Pathophysiology & Drug Therapy for Peptic Ulcer Disease and Hyperacidity

GERD

Stomach acid or bile backs up into esophagus, irritating the lining. Usually as a result of an incompetent lower esophageal sphincter.

What bacteria is a common cause for ulcers?

H. Pylori

Anatacids (Mylanata)

Alkaline that neutralizes stomach acids by raising pH, prevents conversion of pepsinogen to pepsin

What are the contraindications for Mylanta?

Renal failure or a creatinine clearance lower than 30, appendicitis, or inflamed bowel.

What are the adverse effects for aluminum based antacids?

Constipation, hypophosphatemia osteomalacia

What are the adverse effects of magnesium based antacids?

Hypermagnesemia and diarrhea

What is the prototype for Histamine 2 Receptor Antagonists

Cimetidine (Tagamet)

Histamine 2 Receptor Antagonists (Cimetidine/Tagamet)

Inhibits action of histamine at H2 receptors of stomach

What is the prototype for Proton Pump Inhibitors (PPIs)?

Omeprazole (Prilosec)

PPIs (Omeprazole/Prilosec)

Stronger, faster, and longer relief than H2RAs. Most potent inhibitors of gastric acid secretion. Prevents the H+K+ATPase enzyme from pumping or release of gastric acid from parietal cells into stomach.

What is a long term adverse effect of PPIs?

Bone fractures

Bismuth Subaslisylate

Pepto Bismol. May cause dark stool and ringing in ears