PR OTON OTON PUM PUMP INHIBITORS INHIBITORS VS H2 R ECEP ECEPTOR TOR ANTAGONI ANTAGONIS STS
SYM SYMPTOMS TOMS OF GAS GASTR OINTES OINTESTINAL DYSF YSFUNCTION
symptoms can arise from GI dysfunction. Common GI symptoms include heartburn, abdominal abdominal pain, dyspepsia, nausea , vomiting, diarrhoea , constipation, and gastrointestinal bleeding. Signs and symptoms of malabsorption, hepatitis, and GI infection i nfection are also commonly commonly seen.
PEPTIC ULCER DISEASE
peptic
ulcer is an abnormal area of mucosa which has been damaged by the pepsin and hydrochloric acid of gastric juice.
consequent
inflammation of the underlying and surrounding tissues.
most
ulcers occurs in duodenum or in the stomach ,where ph is sufficiently low.
AETIOLOGY H.PYLORI NSAID
INFECTION
INGESTION
STRESS
INDUCED
HEREDITY COMMON
ON O BLOOD GROUPS
SMOKING ALCOHOL AGE
MORE THAN 60 YEARS
CORTICOSTEROIDS
GASTROESOPHAGEAL REFLUX DISEASE Gastroesophageal reflux disease (GERD) is a common medical disorder for symptoms, such as heartburn , dysphagia or bleeding. Endoscopy is used to evaluate mucosal damage from gastroesophageal reflux disease (GERD) key factor in the development of GERD is the retrograde movement of acid or other noxious substances from the stomach into the oesophagus.
ZOLLINGER-ELLISON SYNDROME
ZES
is characterized by gastric acid hyper secretion and recurrent peptic ulceration that results from a gastrin-producing tumour (gastrinoma). 90% of gastrinomas are located in the region of the pancreas, the most common site being the duodenum. Malignant gastrinomas occur in 30% to 50% of patients, with metastases to regional lymph nodes, liver, spleen, and bone.
COUNSELLING Drug to be taken before meals Don¶t crush the capsules BRAND NAMES FORM STRENGTH 1)OMEZ CAP 10,20mg 2)OCID CAP 10,20mg 3)OMEZ INJ 4)OMEZ TAB
PROTON PUMP,H+/K+ AT PASE ± SECRETORY SURFACE OF GASTRIC PARIETAL CELL.
BLOCKS
FORMATION OF GASTRIC ACID
INDICATIONS.R OUTE AND DOSAGE
ACTIVE
DUODENAL ULCER 15mg P.O once daily for 4 weeks TREATMENT FOR EROSIVE ESOPHAGITIS 30 mg P.O once daily up to 8 weeks ZOLLINGER ELLISON SYNDROME Initially 60 mg once daily increased up to 180 mg/day TREATMENT FO GASTRIC ULCER 30 mg P.O daily up to 8 weeks
GERD
15 mg P.O daily up to 8 weeks H.PYLORI ERADICATION DUAL THERAPY LANSOPRAZOLE : 30mg AMOXICILLIN :1000mg Given t.i.d for 14 days TRIPLE THERAPY LANSOPRAZOLE : 30mg AMOXICILLIN :1000mg CLARITHROMYCIN : 500mg
GERD
150mg P.O b.i.d EROSIVE
ESOPHAGITIS
150 mg or 10ml P.O q.i.d FOR OCCASSIONAL HEARTBURN , ACID
INDIGESTION , AND SOUR STOMACH 75 mg once or twice daily or 150 mg o.d INTERACTIONS Decreased ranitidine Increased
absorption with antacids
hypoglycemic effects with glipizide
ADVERSE REACTIONS Granulocytopenia , pancytopenia , thrombocytopenia COUNSELLING if patient taking single dose take it
at bed time
Not
to take otc for a period of 2 weeks without mediacal approval