NURS 2004 Chapter Notes - Chapter 78: Ketoconazole, Aspiration Pneumonia, Phenytoin
28 Jan 2017
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Document Summary
Peptic ulcer disease (pud) refers to a group of upper gastrointestinal (gi) disorders characterized by varying degrees of erosion of the gut wall. Ulceration most common in the lesser curvature of the stomach and duodenum. Peptic ulcers develop when an imbalance exists between mucosal defensive factors and aggressive factors. The major defensive factors are mucus and bicarbonate. The major aggressive factors are helicobacter pylori (gram bacillus that colonizes in the stomach and duodenum), nonsteroidal anti-inflammatory drugs (nsaids), gastric acid, and pepsin. Aggressive factors: h-pylori lives between epithelial cells and the mucus barrier (can stay there for decades). Moa: produces urease which forms co2 and nh3 which are toxic to gastic mucosa. Eradication of this promotes healing of pud and minimizes recurrence: nsaids underlying cause of many gastric (and some duodenum) ulcers. Gastric acid acts directly to injure gi mucosa and indirectly by activating pepsin (proteolytic enzyme) which can also injure unprotected cells of the gi mucosa.
