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Terms in this set (21)
What is the pathophysiology of PUD?
Discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion, pepsin, H.pylori and NSAIDs
What are some risk factors associated with PUD?
Pepsin, NSAIDS, gastric acid, H.pylori, alcohol and smoking, men, age and stress
What is the clinical presentation of PUD?
Abdominal pain, nausea, bloating, fullness, weight loss and satiety (70% of pts are asymptomatic)
Gastric ulcers are in the _______ and duodenal ulcers are in the __________ _________
stomach; small intestine
What are the three causes of PUD?
H.pylori, NSAID-induced and stress-related mucosal damage
What are some non-pharmacologic therapies?
Reduce psychological stress, quit smoking, avoid food and beverages that cause dyspepsia, avoid NSAIDs and surgery
What is the first-line treatment regimen of H.pylori PUD?
Bismuth Quadruple Therapy: PPI (BID), bismuth, tetracycline and metronidazole (10-14 days)
What are alternative treatment options for H.pylori PUD?
Levofloxacin triple: PPI (BID) and levofloxacin and amoxicillin (10-14 days)
Levofloxacin sequential: PPI (BID) and amoxicillin x 5 days THEN levofloxacin and amoxicillin and metronidazole x 5 days (10 days)
Bismuth salts have a topical ________ effect that improves ulcer _________ by inhibiting aggressive factors and increasing protective factors
Adverse effects of bismuth salts are _____________ of _________ and __________
darkening; stools and tongue
What are some adverse effects of metronidazole?
What is an adverse effect of tetracycline?
What are some adverse effects of levofloxacin?
tendon rupture, mental status change, QTc prolongation
The two treatment pathways for NSAID-induced PUD are ____ and _____
prevention and treatment
Which medications are used in prophylaxis of NSAID-induced PUD?
PPIs and misoprostol
Which medications are used in treatment of NSAID-induced PUD?
PPIs, H2RAs and sucralfate
PPI dosing for NSAID-induced ulcers are __________ daily
Misoprostol is given ___________ times a day ________ food
4 with food
What are some side effects of Misoprostol?
diarrhea, abdominal cramps, nausea, vomiting, flatulence and headache
Sucralfate is dosed ______ before meals and ______
What are some side effects of Sucralfate?
constipation, metallic taste, aluminum toxicity in chronic renal failure
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