DRUG ACTING ON GASTROINTESTINAL SYSTEM

Subject: Basic Science Applied to Nursing

ANTI H. PYLORI DRUGS

Chronic inflammation brought on by Helicobacter pylori is a significant contributing factor to 60% of gastric ulcers and up to 90% of duodenal ulcers.
The most common chronic bacterial infection, Helicobacter pylori, is linked to stomach adenocarcinoma, peptic ulcer disease, chronic gastritis, and mucosa associated lymphoid tissue (MALT) lymphoma.
There is no single medicine that can effectively treat H.pylori infections. For seven to fourteen days, triple therapy is given as part of the treatment.

Stomach ulcers.
lining of the stomach inflamed. Infection with H. pylori can irritate and inflame the stomach (gastritis).
Gastric cancer A significant risk factor for some kinds of stomach cancer is H. pylori infection.

First-line triple or quadruple therapy schedules for seven days
ANTIBIOTIC	PROTON PUMP INHIBITOR
Amoxicillin 1g bid and either Clarithromycin 500 mg bid or Metronidazole 400 mg bid	Esomeprazole 20 mg bid or Lansoprazole 30 mg bid or Omeprazole 20-40 mg bid or Pantoprazole 40 mg bid or Rabeprazole 20 mg bid
Penicillin allergy
Metronidazole 400 mg bid and Clarithromycin 250 mg bid

Seven-day, triple- or quadruple-therapy regimens as a second line of defense
ANTIBIOTIC	PROTON PUMP INHIBITOR
Amoxicilllin 1g bid and either: Clarithromycin 500 mg bid or Metronidazole 400 mg bid (whichever was not used first-line)	Esomeprazole 20 mg bid or Lansoprazole 30 mg bid or Omeprazole 20-40 mg bid or Pantoprazole 40 mg bid or Rabeprazole 20 mg bid
Previous clarithromycin and metronidazole exposure
Amoxicillin twice daily and either: A quinolone bid or Tetracyline twice daily (whichever has the lowest acquisition cost)
Penicillin allergy + no previous quinolone exposure
Metronidazole bid and Levofloxacin bid

Administering prescribed drugs.
Avoid NSAIDS, which are anticoagulants, along with colas, tea, coffee, chocolate, and other foods and drinks that contain acid-enhancing caffeine.
Encourage the patient to eat relaxed meals at regular intervals, get regular weights, and support dietary changes.
Promote relaxation strategies.
Assess the patient's degree of concern and what questions they have regarding the disease; encourage them to share their fears in an honest and nonjudgmental manner.
Describe diagnostic procedures and when to take drugs.
Engage in soothing conversation, assist in detecting stressors, and describe successful coping mechanisms.
Encourage family members to assist with caregiving and offer emotional support.
Keep track of and report penetration symptoms (back and epigastric pain not relieved by medications that were effective in the past).
Keep track of and report perforation symptoms (sudden abdominal pain, referred pain to shoulders, vomiting and collapse, extremely tender and rigid abdomen, hypotension and tachycardia, or other signs of shock).