All of the following drugs are included in the triple therapy of peptic ulcer, EXCEPT:

Appeared in: DSSSB 6 September 2024

Explanation

Vancomycin is a glycopeptide antibiotic that is not included in any standard regimen for eradicating H. pylori.
Its primary use is for treating serious infections caused by gram-positive bacteria, such as Methicillin-Resistant Staphylococcus aureus (MRSA) and Clostridium difficile.
H. pylori is a gram-negative bacterium, which falls outside the typical spectrum of vancomycin.

Option A: A Proton Pump Inhibitor (PPI) is a cornerstone of triple therapy.
Option B: Clarithromycin is one of the two standard antibiotics used in triple therapy.
Option D: Amoxicillin is the other standard antibiotic used alongside clarithromycin in triple therapy.

Clinical Relevance

Nursing practice connection: Knowing Pharmacotherapy for Peptic Ulcer Disease (H. pylori Eradication) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Patient education on completing the full 14-day course is critical for successful eradication and preventing the development of antibiotic resistance.
Nurses must assess for penicillin allergies before administering amoxicillin and be prepared to notify the provider, as metronidazole is the common alternative.
Monitoring for and managing common side effects like diarrhea, nausea, and a metallic taste in the mouth improves patient adherence to the therapy.

How to Approach the Question

First, identify the keyword 'EXCEPT'. This signals that you must find the option that does not belong in the specified group.
Next, focus on the core concept: 'triple therapy of peptic ulcer'. This treatment targets the H. pylori bacterium.
Recall the standard components of this therapy: a proton pump inhibitor (PPI) to reduce acid and two specific antibiotics.
The two standard antibiotics are Clarithromycin and Amoxicillin.
Review the options provided: Proton pump inhibitor, Clarithromycin, and Amoxicillin are all correct components of the therapy.
The remaining option, Vancomycin, is not part of this standard regimen, making it the correct answer to the 'EXCEPT' question.

Concept Tested & Keywords

Concept Tested: Pharmacotherapy for Peptic Ulcer Disease (H. pylori Eradication)
Stem keywords: drugs, triple therapy, peptic ulcer
Lead-in keywords: EXCEPT
Negative lead-in flag: The question uses the word 'EXCEPT', asking to identify the drug that is NOT part of the standard regimen.

QyYaRnrEORoAqzi0bggumh

E6 Medicine Harrison 22e Part 2 pp. 431-433, 432-434

Practise the full DSSSB 6 September 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.