Question

Mr. Sanders has recently undergone an EGD which revealed a gastric ulcer. What medication would be recommended at this time? Would a H2 blocker or a Proton Pump Inhibitor be more beneficial to him and why? What is the difference between the two classes of medication? What patient instructions would the nurse practitioner give to the patient?

Answer 1

The recommended primary therapy for H pylori infection is proton pump inhibitor (PPI)–based triple therapy. PPIs are powerful acid blocking drugs that can be taken as a pill or given in an IV.
The goals of pharmacotherapy are
*to eradicate H pylori infection,
*to reduce morbidity, and
*to prevent complications in patients with peptic ulcers.
Acid suppression is the general pharmacologic principle of medical management of acute bleeding from a peptic ulcer, using histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs).
PPIs require a meal to activate them. Patients should eat a meal within 30 minutes to 1 hour after taking this medication for the acid suppression therapy to work most effectively. Waiting later than this time can decrease the positive effect of this medication. This might delay healing or even result in the failure of the ulcer to heal.
Sometimes, duodenal ulcers (not gastric ulcers) will be treated with H2 blockers. H2 blockers are another type of acid reducing medication. Common H2 blockers are ranitidine (Zantac®), cimetidine (Tagamet®), famotidine (Pepcid®) and nizatidine (Axid®).
Both medications work by blocking and decreasing the production of stomach acid, but PPIs are considered stronger and faster in reducing stomach acids.

patient education :

Patient should be instructed to take food within 1 hour after taking the medicine if not it may worsen the current situation of the patient .