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PATHOPHYSIOLOGY. NSAID use. COX-1 inhibition. Migrate across the lipid membrane of epithelial cells. ↓prostaglandins in the gastric mucosa. Ion trapping. ↓ mucin secretion ↓HCO3 secretion ↑ HCl secretion ↓epithelial cell proliferation ↓mucosal blood flow.
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NSAID use COX-1 inhibition Migrate across the lipid membrane of epithelial cells ↓prostaglandins in the gastric mucosa Ion trapping ↓mucin secretion ↓HCO3 secretion ↑HCl secretion ↓epithelial cell proliferation ↓mucosal blood flow Direct epithelial cell toxicity Impairment of mucosal defense system
Disruption of mucosal integrity NSAID use ULCERATION Inhibition of TXA2 Ulcer burrow deeper into the gastric mucosa ↓platelet aggregation Injury to the blood vessels GI BLEEDING Melena Coffe-ground emesis