Peptic ulcer disease treatment

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). 

Salim, A.S. (1992f). Alopurinol and dimethyl sulphoxide improve treatment outcomes in smokers with peptic ulcer disease. J. Lab. Clin. Med. 119, 702-709. 

There are certain histologic subtypes of diffuse, aggressive NHL that respond less well to treatment with conventional regimens such as CHOP. Burkitt s lymphoma, lymphoblastic lymphoma, mantel cell lymphoma, and primary CNS lymphoma are examples of disease that benefit from more intensive therapy. Regimens such as hyper-CVAD, which alternate cycles of hyperfractionated cyclophosphamide, doxorubicin, vincristine, and dexamethasone with high-dose cytarabine and methotrexate, often are substituted for CHOP. Intrathecal therapy with methotrexate is indicated with documented CNS infiltration of tumor or involvement of the sinuses. The recent appreciation of the etiology of Helicobacter pylori in the etiology of peptic ulcer disease and the association between colonization and mucosal-associated lymphoma (MALT) has spurred... 

Faine F, Fendrick AM. (1998) Helicobacter pylori peptic ulcer disease Bridging the gap between knowledge and treatment. Postgrad Med 103 231-238. 

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. 

The goals of medical treatment of peptic ulcer disease are to relieve symptoms, heal the ulcer and to prevent recurrence. For the first two the therapeutic tactics are aimed at reducing aggressive factors, in the first place gastric acid, and to promote or introduce defensive or cytoprotective factors. For... 

For prevention of peptic ulcer disease avoiding ulcerogenic medication such as NSAIDs, including aspirin, is probably the most important strategy. Reducing gastric acidity is also the main approach for the treatment of reflux esophagitis. 

Le. Other Drugs for Treatment of Peptic Ulcer Disease... 

SoU AH. Consensus conference. Medical treatment of peptic ulcer disease. Practice guidehnes. Practice Parameters Committee of the American College of Gastroenterology. JAMA 1996 275(8) 622-9. 

A 55-year-old man who works in the furnace room at a steel foundry has developed chronic peptic ulcer disease that has not responded to treatment with antibiotics and H2 receptor blockers. You are considering giving him an antimuscarinic drug to block gastric acid secretion as adjunctive therapy. What are your concerns regarding the suitability of this treatment for this worker ... 

Misoprostol (Cytotec) is a prostaglandin Ej analogue that is being evaluated as a cervical ripening agent. It also is used in the treatment and prevention of peptic ulcer disease (see Chapter 40). Clinical trials show that misoprostol is an effective agent for both cervical ripening and labor induction. It appears to be as effective as dinoprostone and is much less expensive. 

Unlabeled Uses Peptic ulcer disease, active ulcer bleeding (injection), adjunct in treatment of Helicobacter pylori infecfion. 

G. L. Garay, J. M. Muchowski (1985). Agents for the treatment of peptic ulcer disease. Annu. 

Bismuth compounds have been used in the treatment of peptic ulcer disease. They function by selective binding to the ulcer, coating it and shielding it from the effects of gastric acid. Bismuth may also have activity against bacteria such as Helicobacter pylori, shown to be a causative factor in peptic ulcer disease of the stomach. Bismuth has been administered as bismuth subsalicylate (8.95) or tripotassium dicitrato bismuthate. 

Finally, it is universally accepted at present that Helicobacter pylori infection has a definitive ethiological role in peptic ulcer disease, and that erradication therapy is warranted in these clinical scenarios. The majority of therapeutic trials have included the application of triple therapy with proton pump inhibitors or ranitidine bismuth citrate, clarithromycin and either amoxycillin or metronidazol and is to date the treatment of choice. However, recent studies have reported antibiotic resistance which can be one reason for failure of treatment of Helicobacter pylori infection [101-103], and new treatment strategies are therefore Wellcome. Flavonoids, in addition to their gastroprotective activity previously commented, have been also shown to inhibit Helicobacter pylori growth in vitro. In this way, Beil et al. [50]... 

Lehmann F, Hildebrand P, Beghnger C. New molecular targets for treatment of peptic ulcer disease. Drugs. 2003 63 1785-1797. 

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. 

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