Uses / Management Objectives
Management objectives
Primary Objectives
- apply to all uses of "anti-ulcer" drugs
- Heal lesion
- eliminate cause
- protect surface and promote regeneration
- Relieve pain
- decrease acid secretion
- protect surface
Secondary Objectives
(esp. H. pylori-induced ulcers)
- Remove the possibility of recurrence
- drugs that decrease intragastric acidity will allow a lesion to heal, and will relieve pain (e.g., proton pump inhibitors will heal all duodenal ulcers within 4 weeks)
- however, only antimicrobials will eliminate the infection and prevent recurrence
- Avoid complications of the disease
- untreated H. pylori infection is associated with increased risk for gastric cancer; eliminating the infection reduces the long term risk
- Eliminate maintenance therapy
- treatment of gastric and duodenal ulcers without inclusion of an antibiotic requires long-term treatment to prevent recurrence
- i.e., preventing failure of objective 3 results in failure of objective 5!
- Prevent the development of drug resistance
- treatment failure will lead to the development of drug resistance, which is why multiple antibiotics are typically given in extended regimens