Ulcer oesophageal

Negative endoscopy Duodenal ulcer Oesophagitis Gastric ulcer... 

Losec (omeprazole) Duodenal ulcer Gastro-oesophageal reflux Helicobacter infections 5.7 1.9 1989 - UK and US Once daily, except when used as part of combination therapy... 

Ranitidine is a histamine receptor antagonist. It acts essentially on the H2 receptor and blocks acid production. Ranitidine is used in the treatment and prevention of ulcers, NSAID-induced ulcers, Zollinger-Ellison syndrome and gastro-oesophageal reflux disease. 

C. Visible oesophageal inflammation, ulcer or stricture Proton pump inhibitors e.g., omeprazole 20-40 mg daily, lansoprazole 30 mg daily, pantoprazole 40 mg daily, rabeprazole 20 mg daily... 

It is a sclerosing agent for bleeding oesophageal varices, varicose veins, bleeding gastroduodenal ulcers etc. 

It causes antiemetic action by blocking dopamine (D receptors and it also increases gastric motility. It is absorbed orally but bioavailability is 15% due to first pass metabolism. It is completely biotransformed and metabolites are excreted in urine. It is used in nausea and vomiting in postoperative period, drug induced, radiation, uraemia, hepatitis, peptic ulcer. It is also useful in reflex oesophagitis. 

Omeprazole is more effective than H2 blockers in producing achlorhydria when repeated doses are used in treating peptic ulceration or reflux oesophagitis. However, it is less effective than these in reducing volume and acidity of stomach contents when given as a single preoperative dose, and has no advantage over H2 blockade in this situation. 

Sucralfate is used in the management of peptic ulceration and of reflux oesophagitis, and its cytoprotective effects may be of benefit in radiation-induced mucosal damage elsewhere in the GI tract. 

Use H7K+-ATPase-inhibitory ulcer therapeutic (Zollinger-Ellison Syndrom, reflux oesophagitis)... 

Q8 Examples include famotidine, ranitidine, nizatidine and cimetidine. They prevent food, histamine and acetylcholine-induced gastric-acid secretion. They are used to heal gastric and duodenal ulcers and in gastro-oesophageal reflux disease. 

ALENDRONATE ANALGESICS-NSAIDs Risk of oesophagitis/peptic ulceration Additive effect Avoid co-administration... 

Alimentary active peptic ulcer, active inflammatory bowel disease, oesophageal varices, imcompensated hepatic cirrhosis... 

Direct pressure on varices can be applied by inserting an inflatable triple-lumen (Sengstaken) tube which abuts the gastro-oesophageal junction, and controls bleeding in 90% rebleeding is common when the tube is withdrawn and its use may be accompanied by aspiration, oesophageal ulceration or perforation. 

Baeriswyl G, Bengoa J, de Peyer R, Loizeau E. Importance des ulcerations medicamenteuses dans les lesions endosco-piques de I oesophage. [Importance of drug-induced ulceration in endoscopic lesions of the esophagus.] Schweiz Med Wochenschr Suppl 1985 19 6-9. 

Katsinelos P, Dimiropoulos S, Vasihadis T, Fotiadis G, Xiarchos P, Eugenidis N. Oesophageal ulceration associated with ingestion of mefenamic acid capsules. Eur J Gastroenterol Hepatol 1999 ll(12) 1431-2. 

Ramboer C, Verhamme M. D-penicillamine-induced oesophageal ulcers. Acta Clin Belg 1989 44(3) 189-91. 

Dekkers CP, Beker JA, Thjodleifsson B, Gabryelewicz A, Bell NE, Humphries TJ. Double-blind comparison [correction of double-blind, placebo-controlled comparison] of rabeprazole 20 mg vs. omeprazole 20 mg in the treatment of erosive or ulcerative gastro-oesophageal reflux disease. The European Rabeprazole Study Group. Aliment Pharmacol Ther 1999 13(l) 49-57. 

---