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Updated: Feb 22 2018

Bismuth and Sucralfate

  • Sucralfate
    • Mechanism
      • provides physical protection to ulcer base
        • requires low pH to activate into a paste consistency that adheres to the mucosal wall
        • action may be inhibited by antacids
    • Clinical use
      • ↑ ulcer healing
      • ↓ ulcer recurrence
  • Bismuth subsalicylate
    • Mechanism
      • similar to sucralfate
    • Clinical use
      • ↑ ulcer healing
      • traveler's diarrhea
      • quadruple therapy of H. pylori ulcers (BMT regimen)
        • Bismuth
        • Metronidazole
        • Tetracycline (amoxicillin)
        • PPI
    • Toxicity
      • harmless black coloring of stool
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