Peptic Ulcer

[AnGe|ic]

*Causes:
-gastrin secreting tumor ( Zollinger Ellison Syndrome )
- cigarette smoking
-H.pylori
-NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
-alcohol and stress

*Manifestations:
-gastric ulcer : epigastric pain, precipitated by food
- duodenal ulcer : relieved by food
-nausea, vomiting
-weight loss
-hematoemesis ( blood in vomitus ), melena (blood in stool ), anemia

*Drugs for PePtic Ulcer:
A-Metoclopramide ( Primperan ), Domperidone ( Motilium )

B-Cisapride (Prepulsid, Ciprid )
Note: not taken with antifungal drugs and some antibiotics as clindamycin and erythromycin

C-H2-Blockers: Cimetidine ( Neutronorm, Cimetril, Tagamet ), nizatidine (Axid), famotidine (Gastrodomina), ranitidine (Zantac)
->They block histamine receptors in gastric mucosal cells and hence prevent acid secretion

D-Bichelate:
->They r cytoprotective, toxic to H.pylori, taken with antibiotics

E-Sucralfate (Ulcar) : Aluminium salt of sucrose
->It secretes sodium bicarbonate, mucus, and mucosal prostanoids. It also forms a gel and adheres to the ulcer surface

F-Antacids: aluminium,magnesium hydroxides (Maalox)

G- K/H pump inhibitors (Proton Pump Inhibitors)
->Omeprazole (Ulstop-Gastrimut-Axipron-Risek-Zimor)
->Esmoprazole (Nexium)

H-Misoprostol (Cytotec)
->Its is synthetic PGE1 analogue
->It may cause abortion