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These drugs are among the most widely sold drugs in the world, and are generally considered effective. [3] When these medications are used long term, the lowest effective dose should be taken. [4] They may also be taken only when symptoms occur in those with frequent problems. [5] Proton-pump inhibitors are named using the suffix "-prazole".
Famotidine, sold under the brand name Pepcid among others, is a histamine H 2 receptor antagonist medication that decreases stomach acid production. [4] It is used to treat peptic ulcer disease , gastroesophageal reflux disease , and Zollinger–Ellison syndrome . [ 4 ]
Sucralfate is used for the treatment of active duodenal ulcers not related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), as the mechanism behind these ulcers is due to acid oversecretion. [1] It is not FDA approved for gastric ulcers, but is widely used because of evidence of efficacy. [10]
The pharmacologic treatment of acid peptic disorders centers on redressing this imbalance by either improving mucosal defenses with drugs like sucralfate, bismuth, and prostaglandin analogs, neutralizing acid with antacids, or decreasing acid secretion with histamine 2 receptor antagonists or, more recently, proton pump inhibitors. [2]
Clostridioides difficile, also known more commonly as C. diff, accounts for 10 to 20% of antibiotic-associated diarrhea cases, because the antibiotics administered for the treatment of certain disease processes such as inflammatory colitis also inadvertently kill a large portion of the gut flora, the normal flora that is usually present within the bowel.
[1] [2] The GI cocktail is commonly prescribed in the hospital or emergency department, and has been used to help distinguish chest pain as either gastrointestinal or cardiac. [1] While it has been widely used in the treatment of dyspepsia, studies have suggested that the GI cocktail is only as effective as antacids alone.
Patients should be queried about any side effects, missed doses, and completion of therapy. As culture with antibiotic sensitivities is not routinely performed when a H. pylori infection is diagnosed, it is generally recommended that different antibiotics be given at higher doses for 14 days. [2]
[20] [21] [22] In the United States, the Food and Drug Administration (FDA) has advised that over-the-counter PPIs, such as Prilosec OTC, should be used no more than three 14-day treatment courses over one year. [23] [24] Despite their extensive use, the quality of the evidence supporting their use in some of these conditions is variable.
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