Pud, Gerd, And Others

Front 1

Peptic Ulcer Disease

Back 1

-Gastric
-Duodenal
Caused by:
-H.Pylori
-NSAID
-Stress
-Non H.-Pylori or NSAID

Front 2

H pylori diagnosis

Back 2

-Serology
-Urine antibody test
-fecal antigen test
-urea breath test

Front 3

H pylori treatment

Back 3

-1st line: PPI+ Amox 1g + clarithromycin 500, all BID 7-14 days
-If clarith. or amox allergy, then use metronidazole
-If 2 courses failed: PPI, levo 250mg, amox 1g all BID
-PPI BID, Bismuth525, flagyl 500,tetra500 all QID

Front 4

H pylori tx resistant to clarithromycin and metronidazole

Back 4

-Use furazolidone
-MAOI
-Avoid use with SSRI

Front 5

NSAID induced PUD

Back 5

-D/C NSAID
-If patient must be on NSAID, switch to Celebrex and/or add misoprostol, PPI, or H2-RA

Front 6

Drug-Drug interactions in treating PUD

Back 6

-Antacids and H2RAs should be taken 2h apart
-Take tetra on empty stomach apart from Fe,Ca, antacids
-PPI reduce absorption of drugs that need acid like ketoconazole,digoxin, iron

Front 7

PUD drugs acting as P-450 inhibitors (increased warfarin,cyclosporin,digoxin effect)

Back 7

-Omeprazole
-Cimetidine
-Clarithromycin
-Tetracycline increases warfarin levels by other mechanisms
-Metronidazole (also increases effect of Li)

Front 8

Sucralfate

Back 8

-Take one hour before meals and at bedtime
-Most common side effect: constipation
-Accumulation of aluminum

Front 9

Disulfiram-like reaction

Back 9

-Metronidazole
-Furazolidone

Front 10

Drugs that decrease LES pressure

Back 10

-CCB
-beta-blockers
-anticholinergics
-theophylline
-barbiturates