Drugs Used in H. pylori Induced Peptic Ulcers

Classification of Drugs

Antibiotics:
- Amoxicillin: Disrupts cell wall synthesis of *H. pylori*.
- Clarithromycin: Inhibits protein synthesis by binding to the 50S ribosomal subunit.
- Metronidazole: Produces free radicals that damage *H. pylori* DNA.
- Tetracycline: Inhibits protein synthesis by binding to the 30S ribosomal subunit.
Proton Pump Inhibitors (PPIs): Inhibit H+/K+ ATPase in the stomach lining, blocking acid production.
Bismuth Compounds: Coats the ulcer surface, provides protection and has bactericidal effects on *H. pylori*.
Histamine-2 Receptor Antagonists (H2RAs): Block H2 receptors on parietal cells, reducing acid secretion.

Antibiotics:
- Amoxicillin: Diarrhea, allergic reactions, nausea.
- Clarithromycin: Gastrointestinal upset, taste disturbances, risk of QT prolongation.
- Metronidazole: Metallic taste, nausea, disulfiram-like reaction with alcohol.
- Tetracycline: Photosensitivity, gastrointestinal discomfort, tooth discoloration (in children).
Proton Pump Inhibitors (PPIs): Headache, nausea, diarrhea, potential long-term risks (B12 deficiency, osteoporosis).
Bismuth Compounds: Blackened stools, darkened tongue, constipation.
Histamine-2 Receptor Antagonists (H2RAs): Dizziness, constipation, headache, drug interactions.

Antibiotics:
- Amoxicillin: Contraindicated in patients with penicillin allergy.
- Clarithromycin: Avoid in patients with QT prolongation or arrhythmias.
- Metronidazole: Avoid alcohol due to disulfiram-like reaction.
- Tetracycline: Contraindicated in pregnancy and children under 8 years.
Proton Pump Inhibitors (PPIs): Avoid in patients with hypersensitivity to PPIs; caution in osteoporosis patients.
Bismuth Compounds: Contraindicated in patients with renal impairment or aspirin allergy.
Histamine-2 Receptor Antagonists (H2RAs): Contraindicated in hypersensitivity to H2RAs; caution in renal impairment.

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