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Related Concept Videos

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors01:13

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors

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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.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
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Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

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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.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
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Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists01:28

Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists

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Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
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Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents01:20

Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents

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The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
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Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Related Experiment Video

Updated: Nov 12, 2025

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
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[Evidence-Based Indication for Proton Pump Inhibitors - a Group Practice Perspective].

Tonia Gerber1, Andreas Zeller1

  • 1Universitäres Zentrum für Hausarztmedizin beider Basel (uniham-bb), Liestal.

Praxis
|March 17, 2021
PubMed
Summary

Nearly half of proton pump inhibitor (PPI) prescriptions in Swiss general practice lack evidence-based indications. This study highlights the need for physicians to reassess PPI prescribing for smarter medicine and improved patient care.

Keywords:
HausarztpraxisInhibiteurs de la pompe à protonsProton pump inhibitorsProtonenpumpeninhibitorenevidence-based indicationevidenzbasierte Indikationgeneral practiceindication fondée sur la preuvemédecine familiale

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Area of Science:

  • Internal Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Proton pump inhibitors (PPIs) are widely prescribed, but concerns exist regarding non-evidence-based use in outpatient settings.
  • A 2014 Swiss initiative recommended against long-term PPI therapy, emphasizing judicious prescribing.

Purpose of the Study:

  • To determine the proportion of patients receiving PPIs without a clear evidence-based indication in a Swiss general practice setting.
  • To evaluate the impact of

Main Methods:

  • An observational study retrospectively analyzed patient data over three months in a six-general practitioner practice.
  • Prescription data for proton pump inhibitors (PPIs) was reviewed to assess the evidence-based indication for each patient.

Main Results:

  • Out of 2225 patients, 11.1% (n=248) were prescribed PPIs.
  • A significant 46.8% of these patients lacked a clear evidence-based indication for their PPI therapy.
  • This suggests nearly half of PPI prescriptions may be inappropriate.

Conclusions:

  • A substantial proportion of proton pump inhibitor (PPI) prescriptions in this Swiss general practice setting were not supported by evidence-based indications.
  • These findings underscore the importance for general practitioners to critically re-evaluate PPI prescribing habits.
  • Promoting