Sucralfate is as effective as h2 antagonists at

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Unformatted text preview: o acetylcholine • Examples: – cisapride (Propulsid®), metoclopramide (Reglan®) • Relaxes pylorus and stimulates motility. • Relieves heartburn and nausea caused by gaseous distention. About Ulcers: About • Older ulcer treatments focused on antacids. – Best to use antacids ® times per day at 1 and 3 hours after each meal and at bedtime. – Not quite as effective as H2 antagonists, but not as much rebound ulceration. • Note: Sucralfate (Carafate®), aluminum hydroxide and sulfate sucrose – minimal antacid effect – adheres to ulcerated region (protecting it) and decreasing pepsin activity. – Sucralfate is as effective as H2 antagonists at healing. It's best used before meals and before antacids because it needs some acid to become active. Submucosa: Nerve & Lymph Network Submucosa: Benign Benign vs. Cancer Modern ulcer therapy: Modern • The bacterium Heliobacter pylori is present in the majority of ulcer cases so therapy should include: – an antisecretory agent, especially an H2 antagonist or proton pump inhibitor – Bismuth (Pepto-Bismol®) to reduce bacterial adherence to mucosal cells and damage bacterial cell walls – At least 2 antibiotics to avoid resistance. • Amoxicillin,...
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