Ulcer
Do all ICU patients need Stress Ulcer Prophylaxis?
Introduction ㅡ Patients who are admitted to ICU may suffer from Stress Ulceration, which is the development of superficial ulcers in the upper gastrointestinal (GI) tract. This differs from the reactivation of chronic duodenal or gastric ulcers as it is caused by either hypersecretion of gastric acid or impaired mucosal protection. Thus, m…
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Stress Ulcer
Minimize unsuitable use of PPIs for stress ulcers
As a critical care pharmacist, you will be asked to re-evaluate the use of proton pump inhibitors (PPIs) or H2-blockers for stress ulcer prophylaxis. We know that stress ulcer prophylaxis isn't indicated for floor patients. But many ICU patients don't need it either... Mounting evidence suggests it doesn't decrease mortality or clinically significan…
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Stress Ulcer
Quick guide of dyspepsia
Overview ㅡ Dyspepsia is a predominant epigastric pain. It may be associated with epigastric fullness, nausea, heartburn, or vomiting. Endoscopy is warranted in all patients aged 60 years or older and selected younger patients with "alarm" features. In all other patients, testing for Helicobacter pylori is recommended; if positive, empiric treatment …
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Stress Ulcer
Management of gastroesophageal reflux disease
OVERVIEW ㅡ Gastroesophageal reflux disease (GERD) is a common chronic, relapsing condition that is associated with a risk of significant morbidity and the possibility of mortality from complications. Patients have heartburn, the hallmark of acid regurgitation, at least once a month. Many patients self-diagnose and self-treat, and do not seek medical attention for th…
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Stress Ulcer
Pharmacology of histamine 2 (H2) antagonists
Therapeutic actions ㅡ H2 antagonists or H2-blocker inhibit the action of histamine at the H2 receptors of the stomach, inhibiting gastric acid secretion and reducing total pepsin output; the resultant decrease in acid allows healing of ulcerated areas. See additional notes Peptic Ulcer; assessment and management and Dyspepsia . Th…
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