Tell your doctor if the medicines make you feel sick or dizzy or cause diarrhea or headaches. Epidemiology etiopathophysiology history of drug development pharmacological agents used in treatment moa, pharmacokinetics, clinical uses, adverse drug reactions eradication of. It is important to confirm that an ulcer is present, by either endoscopy or an upper gi radiographic series, before treatment is initiated. Eradication is recommended for all helicobacter pyloripositive patients, especially those patients with an active ulcer, a documented history of a prior ulcer, or a history of ulcer. New york chicago san francisco lisbon london madrid mexico city milan new delhi san juan seoul singapore sydney toronto pharmacotherapy casebook a patientfocused. Pharmacotherapy gi disorders free download as powerpoint presentation. Peptic ulcer disease pud refers to a defect in the gastric or duodenal mucosal wall that extends through the muscularis mucosa into the deeper layers of the submucosa. Bushra hasan khan junior resident1, department of pharmacology, jnmc,amu,aligarh. Weigh risks and benefits of nrt in patients with active ulcer. Pdf pharmacotherapy of peptic ulcer disease researchgate. Doctors only prescribe one protectantsucralfate carafatefor peptic ulcer disease.
Pharmacotherapy gi disorders indigestion peptic ulcer. Lack of response to conventional treatment for peptic ulcer disease should suggest conditions other than benign peptic ulcers, and should warrant endoscopy or. A variety of options are available for the medical treatment of peptic ulcer disease, including antacids, histamine2 receptor antagonists, omeprazole, prostaglandin analogues, and sucralfate and bismuth formulations. The studies of prescribing patterns of gastric acid suppressant treatment in peptic ulcer disease suggest a more frequent use of histamine h2. The discovery of helicobacter pylori as a cause of peptic ulcer has changed our approach greatly towards this disease. Epidemiological data for this disease and its complications have. The incidence of outpatient and inpatient care visits for peptic ulcer disease has steadily declined in the united states since the 1970s. A peptic ulcer disease or pud is an ulcer defined as mucosal erosions equal to or greater than 0. Peptic ulcer disease pharmacological treatment pharmaceutical. Peptic ulcers have unquestionably been a disease of the twentieth century. Pdf on aug 19, 2019, balaji ommurugan and others published pharmacotherapy of peptic ulcer disease and latest research find, read and cite all the research you need on researchgate. Constipation, diarrhea, and irritable bowel syndrome 22. The mortality from peptic ulcer disease has similarly decreased over the same interval, which has been attributed to increased helicobacter pylori eradication rates and the widespread adoption of acidsuppression medications. Peptic ulcer bleeding is a common and potentially fatal condition.
These typically include proton pump inhibitors like. The recommended treatment for severe peptic ulcer bleeding after appropriate endoscopic treatment is the iv administration of a ppi loading dose followed by a. Pdf pharmacotherapy of peptic ulcer disease and latest research. Peptic ulcer disease peptic ulcer is defined as disruption of the mucosal integrity of the stomach andor duodenum leading to a local defect or excavation due to active inflammation. The most common remedy is a combination of antibiotic drugs to kill the h. Pharmacology chapter 62 pharmacotherapy of peptic ulcer. In the seventh edition, information on the management of pharmacotherapy in the elderly has been added as an appendix. Seventy percent to 90% of peptic duodenal and gastric ulcers will heal after 4 to 8 weeks of therapy. Pharmacotherapy clinical approaches peptic ulcer disease pud tom hsiung, b. South texas veterans health care system, san antonio, tx. A cost analysis of alternative treatments for duodenal ulcer.
Division of pharmacotherapy, the university of texas at austin college of pharmacy. Patients with peptic ulcer disease pud should reduce psychological stress, cigarette smoking, and nonsteroidal antiinflammatory drug nsaid use and avoid foods and beverages that exacerbate ulcer symptoms. Descriptive epidemiology, risk factors, management and prevention. Peptic ulcer disease is common condition throughout the world. Ulcers affect 1114% of men and 811% of women at some time in their lives.
The third module covers gastroesophageal reflux disease and peptic ulcer disease. Gastric ulcers, in the stomach, and duodenal ulcers, in the upper portion of the small intestine, occur most often. Evidencebased clinical practice guidelines for peptic. The final module includes three new interactive features.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Content outline for the pharmacotherapy certification examination the following domains, tasks and knowledge statements were delineated by the bps specialty council on pharmacotherapy and validated through a role delineation study. Nih consensus development panel on helicobacter pylori in peptic ulcer disease. Dipiro jt, talbert rl, yee gc, matzke gr, wells bg, posey ml, eds. The healing rare increases with time for active medication and placebo, and is lower among smokers than nonsmokers for all drugs but misoprostol.
