Drug of choice for NSAID induced gastric ulcer is: September 2008, March 2012
**Core Concept**
NSAID-induced gastric ulcers are a common complication of non-steroidal anti-inflammatory drug (NSAID) therapy, which inhibits prostaglandin synthesis and impairs gastric mucosal defense mechanisms. The drug of choice for managing NSAID-induced gastric ulcers should ideally counteract these effects.
**Why the Correct Answer is Right**
Misoprostol, a synthetic prostaglandin E1 analogue, is the drug of choice for NSAID-induced gastric ulcers. It works by mimicking the protective effects of endogenous prostaglandins, promoting mucosal defense mechanisms, and enhancing gastric mucosal blood flow. This helps to counteract the ulcerogenic effects of NSAIDs and promote healing of existing ulcers.
**Why Each Wrong Option is Incorrect**
**Option A:** Ranitidine is a histamine-2 (H2) receptor antagonist that reduces gastric acid secretion, but it does not directly counteract the effects of NSAIDs on gastric mucosal defense mechanisms.
**Option B:** Omeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion, but it does not directly counteract the effects of NSAIDs on gastric mucosal defense mechanisms.
**Option C:** Sucralfate is a cytoprotective agent that forms a protective barrier over ulcers, but it does not directly counteract the effects of NSAIDs on gastric mucosal defense mechanisms.
**Clinical Pearl / High-Yield Fact**
Remember that misoprostol is the only drug that specifically counteracts the ulcerogenic effects of NSAIDs by promoting prostaglandin-mediated mucosal defense mechanisms.
**Correct Answer:** C. Misoprostol.