25. In the event of hemorrhage associated with excess Heparin administration, wh

Question

25. In the event of hemorrhage associated with excess Heparin administration, which of the following can be administered as an antidote? a) Sucralfate b) Vitamin K c) Thrombin d) Protamine Sulfate 26. A 44-yr old woman with recurrent peptic ulcer disease has not experienced any relief despite an aggressive regimen for Helicobacter pylori (amoxicillin and clarithromycin) and hig doses of cimetidine. Her lab results are normal except for an elevated fasting gastrin level of 4,567pg/ml (normal: 1-100 pg/ml). Endoscopic examination revealed the presence of esophageal and duodenal ulcerations. What drug would you use to best treat your patients condition? a) Omeprazole b) Ranitidine c) Atropine d) Sucralfate

Explanation / Answer

25. In the event of hemorrhage associated with excess heparin administration ,which of the following can be administered as an antidote?

ANS.D

a) SUCRALFATE: It is a gastric mucosa protectant. Helps in treatment of duodenal ulcers. Reduces the gastroesophageal reflux.

b)VITAMIN- K : It is a fat solube vitamin. It helps in blood clotting mechanism and prevent excessive bleeding. It is an antidote to Warfarin overdosage.

c)THROMBIN: Thrombin is an enzyme involved in hemostasis, it acts an catalyst in the conversion of fibrinogen to fibrin which is important for blood clotting.

d) PROTAMINE SULPHATE: It is the antidote for heparin overdosage. Protamine sulphate 1mg can neutralise 100 units of heparin.The protamine sulfate injection should be given by slow intravenous route.

26.A 44yr old woman with recurrent peptic ulcer disease has not experienced any relief despite an aggressive regimen for helicobacter pylori(amoxicillin and clarithromycin)and high doses of cimentidine. Her lab results are normal except for an elevated fasting gastrin level of 4,567pg/ml (normal:1-100pg/ml). Endoscopic examination revealed the presence of esophageal and duodenal ulcerations. What drug would you use to best treat your patients condition?

ANS:A

a) Omeprazole: It is used in treatment of GERD, peptic ulcer disease and Zollinger- ellison syndrome. It acts by reducing the acid secretion in stomach . The elevated levels of fasting gastrin may be a symptom of Zollinger- ellison syndrome . Omeprazole being a proton pump inhibitor is effective in treatment for the patient's condition.

b)Ranitidine: Ranitidine is a H2 receptor antagonist helps to reduce stomach acid. It also helps to treat patient with Zollinger- ellison syndrome , but here as the fasting gastrin level is very high ranitidine is not first drug of choice.

c)Atrophine: Atrophine is an anticholinergic and muscarinic agent used to reduce secretions like saliva and bronchial. It can help in reducing gastric secretions but in minimal amount only.

d)Sucralfate: It is  used to treat ulcers of the upper GI tract. Sucralfate is used to treat pepticulcer disease and prevent ulcers from recurring

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