Ulcer with the right medicine
Once the diagnosis of peptic ulcer disease, accurate and rational selection of anti-peptic ulcer drugs becomes key. Scientific, rational use of drugs to guarantee the efficacy, shorten the course of treatment, reduce patient suffering, to prevent the occurrence of complications and recurrence all have an extremely important role.
According to the type of ulcer drug selection. In recent years, with the pathogenesis of the in-depth studies suggest that the incidence of gastric ulcer is due to decreased gastric mucosal barrier dominated, therefore, drug selection should be to protect the gastric mucosal barrier in drug-based, such as sucralfate, fruit plastic bismuth, marzulene-S, etc., if the high acid to reduce stomach acid may be supplemented with a drug; because of duodenal ulcer is increased gastric acid and pepsin play a leading role in the election should be to acid-suppressing agent-based medicine, supplemented by mucosal protection of drugs, this can promote the healing of the rapid elimination of symptoms.
Determination of gastric acid secretion of drug selection. In general, duodenal ulcer acid high, normal or high gastric ulcer and gastric acid, but there are individual differences. Therefore, it is best done once in the treatment of gastric juice analysis, so that drugs are more targeted. Should be used in patients with the treatment of high gastric acid-suppressing role of the strong medicine, for patients who never used acid-suppressing drugs ranitidine or famotidine may be preferred, such as the effect of acid-suppressing role of the poor can choose a stronger Losec , such as normal stomach acid, not to abuse the acid-suppressing agents, in order to avoid stomach flora, fungi ‘take advantage’ cause trouble.
Clear secluded bacteria, caution bismuth. Research data indicate that H. pylori affecting ulcer healing and lead to recurrence of the important factors. Therefore, any risk of peptic ulcer patients with H. pylori should be doing the inspection. In particular, should actively consider the following cases of Helicobacter pylori infection: a, after the regular acid suppression agent for peptic ulcer treatment fails. Second, frequent recurrence of peptic ulcer. 3, ulcers had healed, but there are still symptoms. 4, duodenal ulcer associated with significant activity in patients with gastric inflammation. If You-positive bacteria, can be used, such as triple therapy (omeprazole, amoxicillin, metronidazole, or Watergate, amoxicillin, metronidazole), which is not Watergate took more than six weeks straight. Therefore, drugs are bismuth, long-term use with cellular toxicity and neurotoxicity, which can cause headache, joint pain, liver and kidney.
According to the disease, choose the medication. Refractory, intractable duodenal ulcer omeprazole should be preferred until the ulcer healed after maintenance therapy with other drugs. Gastric ulcer duodenal reflux, it can at the same time and use of metoclopramide to increase gastric motility and promote gastric emptying. Peptic ulcer associated with constipation may have a laxative effect and use of anti-acid agents, such as the compound magnesium oxide powder, the stomach must be governance. Peptic ulcer associated with diarrhea should have a convergence effect, and with antacids such as aluminum hydroxide, Wei Shuping, bismuth such as pectin.
Note that taboo medication to prevent the toxic side effects. Gastric ulcer should not use anti-cholinergic drugs, because such drugs can promote gastric tension is low, gastric antrum retention, thereby increasing gastrin secretion. In patients with renal dysfunction should not take magnesium containing antacids, so as to avoid hypermagnesemia produce central nervous system and heart toxicity. For elderly patients is equal to ‘worse’. Anti-cholinergic drugs can glaucoma, prostatic obstruction, reflux esophagitis increased, so has the above-mentioned disease patients, used with caution in the class medicine.
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