Detailed description regarding acid peptic disorders along with pharmacology
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"peptic ulcer disease"[MeSH Terms] AND "drug therapy"[MeSH Terms]
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peptic ulcer disease gastric mucosal barrier pathophysiology
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The above is a comprehensive, textbook-sourced reference on acid peptic disorders. Here's a quick orientation to the sections:
What's covered:
- Spectrum of APD — PUD, GERD, stress ulcers, Zollinger-Ellison, dyspepsia
- Pathophysiology — the offensive vs. defensive balance, how H. pylori destroys the mucosal barrier, how NSAIDs inhibit prostaglandin protection
- Clinical features — classic symptom patterns of duodenal vs. gastric ulcers, plus complications (hemorrhage, perforation, obstruction, malignancy)
- Diagnosis — endoscopy, urea breath test, stool antigen, barium studies
Pharmacology (full detail):
- Antacids — types (NaHCO₃, CaCO₃, Mg/Al hydroxides), mechanisms, adverse effects, interactions
- H2-receptor antagonists — cimetidine, famotidine, nizatidine; mechanism, dosing table, CYP interactions, cimetidine-specific effects (gynecomastia, multiple drug interactions)
- PPIs — all 6 agents; irreversible H⁺/K⁺-ATPase blockade mechanism; pharmacokinetics table; clinical uses; long-term risks (hypomagnesemia, fractures, C. diff, B12 deficiency); clopidogrel interaction warning
- Mucosal protective agents — sucralfate (physical barrier + prostaglandin stimulation), misoprostol (PGE₁ analog), bismuth
- H. pylori eradication — triple therapy, bismuth quadruple, clarithromycin resistance guidance, salvage regimens
- P-CABs (Vonoprazan) — newer class with advantages over PPIs
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