Pepticulcer
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Pepticulcer

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Pepticulcer Presentation Transcript

  • 1. gastric ulcer proton pump inhibitors
  • 2. NSAIDs proton pump inhibitors Helicobacter pylori proton pump inhibitors ** Scenario 2-3 ** Scenario
  • 3. PPI-based triple therapy PPI Amoxicillin Clarithromycin 7-14 **. Scenario
  • 4. Omeprazole • proton pump inhibitor PPI • block H+/K+ ATPase parietal cell lumen Joseph T. DiPiro,Pharmd,FCCP.Pharmacotherapy A Pathophysiologic Approach.Seventh Edition.New York. McGraw Hill Medical,2008,page 555 -peptic ulcer -gastritis -esophageal reflux -Zollinger- Ellison
  • 5. pH<5
  • 6. Amoxicillin wider spectrum  extended spectrum penicillin gram-positive bacteria gram-negative rods  : penicillin-binding proteins (PBPs) (transpeptidase enzymes)  : Hypersensitivity reactions, pseudomembranous colitis.
  • 7. Clarithromycin  Macrolides : Erythromycin, azithromycin, clarithromycin  : blocking translocation ; 23S rRNA 50s ribosomal subunit. bacteriostatic  : prolonged QT interval, GI discomfort ( , eosinophilia( eosinophill ),skin rash, anticoagulants. resistance : methylation 23S rRNA binding
  • 8. Clarithromycin