NAPLEX Peptic Ulcer Disease

What type of bacteria is H.pylori?

Gram Negative

What are 4 common causes of Peptic Ulcer Disease?

H.Pylori, NSAIDs, critical illness, mechanical ventilation

How long before testing for H.pylori should PPIs, bismuth, and antibiotics be discontinued?

PPIs: 2 weeks

Bismuth & antibiotics: 4 weeks

How long are all treatment regimens for H.pylori?

14 days

What is the preferred treatment for H.pylori?

Bismuth Quadruple Therapy which includes (Bismuth, Metronidazole, Tetracycline, and a PPI)

What are the two alternative therapies for h.pylori?

Rifabutin Triple Therapy (includes amoxicillin, rifabutin, and omeprazole)

PCAB Dual Therapy (includes amoxicillin and vonoprazan)

What is the MOA of metoclopramide?

Dopamine Agonist - enhances GI tract response to acetylcholine which is pro-kinetic

What is the Black Box Warning of metoclopramide?

Tardive Dyskinesia

What are the common warnings associated with metoclopramide?

Extra-pyramidal symptoms (EPS) and Parkinson-like symptoms

Fill in the Blank: COX-2 selective drug Celecoxib has a _____ GI risk but a _____ cardiovascular risk compared to other NSAIDs

Lower GI risk, but a higher cardiovascular risk

What are the two cytoprotective drugs that can be used in peptic ulcer disease?

Misoprostol and Sucralfate

What is the Black Box Warning associated with misoprostol?

Abortion

What is an important drug interaction to be aware of with Sucralfate?

Chelation - separate from other cations by 2-4 hours