Your patient Maria takes NSAIDS for her degenerative joint disease, and has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?
A. calcium carbonate (Tums)
B. famotidine (Pepcid)
C. misoprostol (Cytotec)
D. sucralfate (Carafate)
Correct Answer: C. misoprostol (Cytotec)
Misoprostol restores prostaglandins that protect the stomach from NSAIDS, which diminish the prostaglandins. Currently, misoprostol is FDA-approved only for the prevention and treatment of NSAID-induced gastric ulcers in patients taking NSAIDs and at high risk for ulceration. It has an indication (but not FDA approved) in the short-term treatment of active duodenal or gastric ulcers with other etiologies.
Option A: Calcium carbonate is an inorganic salt primarily used in the management and treatment of low calcium conditions, GERD, CKD, and a variety of other indicated conditions. It is classified as a calcium supplement, antacid, and as a phosphate binder.
Option B: Famotidine is a competitive histamine H-receptor antagonist (H2RA) that binds to the H-receptors located on the basolateral membrane of the parietal cell in the stomach, effectively blocking histamine actions. Its pharmacologic activity results in the inhibition of gastric secretion by suppressing acid concentration and volume of gastric secretion.
Option D: Sucralfate is a medication used to treat duodenal ulcers, epithelial wounds, chemotherapy-induced mucositis, radiation proctitis, ulcers in Behcet disease, and burn wounds. Sucralfate exhibits its action by forming a protective layer, increasing bicarbonate production, exhibiting anti-peptic effects, promoting tissue growth, regeneration, and repair.
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