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Related Concept Videos

Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids01:31

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In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.
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Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
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The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
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Identifying Risk Factors Associated with Inappropriate Use of Acid Suppressive Therapy at a Community Hospital.

Amandeep Singh1, Vijay Bodukam1, Kirit Saigal1

  • 1Crozer Chester Medical Center, Upland, Philadelphia, PA, USA.

Gastroenterology Research and Practice
|November 8, 2016
PubMed
Summary

Inappropriate prescribing of acid suppressive therapy (AST) is common, with over 70% of new prescriptions being unwarranted. Younger age, female sex, and care transitions increase the risk of this inappropriate medication use.

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Area of Science:

  • Internal Medicine
  • Pharmacology
  • Patient Safety

Background:

  • Acid suppressive therapy (AST) is widely used but often prescribed inappropriately.
  • Identifying risk factors for inappropriate AST is crucial for improving patient safety and healthcare costs.

Purpose of the Study:

  • To examine prescribing patterns of AST during hospitalization and at discharge.
  • To identify risk factors associated with inappropriate AST use.

Main Methods:

  • Retrospective observational study of inpatient records from January 2011 to December 2013.
  • Defined appropriate AST as treatment with a known indication or for stress ulcer prophylaxis.

Main Results:

  • High rates of inappropriate AST initiation were observed: 72% in 2011, 84% in 2012, and 75% in 2013.
  • 19% of patients inappropriately started on AST were discharged with the medication.
  • Younger age, female sex, and multiple care handoffs were significant risk factors for inappropriate AST.

Conclusions:

  • Inappropriate AST prescription increases healthcare costs and patient risk for adverse events.
  • Regularly reassessing the need for AST, especially in patients with identified risk factors, is essential.
  • Optimizing AST prescribing practices can improve patient outcomes and reduce healthcare expenditure.