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

GroupExamples
Proton pump inhibitorsOmeprazole
H2 receptor antagonistsRanitidine
AntacidsAluminium hydroxide
Mucosal protective agentsSucralfate, 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.

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