Paper II — 2023 January (Supplementary) (2019 Scheme) — Q5
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Paper II
2023 January (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
(
(a) Classify the drugs used in the pharmacotherapy of Peptic ulcer. Discuss the
pharmacological management of Helicobacter pylori infection.
( 3 mark(s)
(b) Briefly describe Methotrexate. 2 mark(s)
Q55 marksShort Essays
Answer
a) Classification for peptic ulcer, and H. pylori management
Group
Examples
Proton pump inhibitors
Omeprazole
H2 receptor antagonists
Ranitidine
Antacids
Aluminium hydroxide
Mucosal protective agents
Sucralfate, Misoprostol
Management of H. pylori infection: standard triple therapy — a PPI plus two antibiotics (typically Clarithromycin and Amoxicillin, or Metronidazole in penicillin-allergic patients) for 10-14 days; bismuth-based quadruple therapy (Bismuth, Metronidazole, Tetracycline, PPI) is used where clarithromycin resistance is prevalent or triple therapy has failed.
b) Methotrexate
A folate-antagonist antimetabolite. MOA: competitively inhibits dihydrofolate reductase, blocking tetrahydrofolate regeneration and halting purine/thymidine synthesis. Uses: acute lymphoblastic leukemia, choriocarcinoma; low-dose — rheumatoid arthritis, psoriasis. Adverse effects: bone marrow suppression, hepatotoxicity, mucositis, teratogenicity.