Which agent is used specifically to prevent NSAID-induced ulcers in patients who must continue NSAID therapy?

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Multiple Choice

Which agent is used specifically to prevent NSAID-induced ulcers in patients who must continue NSAID therapy?

NSAIDs increase ulcer risk because they inhibit prostaglandin synthesis, which normally protects the gastric lining by promoting mucus and bicarbonate production and maintaining mucosal blood flow. To prevent NSAID-induced ulcers in patients who must continue NSAID therapy, the agent that directly counteracts this disruption is a prostaglandin E1 analog. Misoprostol replenishes the protective prostaglandins, boosting mucus and bicarbonate, improving mucosal blood flow, and even reducing acid exposure. This mechanism addresses the exact gap NSAIDs create in gastric defenses, making misoprostol specifically effective for ulcer prophylaxis in long-term NSAID users. Typical dosing is about 200 mcg four times daily with NSAIDs, though it can cause diarrhea and abdominal cramps and is contraindicated in pregnancy due to uterine contractions. H2 blockers, sucralfate, and antacids can help with general gastric symptoms or healing but do not provide the prostaglandin-mediated mucosal protection that misoprostol offers for NSAID-associated ulcer prevention.

NSAIDs increase ulcer risk because they inhibit prostaglandin synthesis, which normally protects the gastric lining by promoting mucus and bicarbonate production and maintaining mucosal blood flow. To prevent NSAID-induced ulcers in patients who must continue NSAID therapy, the agent that directly counteracts this disruption is a prostaglandin E1 analog. Misoprostol replenishes the protective prostaglandins, boosting mucus and bicarbonate, improving mucosal blood flow, and even reducing acid exposure. This mechanism addresses the exact gap NSAIDs create in gastric defenses, making misoprostol specifically effective for ulcer prophylaxis in long-term NSAID users. Typical dosing is about 200 mcg four times daily with NSAIDs, though it can cause diarrhea and abdominal cramps and is contraindicated in pregnancy due to uterine contractions.

H2 blockers, sucralfate, and antacids can help with general gastric symptoms or healing but do not provide the prostaglandin-mediated mucosal protection that misoprostol offers for NSAID-associated ulcer prevention.

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