GT is a 59-year-old man with a documented NSAID-induced ulcer, who is Helicobacter pylori negative. He needs to continue taking an NSAID for severe osteoarthritis. Which is the preferred medication for treating NSAID-induced ulcer? Select all that apply.
Lansoprazole
Misoprostol
Ranitidine
Sucralfate
Answer a is correct. A PPI is the agent of choice if the NSAID must be continued in the presence of ulcer disease. If a patient tests positive for H. pylori, treatment is recommended.
Answer b is incorrect. Misoprostol is indicated for the prevention of NSAID-induced gastric ulcers.
Answer c is incorrect. H2-receptor antagonists have been shown to prevent only duodenal ulcers and therefore should not be recommended for prophylaxis of gastric ulcers.
Answer d is incorrect. Sucralfate has not been shown to be effective in preventing or treating NSAID-related ulcers.