that neurotransmitter and thus possess anticholinergic-antispasmodic activity. One such agent is methantheline bromide (4), used in the treatment of peptic ulcer and as an antispasmodic agent in intestinal disorders. Its synthesis Involves Friedel-Crafts cyclization of o-... 

Very recently, a very bold chemical model for histamine H2-receptors has been proposed using [18]aneN6-3H+ 84), which can chemically recognize histamine, histamine H2-agonists, and histamine H2-antagonists such as cimetidine XII or ranitidine XIII that are currently in world-wide use for treatment of peptic ulcers 85). 

FIGURE 1.7 Key compounds synthesized to eliminate the efficacy (burgundy red) and enhance the affinity (green) of histamine for histamine H2 receptors to make cimetidine, one of the first histamine H2 antagonists of use in the treatment of peptic ulcers. Quotation from James Black [10]. 

Antacids are neutralizing agents. Examples are magnesium hydroxide, magnesium trisylicate and aluminium hydroxide. Prior to the introduction of histamine-H2 receptor antagonists and proton pump inhibitors, they were the standard drugs for the treatment of duodenal/ peptic ulcers. Today their clinical use is limited to the treatment of dyspepsia and the symptomatic relieve for patients with peptic ulcers. 

Chemical changes in the cellular environment include inactivation of cellular functions or the alteration of the chemical components of body fluid, such as a change in the pH. For example, antacids neutralize gastric acidity in patients with peptic ulcers. 

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. 

Before administering an NSAID, it is important for the nurse to determine if the patient has any history of allergy to aspirin or any otiier NSAID. The nurse determines if die patient has a history of gastrointestinal bleeding, hypertension, peptic ulceration, or impaired hepatic or renal function. If so, the nurse notifies the primary health care provider before administering an NSAID. 

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 drags are contraindicated in patients with an allergy to the (3 blockers, in patients with sinus bradycardia, second- or third-degree heart block, heart failure, and those with asthma, emphysema, or hypotension. The drug are used cautiously in patients with diabetes, thyrotoxicosis, and peptic ulcer. 

The peripherally acting antiadrenergic drugs are contraindicated in patients with a hypersensitivity to any of the drugs. Reserpine is contraindicated in patients who have an active peptic ulcer or ulcerative colitis and in... 

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. 

EDUCATING THE PATIENT WITH A PEPTIC ULCER The nurse gives the patient with a peptic ulcer a full explanation of Hie treatment regimen, which may include dru and a special diet. The patient is instructed to take the drug exactly as prescribed by file primary health care provider (eg, 30 minutes before meals or between meals) to obtain file desired results. The nurse discusses file importance of diet in file treatment of peptic ulcer and gives a full explanation of file special diet (when ordered). 

Mr. Anthony is prescribed a cholinergic blocking drug for the treatment of peptic ulcer. In planning patient teaching for Mr. A nthony before dismissal from the hospital, determine what information must be included to prevent complications of therapy. 

Develop a teaching plan for Ms. Likens, age 54 years, who will be taking glycopyrrolate (Robinul) for a peptic ulcer. Ms. Likens is alert, well oriented, and teaches school at a local high school. 

A patient taking clidinium for a peptic ulcer complains of dry mouth. The nurse should ... 

---