Question

Katie G. is a 29 year old culinary arts student who comes to the clinic for a routine prophylaxis. She notes on her medical history that she suffers from "heartburn" almost every evening. Her chief complaint is stain on her anterior teeth, which she blames on her two packs per day cigarette habit and from sinking black coffee all day. Her blood pressure is 138/96, pulse is 90, and respirations are 15 per minute. During the intraoral examination, the hygiene student notes severe erosion on the mandibular molars, and her throat and soft palate are redder than normal. Katie's medication history includes over the counter antacids taken to relieve her symptoms, oral contraceptive, and ibuprofen almost every day for headaches.

If it were determined that Katie is suffering from peptic ulcer disease rather than GERD, which medication groups would be indicated?
A. Histamine2-receptor antagonists
B. Proton pump inhibitors
C. Antacids
D. Antibiotics
E. All of the above
F. A, B, and C
G. A, C and D

Answer 1

The indicated medication groups for peptic ulcer disease would be B. Proton pump inhibitors and D. Antibiotics.

Step-by-step explanation:

Peptic ulcer disease often involves the presence of Helicobacter pylori bacteria, necessitating the use of antibiotics (D) to eradicate the infection. Additionally, proton pump inhibitors (B) are recommended to reduce stomach acid production, aiding in the healing of ulcers. These medications work synergistically to alleviate symptoms and promote ulcer healing.

Proton pump inhibitors, such as omeprazole and lansoprazole, hinder the action of proton pumps in the stomach's parietal cells, substantially decreasing acid secretion. This reduction in acid levels assists in ulcer healing by providing a less acidic environment. Antibiotics targeting H. pylori, like clarithromycin or amoxicillin combined with metronidazole, are typically prescribed in a multi-drug regimen for about two weeks to eradicate the bacterial infection, hence aiding in ulcer resolution.

Although histamine2-receptor antagonists (A) and antacids (C) can alleviate symptoms associated with peptic ulcers by temporarily reducing stomach acid, they are not sufficient for treating the root cause, particularly the H. pylori infection. Thus, while they might provide short-term relief, they are not the primary medications for addressing peptic ulcer disease. Hence, the optimal combination for treating peptic ulcers involves proton pump inhibitors to suppress acid production and antibiotics to eradicate the underlying bacterial infection.