Ulcer Prophylaxis and Treatment

Magnesium/Aluminum Hydroxide Suspension, Aluminum Hydroxide Suspension, 

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Meadowsweet is reputed to have stomachic, mild urinary antiseptic, antirheumatic, astringent, and antacid properties. Traditionally, it has been used for atonic dyspepsia with heartburn and hyperacidity, acute catarrhal cystitis, rheumatic muscle and joint pains, diarrhea in children, and specifically for the prophylaxis and treatment of peptic ulcers. 

Bacitracin is indicated in prophylaxis and treatment of local infections, treatment of secondary pyodermas, as an adjunct in burn treatment, and as prophylaxis in operative wounds. However, it is not indicated in the treatment of chronic ulcers because of the increased risk of allergic reactions. There are several reports of delayed hypersensitivity, acute IgE-mediated allergic reactions, and anaphylactic reactions to bacitracin.51-53... 

Silver sulfadiazine is used for prophylaxis and treatment of infected bums, leg ulcers and pressure sores because of its wide antibacterial spectrum (which includes pseudomonads). 

Clinical uses and toxicity The drug is used for prophylaxis and treatment of cytomegalovirus (CMV) infections (including CMV retinitis) and has activity against ganciclovir-resistant strains of this virus (Table 49-1). Foscarnet inhibits herpes DNA polymerase in acyclovir-resistant strains that are thymidine kinase-deficient and may suppress such resistant herpetic infections in patients with AIDS. Adverse effects include nephrotoxicity (30% incidence) with disturbances in electrolyte balance (especially hypocalcemia), genitourinary ulceration, and CNS effects (headache, hallucinations, seizures). 

Sucralfate (Carafate) Sucrose and polyaluminum hydroxide polymerize at low pH to form protective coating. Prophylaxis and treatment of duodenal ulcers. Constipation. 

The pharmacokinetios of interferon is not well understood. Maximum levels in blood after intramuscular injection was obtained in 5 to 8 hours. Interferon does not penetrate well into cerebrospinal fluid (CSF). Oral administration of interferon does not indicate a detectable serum level, and as such, oral administration is olinioally ineffective. After intramuscular or suboutaneous injection, drug concentration in plasma is dose related. Clinioal use of interferon is limited to topioal administration (nasal sprays) for prophylaxis and treatment of rhinovirus infections. Adverse reaotions and toxioity include influenza-like syndrome of fever, ohills, headaohe, myalgias, nausea, vomiting, diarrhea, bone marrow suppression, mental confusion, and behavioral changes. Intranasal administration produoes mucosal friability, ulceration, and dryness. 

GI Age > 65 Previous ulcer Steroid treatment Treatment with more than one NSAID Scrutinize the indication, inform about the risks and choose another analgesic. Consider ulcer prophylaxis with proton pump inhihitors or misoprostol, or alternatively choose a COX-2 inhihitor... 

Clarithromycin is approved for prophylaxis against and treatment of M avium complex and as a component of drug regimens for ulcers due to Helicobacter pylori. 

These drug are used for the medical treatment of agastric or duodenal ulcer, gastric hypersecretory (excessive gastric secretion of hydrochloric acid) conditions, and GERD. These drug may also be used as prophylaxis of stress-related ulcers and acute upper GI bleeding in critically ill patients. 

It is indicated in giardiasis, amoebic liver abscess, intestinal amoebiasis, trichomoniasis, ulcerative gingivitis, treatment and prophylaxis of anaerobic infections. 

Sulfacetamide is the IV-acetyl derivative of sulfanilamide. The sodium salt of sulfacetamide, because of its effectiveness and low toxicity, continues to be the most widely prescribed sulfonamide in the form of eye-drops and ointment for ophthalmic infections. It was introduced in Europe as "Albucid" in 1938 for various eye and other topical infections. Since its use in the treatment of corneal ulcers (1), sulfacetamide is still popular in ophthalmology. The sodium salt is highly soluble at the physiologic pH of 7.4, and is especially suited, as a 10-30% solution, for repeated topical application in the local management of ophthalmic infections (2-4). It is used mainly in the treatment of acute conjunctivitis and in the prophylaxis of ocular infections after injuries or burns (5). Several reviews on various aspects of sulfacetamide have been published (6-10). 

Viral infections that occur after transplantation are not limited to the lung. Herpes simplex infections are frequent early after the procedure, manifesting as oral vesicles or ulcerations. Less frequent is genital involvement by herpes simple virus, hepatitis or encephalitis. Herpes zoster and varicella reactivate in most patients, particularly if aciclovir prophylaxis is discontinued. Occasionally, severe cerebral arteritis or pneumonia caused by this virus may occur. CMV infection is frequent after transplantation and has to be regularly monitored by antigenemia and/or PCR for early treatment avoiding CMV disease. Epstein Barr virus (EBV) infection and EBV-associated lymphoproliferative disorders have also to be tested on a regular basis, especially in transplants with in... 

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