Bushra hasan khan junior resident1, department of pharmacology, jnmc,amu,aligarh. Descriptive epidemiology, risk factors, management and prevention. Seventy percent to 90% of peptic duodenal and gastric ulcers will heal after 4 to 8 weeks of therapy. Seventy percent to 90% of peptic duodenal and gastric ulcers will heal after 4. Lack of response to conventional treatment for peptic ulcer disease should suggest conditions other than benign peptic ulcers, and should warrant endoscopy or. Pharmacotherapy of peptic ulcer linkedin slideshare. Constipation, diarrhea, and irritable bowel syndrome 22. Gastric ulcers, in the stomach, and duodenal ulcers, in the upper portion of the small intestine, occur most often.
Content acid peptic disease gastric anatomy and gastric physiology what is peptic ulcer. These typically include proton pump inhibitors like. 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. It is best managed using a multidisciplinary approach by a team with medical. The recommended treatment for severe peptic ulcer bleeding after appropriate endoscopic treatment is the iv administration of a ppi loading dose followed by a. Adefinitive diagnosis of peptic ulcer disease pud can only be made by performing an endoscopy. Drug treatment of peptic ulcer disease open access ebooks.
Diagnosis and treatment of peptic ulcer disease and h. Evidencebased clinical practice guidelines for peptic. Drugs that control gastric acid secretion and treat peptic ulcers. Contents physiology of gastric acid secretion an introduction to peptic ulcer disease drugs used in pud 2 3. The healing rare increases with time for active medication and placebo, and is lower among smokers than nonsmokers for all drugs but misoprostol. Jsge revised the evidencebased clinical practice guidelines for peptic ulcer disease in 2014 and has created an english version. In the seventh edition, information on the management of pharmacotherapy in the elderly has been added as an appendix.
Several classes of drugs that are able to efficiently treat some of these diseases have been developed. Pharmacotherapy gi disorders indigestion peptic ulcer. Drinking alcohol and smoking slow the healing of a peptic ulcer and can. 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. Current trends in the pharmacotherapy for peptic ulcer disease. In united states alone around 4 million individuals are affected. Adjuvant pharmacotherapy for peptic ulcer bleeding. Peptic ulcer disease pharmacotherapy linkedin slideshare. The most common remedy is a combination of antibiotic drugs to kill the h. The role of helicobacter pylori in peptic ulcer disease. 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.
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. Tell your doctor if the medicines make you feel sick or dizzy or cause diarrhea or headaches. A peptic ulcer disease or pud is an ulcer defined as mucosal erosions equal to or greater than 0. 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. 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. Interestingly, those at the highest risk of contracting peptic ulcer disease are those generations born around the middle of the 20th century. 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. Peptic ulcer can occur at any age, although they are rare in children. New york chicago san francisco lisbon london madrid mexico city milan new delhi san juan seoul singapore sydney toronto pharmacotherapy casebook a patientfocused. Peptic ulcer disease pud is one of the most common diseases affecting the gastroinestinal gi tract. Peptic ulcer bleeding is a common and potentially fatal condition. Pharmacotherapy gi disorders free download as powerpoint presentation. Pharmacokinetics and pharmacodynamics of important groups of. It is important to confirm that an ulcer is present, by either endoscopy or an upper gi radiographic series, before treatment is initiated.
Which of the following is not a common cause of peptic ulcer disease pud. 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. A cost analysis of alternative treatments for duodenal ulcer. Weigh risks and benefits of nrt in patients with active ulcer. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Although no studies are available on nrts effects on ulcer disease, nicotine may delay healing of active ulcers. Epidemiological data for this disease and its complications have. Alternative management strategies for patients with suspected peptic ulcer disease. Ulcers affect 1114% of men and 811% of women at some time in their lives.
The studies of prescribing patterns of gastric acid suppressant treatment in peptic ulcer disease suggest a more frequent use of histamine h2. The authors of this study used the ambiguous term concomitant disease that made inclusion inappropriate as a criterion for exclusion. Pdf pharmacotherapy of peptic ulcer disease researchgate. Peptic ulcer disease pharmacological treatment pharmaceutical. Nih consensus development panel on helicobacter pylori in peptic ulcer disease. Pharm, class of 2018 sop, china pharmaceutical university nanjing, jiangsu, chn 211198. Pharmacology chapter 62 pharmacotherapy of peptic ulcer. Pharmacotherapy of peptic ulcer disease and latest research. Epidemiology etiopathophysiology history of drug development pharmacological agents used in treatment moa, pharmacokinetics, clinical uses, adverse drug reactions eradication of. An estimated 15,000 deaths per year occur as a consequence of complication of peptic ulcers.
Peptic ulcer disease is common condition throughout the world. What are the goals of pharmacotherapy for peptic ulcer. Peptic ulcers have unquestionably been a disease of the twentieth century. 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. The third module covers gastroesophageal reflux disease and peptic ulcer disease. Peptic ulcer disease and its complications cost the u. Basic concepts of pharmacotherapy principles and practices. 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 discovery of helicobacter pylori as a cause of peptic ulcer has changed our approach greatly towards this disease.
The final module includes three new interactive features. 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. South texas veterans health care system, san antonio, tx. Pharmacotherapy clinical approaches peptic ulcer disease pud tom hsiung, b. Division of pharmacotherapy, the university of texas at austin college of pharmacy. Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone. In the antrum 60% at the junction of the antrum and body on the lesser curvature 25% major causes of peptic ulcer disease. Current trends in the pharmacotherapy for peptic ulcer. The goals of pharmacotherapy are to eradicate h pylori infection, to reduce morbidity, and to prevent complications in patients with peptic ulcers. Pdf pharmacotherapy of peptic ulcer disease and latest. Effect on persistent or rebleeding of peptic ulcer in patients with peptic ulcer and h. Doctors only prescribe one protectantsucralfate carafatefor peptic ulcer disease. Most patients in the hospital setting will have been referred. Pdf the etiology of peptic ulcer is multifactorial.
Peptic ulcer disease usually occurs in the stomach and proximal duodenum. The incidence of outpatient and inpatient care visits for peptic ulcer disease has steadily declined in the united states since the 1970s. Pharmacotherapy of duodenal and gastric ulcerations. Peptic ulcer disease represents a serious medical problem. Pdf pharmacotherapy of peptic ulcer disease and latest research. The predominant causes in the united states are infection with helicobacter pylori and use of nonsteroidal anti. 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. Dipiro jt, talbert rl, yee gc, matzke gr, wells bg, posey ml, eds. Peptic ulcer is a break in the gastric or duodenal mucosa, extending through the muscularis mucosa, and usually 5 mm in diameter. Scribd is the worlds largest social reading and publishing site. Pharmacotherapy education and research center, university of texas health science center at san antonio.
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