Term
| First line tor H. Pylori Ulcers |
|
Definition
| 3 Drug Regimen for 7-14 days |
|
|
Term
| 3 Drug Regimen for H. Pylori Ulcer Eradication |
|
Definition
PPI, Clarithromycin, Amoxicillin
or
PPI, Clarithromycin, Metronidazole |
|
|
Term
| 4 Drug Regimen for H. Pylori Ulcer Eradication |
|
Definition
2nd line if 1st line fails or cannot tolerate
PPI + Bismuth Subsalicylate + Metronidazole + Tetracycline (or Amoxcicillin or Clarithromycin)
or
H2RA +Bismuth Subsalicylate + Metronidazole + Tetracycline (or Amoxcicillin or Clarithromycin) |
|
|
Term
1st step of treatment for NSAID Induced Ulcer
then... |
|
Definition
D/C offending non-selective NSAID
Then initiate:
H2RA, PPI, Sucralfate
PPI have the most rapid relief from symptoms. |
|
|
Term
| Treat NSAID Ulcer if you must continue the NSAID |
|
Definition
Continue the NSAID:
1) Decrease the dose
2) change to paritally selective COX 2
3) PPI is DOC if you must continue NSAID |
|
|
Term
| Treat NSAID Ulcer if you must continue the NSAID |
|
Definition
Continue the NSAID:
1) Decrease the dose
2) change to paritally selective COX 2
3) PPI is DOC if you must continue NSAID (Better tolerated than misoprostal and superior to H2RA)
4) Change to COX-2 selective (Celecoxib
5) May use Cox2 with PPI in very high risk patients |
|
|
Term
| How to treat Peptic Ulcer Bleeding |
|
Definition
Treatment Endoscopy
Antisecretory therapy with PPI (clots are less stable in high acid conditions)
Do 80mg loading dose and then 8mg/hr CI x 72 hours ( Omeprazole used) |
|
|
Term
| Who to Prophylax for Stress Related Mucosal Bleeding? |
|
Definition
1. Mechanical Vent > 48 hours
2. Coagulopathy (Warfarin, Clopidagrel, AsA)
3. Hypotension
4. Sepsis
5. Hepatic Failure
6. Acute Renal Failure
7. Multiple Trauma
8. Severe Burns >35%
9. Head Injury
10. Traumatic Spinal Cord injury.
11. History of GI bleed |
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