000130203 001__ 130203
000130203 005__ 20241125101146.0
000130203 0247_ $$2doi$$a10.1080/14656566.2023.2199922
000130203 0248_ $$2sideral$$a133558
000130203 037__ $$aART-2023-133558
000130203 041__ $$aeng
000130203 100__ $$aBorao Laguna, Cristina
000130203 245__ $$aAdvances in the pharmacotherapeutic management of refractory peptic ulcers
000130203 260__ $$c2023
000130203 5060_ $$aAccess copy available to the general public$$fUnrestricted
000130203 5203_ $$aIntroduction: Refractory peptic ulcer is now a rare disease since most peptic ulcers heal with appropriate treatment with proton pump inhibitors (PPIs) and/or Helicobacter pylori eradication. Areas covered: The most frequent cause of apparent refractoriness is lack of adherence to treatment. Persistence of H. pylori infection, use or abuse (often surreptitious) of high dose non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin (ASA) are the two major causes of true refractory ulcers. There is a growing number of peptic ulcers which are not linked to either NSAIDs or H. pylori infection. Refractoriness in these ulcers can be linked to gastric acid hypersecretion, rapid PPI metabolization, ischemia, chemo-radiotherapy, immune diseases, more rarely to other drugs or be fully idiopathic. Treatment of the cause of the ulcer, if known, is essential. This review is based on pertinent publications retrieved by a selective search in PubMed, with particular attention to refractory peptic ulcer. Expert opinion: High-dose PPI or the new potassium competitive acid blocker or the combination of PPIs with misoprostol can be recommended in these cases. Other more experimental treatments such the topical application of platelet-rich plasma or mesenchymal stem cells have also been suggested. Surgery is the last option, but there is no guarantee of success, especially in NSAID or ASA abusers.
000130203 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000130203 590__ $$a2.5$$b2023
000130203 592__ $$a0.687$$b2023
000130203 591__ $$aPHARMACOLOGY & PHARMACY$$b180 / 354 = 0.508$$c2023$$dQ3$$eT2
000130203 593__ $$aMedicine (miscellaneous)$$c2023$$dQ2
000130203 593__ $$aPharmacology (medical)$$c2023$$dQ2
000130203 593__ $$aPharmacology$$c2023$$dQ2
000130203 594__ $$a5.6$$b2023
000130203 655_4 $$ainfo:eu-repo/semantics/review$$vinfo:eu-repo/semantics/acceptedVersion
000130203 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, Ángel$$uUniversidad de Zaragoza
000130203 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000130203 773__ $$g24, 7 (2023), 825-833$$pExpert opin. pharmacother.$$tEXPERT OPINION ON PHARMACOTHERAPY$$x1465-6566
000130203 8564_ $$s445802$$uhttps://zaguan.unizar.es/record/130203/files/texto_completo.pdf$$yPostprint$$zinfo:eu-repo/semantics/openAccess
000130203 8564_ $$s842185$$uhttps://zaguan.unizar.es/record/130203/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint$$zinfo:eu-repo/semantics/openAccess
000130203 909CO $$ooai:zaguan.unizar.es:130203$$particulos$$pdriver
000130203 951__ $$a2024-11-22-12:04:34
000130203 980__ $$aARTICLE