Pharmacotherapy of Duodenal and Gastric Ulcerations

PROLOGUE Peptic ulcer, an excavation in the mucosal lining penetrating below the muscularis mucosa of the stomach or duodenum (See Figure 1), is a common disorder. The incidence varies with the age, gender, and geographical location with duodenal ulcers occurring in approximately four to ten percent of the United States (U.S.) population and gastric ulcers occurring in less than one percent. Both gastric and duodenal ulcers are associated with severe complications including hemorrhages, perforations, gastrointestinal obstruction, and malignancy. Peptic ulcer disease and its complications cost the U.S. health care budget greater than three billion dollars annually. Based on the high incidence and the enormous amount of money that is spent on peptic ulcer disease, it is very important for pharmacists and pharmacy students to be educated about this disease and the medication regimens used to treat it. This lecture provides a basic review of the pathophysiology, clinical presentation and evaluation, and medications used to treat uncomplicated duodenal and gastric ulcerations.