Treatment of Peptic Ulcer Diseases

Treatment of Peptic Ulcer Diseases
A. ANTACIDS
1. Dietary Antacids:-
Milk
Fats
Oil
2. Chemical Antacids:-
a) Systemic Antacids:-
Sodium bicarbonate
b) Non-Systemic Antacids:-
1. Mg Salts:-
Mg trisilicate Mg carbonate
Mg hydroxide Mg oxide
2. Ca Salts:-
Ca carbonate
3. Al Salts:-
Al hydroxide Al carbonate
Al sulphate
4. Bi Salts:-
Bi subcarbonate
3. Physical Antacids:-
a) Drugs forming colloidal solution:-
Gastric Mucin
Al hydroxide Gel
Mg Trisilicate
b) Anion Exchange Resins
B. GASTRIC ANTI-SECRETORY DRUGS:-
1. H2 Receptor Antagonists:-
Cimitidine
Ranitidine
Famotidine
Nizatidine
Oxmitidine
2. Anti- Cholinergics:-
a) Natural:-
Belladonna alkaloids e.g.
Atropine
Hyoscine
b) Sami synthetic:-
Hyoscine Butyl bromide
c) Synthetic:-
Tertiary Amines e.g. Dicyclomine
Quaternary Ammonium Compounds e.g.
Propanthilien
Poldine
d) Selective Anti- Cholinergics:-
Pirenzepine

3. Proton Pump Inhibitors:_
Omeprazole
Lansoprazole
Rabeprazole
Pantoprazole
Esomeprazole
4. Somatostatin Analogues:-
Octreotide
C. MUCOSAL PROTECTIVE AGENTS:-
1. Sucralfate:-
Sulphated Sucrose and Al hydroxide
2. Liquorice Derivatives:-
Carbenoxolone
3. Bismuth Chelate:-
Tripotassium Dicitrotobismutate
4. Prostaglamdin Analogues:-
Misoprostol
5. Miscellaneous:-
Meotclopramide
Oxethozain
Antimicrobial Agents
D. MISCELLANIOUS DRUGS:-
1. D2 Receptor Antagonists:-
Metoclopramide
2. Macrolides:-
Erythromycin


Therapeutic Classification
1. GERD:-
Once daily:-
Omeprazole
Esomeprazole
Twice Daily:-
Cimitidine
Ranitidine
2. Peptic Ulcer Disease:-

1) H-pylon associated Ulcers:-
Double therapy:-
Clarithromycin
+
Ranitidine
Triple therapy:-
Omeprazole
+
Clarithromycin
+
Amoxicillin
OR
Bi-salt + metronidazole + tetracycline
Quadruple therapy:-
Bi salt + triple therapy
2. NSAID associated Ulcers
Omeprazole
Pantoprazole
Lansoprazole
3. Non-Ulcer Dyspepsia:-
Omeprazole
Ranitidine
Erythromycine
4. Prevention of Stress related mucosal
Bleeding:-
Loading Dose:-
Omeprazole bid
Maintenance Dose:
Omeprazole (once daily)
5. Gastrinoma and other hypersecretory
Conditions:-
Omeprazole
Esomeprazole
Pantoprazole
6. Zollinger Ellison Syndrome:-
Cimetidine
Famotidine
7. Steatorrhoea:-
Famotidine
Nizatidine


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