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Peptic ulcer :volcano: (Signs and Sx (Burning pain (From navel up to…
Peptic ulcer :volcano:
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Pharmacological Approach
H2RA
cimetidine, ranitidine, nizatidine, famotidine
Reduce inflammation, healing rate within 6-8 weeks
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Dizziness, diarrhoea, thrombocytopenia, confusion
PPI
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Omeprazole, lansoprazole, pantoprazole
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Common side effect: abdominal pain, nausea
DDI
Omeprazole
Inhibits CYP2C19 - higher levels of warfarin (increased PT), phenytoin
Lansoprazole
Induces CYP1A, induces theophylline metabolism
Increases bioavailabiltiy of digoxin and nifedipine, decrease absorption of ketoconazole and itraconazole
Sucralfate
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Constipation, nausea, dry mouth
Bismuth salicylate
Increase PG production, gastroprotective effect, effective against H pylori
SE: Salicylism: headache, dizziness, abdominal pain; blackened stools
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Maintenance and Relapse
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Maintenance
When recurrence is likely, history of bleeding, NSAIDs continuous treatment
Low dose PPI, H2RA for DU
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