BIOL 3051 Lecture Notes - Lecture 6: Bismuth Subsalicylate, Calcium Channel Blocker, Indigestion
20 Apr 2020
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Introduction: dyspepsia is pain/discomfort located in upper abdomen. Symptoms include nausea, vomiting, fullness, early satiety & bloating: symptoms of pud is dyspepsia, pud: development of breaks in mucosa of stomach or duodenum, gerd: heartburn regurgitations. Goals of therapy: relieve & prevent symptoms of dyspepsia, treat underlying pud, prevent recurrences of pud, prevent pud-related complications in users of. Nonpharmacologic choices: avoid coffee, oj, alcohol, spicy food, fatty , large meals, nsaids, asa. Dyspepsia w/normal endoscopy aka functional: treatment with ppi or h2ra for 4-8 weeks, prokinetic agents- metoclopramide domperidone provide symptomatic improvements, tca (amitriptyline, nortriptyline) Treatment of pud due to pylori: 14-day quadruple treatment as first-line: Ppis bid, bismuth subsalicylate qid, metronidazole tid qid and tetracycline. Prevention of pud during asa/nsaid therapy: consider use of gi agent for patients on chronic. Use of high dose or multiple nsaids. Concomitant of corticosteroids, antiplatelet agents (clopidogrel), anticoagulants (warfarin) or ssris. Comorbidity: heart failure, copd, renal or hepatic disease, malignancy.
