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GI prophylaxis

Indications: - risk for peptic ulcer - aspirin/NSAID use, NSAID gastropathy - stress ulcer prophylaxis Management: - proton pump inhibitors should be considered for patients on long-term antiplatelet therapy if: [1] a) history of peptic ulcer or gastrointestinal bleeding b) dual antiplatelet therapy or concomitant anticoagulation c) additional risk factors (age >= 60 [3], glucocorticoid use, dyspepsia, or gastroesophageal reflux) - famotidine 20 mg BID prevents peptic ulcers & erosive esophagitis in patients taking low-dose aspirin [2] - see stress ulcer prophylaxis & stress ulceration for hospitalized patients

Related

gastritis peptic ulcer disease (PUD)

Specific

stress ulcer prophylaxis

General

prophylaxis (prevention, ppx)

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  2. Taha AS Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial. Lancet, Volume 374, Issue 9684, Pages 119-125, 11 July 2009 PMID: 19577798
  3. Li L, Geraghty OC, Mehta Z et al Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study. Lancet. Jun 13, 2017 PMID: 26227434 Free full text http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30770-5/fulltext - Diener HC Preventing major gastrointestinal bleeding in elderly patients. Lancet. Jun 13, 2017 PMID: 28622952 Free Article http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31507-6/fulltext