The predominant causes in the united states are infection with helicobacter pylori and use of nonsteroidal anti. Based on the high incidence and the enormous amount of money that is spent on peptic ulcer disease, it is very important for pharmacists and pharmacy students to be educated about this disease and the medication regimens. Peptic ulcer is a break in the gastric or duodenal mucosa, extending through the muscularis mucosa, and usually 5 mm in diameter. Pharmacotherapy of duodenal and gastric ulcerations. Current trends in the pharmacotherapy for peptic ulcer disease.
Adjuvant pharmacotherapy for peptic ulcer bleeding. Peptic ulcer disease pharmacotherapy linkedin slideshare. In the antrum 60% at the junction of the antrum and body on the lesser curvature 25% major causes of peptic ulcer disease. Pharmacotherapy education and research center, university of texas health science center at san antonio. The goals of pharmacotherapy are to eradicate h pylori infection, to reduce morbidity, and to prevent complications in patients with peptic ulcers. Basic concepts of pharmacotherapy principles and practices. Jsge revised the evidencebased clinical practice guidelines for peptic ulcer disease in 2014 and has created an english version. The role of helicobacter pylori in peptic ulcer disease. Scribd is the worlds largest social reading and publishing site.
Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone. Peptic ulcer can occur at any age, although they are rare in children. Drug treatment of peptic ulcer disease open access ebooks. Pdf the etiology of peptic ulcer is multifactorial. The authors of this study used the ambiguous term concomitant disease that made inclusion inappropriate as a criterion for exclusion. Start studying pharmacology chapter 62 pharmacotherapy of peptic ulcer disease. It is best managed using a multidisciplinary approach by a team with medical. Drinking alcohol and smoking slow the healing of a peptic ulcer and can. Pdf pharmacotherapy of peptic ulcer disease and latest.
Pharm, class of 2018 sop, china pharmaceutical university nanjing, jiangsu, chn 211198. What are the goals of pharmacotherapy for peptic ulcer. Pharmacotherapy of peptic ulcer disease and gastroesophageal reflux disease gerd peptic ulcer disease and gerd are best treated with a combination of pharmacotherapy and lifestyle changes to relieve symptoms, promote healing and prevent complications and recurrence key factors. Gitu, md, florida state university college of medicine family medicine. Which of the following is not a common cause of peptic ulcer disease pud. Peptic ulcer disease and its complications cost the u. Contents physiology of gastric acid secretion an introduction to peptic ulcer disease drugs used in pud 2 3. Peptic ulcer disease represents a serious medical problem. A variety of options are available for the medical treatment of peptic ulcer disease, including antacids, histamine 2 receptor antagonists, omeprazole, prostaglandin analogues, and sucralfate and bismuth formulations. Several classes of drugs that are able to efficiently treat some of these diseases have been developed. Peptic ulcer is a break like a sore in the lining of the stomach or the upper part of the small intestine 1, with a diameter of at least 0. In united states alone around 4 million individuals are affected. Peptic ulcer disease usually occurs in the stomach and proximal duodenum. Current trends in the pharmacotherapy for peptic ulcer.
Seventy percent to 90% of peptic duodenal and gastric ulcers will heal after 4. Pharmacotherapy of peptic ulcer disease and latest research. Pharmacotherapy of peptic ulcer linkedin slideshare. Diagnosis and treatment of peptic ulcer disease and h. Effect on persistent or rebleeding of peptic ulcer in patients with peptic ulcer and h. The stomach is an outpocket of the gastrointestinal tract in which ingested food undergoes mechanical and chemical changes that promote absorption in the small and large intestine.
Adefinitive diagnosis of peptic ulcer disease pud can only be made by performing an endoscopy. Most patients in the hospital setting will have been referred. Interestingly, those at the highest risk of contracting peptic ulcer disease are those generations born around the middle of the 20th century. The pathophysiology of peptic ulcer disease pud is often described as an imbalance between aggressive factors such as acid and pepsin and alterations in the mucosal protective mechanisms. Pharmacokinetics and pharmacodynamics of important groups of.
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