Medical Archive

http://endotoday.com/endotoday/alumni_17_01.pdf

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K29.7
K30
(???) K25.71 ??? ?????.

????

PPI – S-pantoprazole 10mg (??) qd
Rebamipide 100mg (??) tid
Antispasmodics (??) tid
x 3??

PPI – ???? – omeprazole qd
Prokinetics – ????? – mosapride tid
???, ??? – artemisia herb tid
x 8???

?????

About symptom

Ulcer-like

Antiacid
Antisecretory drugs (Cimetidine, Omeprazole)

Reflux-like

Antisecretory drugs
Prokinetic drugs (domperidone, metoclopramide) Simethicone

Dysmotility-like

Prokinetic drugs (domperidone, metoclopramide) Simethicone

Alarm sign!

Age >40yrs, awakening pain, weight loss (>5%/1mo or >10%/6mo), history of GI bleeding, chronic vomiting, dysphagia, jaundice, anemia

About mechanism

<??? ??? ??? ??>
??????? ???????, ???????, ????? ?? ?? ???? ???? ? ?? ??? 1?? ???? ?? ?????. ?? ???? ??? ?? ?????.
???????? ??? ?? ???(PPI)? H2 ??? ???(H2RA) ?? ???, ???????? Rebamipide, Teprenone ?? ??? ???? ????. ?? ?????? Prokinetics? ????.
??? ?? ??? ??? ?? 4?? ??? ??? ??? ?? ??? ???? ????? ???. ?? ????? ??? ???? Digestive ??(?????? ??), trimebutine ??, anticholinergic ?? ?? ???? ??? ?? ????.

???????, ???????, GI modulator, ???

????? ?? ???? ?????? ?? ??? 4???, ????? ?? ???? ??? ??? ???, ???? ?? ??? ???? ????.

Antiacid

Neutralization HCl. Aluminium, Magnesium, Calcium carbonate, Sodium bicarbonate ?? 1-2???, ?? ??.

Antisecretory drugs

H2 antagonist: cimetidine, ranitidine PPI: omeprazole

Prokinetics

https://blog.naver.com/ijspmy9193/220597416778

• Levosulpiride
  • D2 antagonism -> increased Ach secretion
  • ??, tid
  • S/E
    • EPS, hyperprolactinemia
    • Aggravation of Parkinsonism
• Mosapride
  • 5-HT4 agonism -> prokinetics
  • 5-HT3 antagonism -> inhibit vomiting
  • ??? ??, tid
  • S/E
    • ??, ?? ?, ??, ??
• Erythromycin
  • Motilin agonist

Simethicone