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Questions and Answers
What is the primary cellular mechanism that initiates gastric acid secretion?
What is the primary cellular mechanism that initiates gastric acid secretion?
Which ethnic group demonstrated the highest prevalence of gastritis according to the study conducted in Malaysia?
Which ethnic group demonstrated the highest prevalence of gastritis according to the study conducted in Malaysia?
What effect do proton pump inhibitors primarily have on gastric acid secretion?
What effect do proton pump inhibitors primarily have on gastric acid secretion?
Which mechanism is NOT involved in the regulation of gastric acid secretion?
Which mechanism is NOT involved in the regulation of gastric acid secretion?
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What is a major risk factor for developing gastritis as indicated by the study findings?
What is a major risk factor for developing gastritis as indicated by the study findings?
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Which class of drugs is generally used to neutralize gastric acid?
Which class of drugs is generally used to neutralize gastric acid?
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What role do enterochromaffin-like cells (ECL cells) play in gastric secretions?
What role do enterochromaffin-like cells (ECL cells) play in gastric secretions?
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What is the outcome of increased gastric acidity in the digestive system?
What is the outcome of increased gastric acidity in the digestive system?
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Which hormone directly activates parietal cells through M3 cholinoceptors?
Which hormone directly activates parietal cells through M3 cholinoceptors?
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What compound is formed when H+, Cl-, and H2O combine in the stomach?
What compound is formed when H+, Cl-, and H2O combine in the stomach?
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Which factor does NOT stimulate gastric acid secretion?
Which factor does NOT stimulate gastric acid secretion?
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What role does histamine play in gastric acid secretion?
What role does histamine play in gastric acid secretion?
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Which medication is known to contribute to the breakdown of the protective layer in the stomach?
Which medication is known to contribute to the breakdown of the protective layer in the stomach?
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What is the primary bacterial cause of peptic ulcers?
What is the primary bacterial cause of peptic ulcers?
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What effect does cholecystokinin (CCK) have on parietal cells?
What effect does cholecystokinin (CCK) have on parietal cells?
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What is the primary mechanism by which proton pumps secrete H+ ions?
What is the primary mechanism by which proton pumps secrete H+ ions?
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What is a common symptom of peptic ulcers?
What is a common symptom of peptic ulcers?
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Which medication group is known to irritate the stomach lining and potentially cause ulcers?
Which medication group is known to irritate the stomach lining and potentially cause ulcers?
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Which of the following lifestyle factors can increase the risk of peptic ulcers?
Which of the following lifestyle factors can increase the risk of peptic ulcers?
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What is the primary mode of transmission for H.pylori infection?
What is the primary mode of transmission for H.pylori infection?
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What is NOT a part of the triple-drug therapy for treating H.pylori infection?
What is NOT a part of the triple-drug therapy for treating H.pylori infection?
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Which type of foods can contribute to peptic ulcer risk by irritating the stomach lining?
Which type of foods can contribute to peptic ulcer risk by irritating the stomach lining?
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What effect do NSAIDs have on mucus secretion in the stomach?
What effect do NSAIDs have on mucus secretion in the stomach?
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Which other medication type can increase the risk of ulcers when taken with NSAIDs?
Which other medication type can increase the risk of ulcers when taken with NSAIDs?
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What substances are commonly avoided in the non-pharmacological treatment of peptic ulcers?
What substances are commonly avoided in the non-pharmacological treatment of peptic ulcers?
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What is the primary action of non-systemic antacids?
What is the primary action of non-systemic antacids?
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What is the danger of untreated gastroesophageal reflux disease (GERD)?
What is the danger of untreated gastroesophageal reflux disease (GERD)?
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Which of the following treatments is considered systemic for peptic ulcers?
Which of the following treatments is considered systemic for peptic ulcers?
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What does the term 'barium swallow' refer to in medical imaging?
What does the term 'barium swallow' refer to in medical imaging?
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Which of the following is a potential side effect of using non-systemic antacids?
Which of the following is a potential side effect of using non-systemic antacids?
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Which of the following is NOT a recommended non-pharmacological strategy for managing peptic ulcers?
Which of the following is NOT a recommended non-pharmacological strategy for managing peptic ulcers?
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What is a common characteristic of the substances used in non-systemic antacids?
What is a common characteristic of the substances used in non-systemic antacids?
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Which class of drugs includes amoxicillin and clarithromycin?
Which class of drugs includes amoxicillin and clarithromycin?
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What is the primary action of proton pump inhibitors (PPIs)?
What is the primary action of proton pump inhibitors (PPIs)?
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Which medication is contraindicated in pregnancy due to its association with self-induced abortion?
Which medication is contraindicated in pregnancy due to its association with self-induced abortion?
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What is the mechanism of action for sucralfate in treating ulcers?
What is the mechanism of action for sucralfate in treating ulcers?
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Which drug has been withdrawn from the US market due to safety concerns?
Which drug has been withdrawn from the US market due to safety concerns?
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Antacids provide rapid relief by doing what?
Antacids provide rapid relief by doing what?
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What condition is indicated by a burning sensation in the chest?
What condition is indicated by a burning sensation in the chest?
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Which of the following is a mechanism of action for misoprostol?
Which of the following is a mechanism of action for misoprostol?
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Which diagnostic test is considered most accurate for detecting H.pylori infection?
Which diagnostic test is considered most accurate for detecting H.pylori infection?
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Which of the following medications is classified as an H2 blocker?
Which of the following medications is classified as an H2 blocker?
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What symptom can improve when eating, drinking, or taking antacids?
What symptom can improve when eating, drinking, or taking antacids?
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Which factor may prompt a doctor to recommend endoscopy as a diagnostic procedure?
Which factor may prompt a doctor to recommend endoscopy as a diagnostic procedure?
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What should patients inform their doctor about prior to H.pylori testing?
What should patients inform their doctor about prior to H.pylori testing?
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What may be observed in vomit if there is internal bleeding?
What may be observed in vomit if there is internal bleeding?
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Which test is NOT typically used to diagnose a peptic ulcer?
Which test is NOT typically used to diagnose a peptic ulcer?
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Anemia can cause which of the following symptoms?
Anemia can cause which of the following symptoms?
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Study Notes
Pharmacotherapy of GIT and Respiratory Disorders RPB20403
- Course name: Pharmacotherapy of GIT and Respiratory Disorders
- Course code: RPB20403
- Instructor: Dr. Omar AH
- Date: 20.08
Topic 2: Drugs used to inhibit or neutralize gastric acid secretion
- Learning Outcomes:
- Pathophysiology of ulcers
- Regulation of acid secretion by Parietal cells
- Causes and risk factors
- Signs and Symptoms/Diagnosis
- Antacids & dimethicone
- Histamine (2) antagonist
- Proton Pump Inhibitors
- Prostaglandin analogues
- Drugs are used to reduce gastric acid secretion for conditions like ulcers.
Prevalence of Gastric Acid in Malaysia
- Study conducted in Selangor, Malaysia in 2017
- Participants were Malaysians aged 18+
- Malay ethnicity had the highest percentage of gastritis (50.8%)
- 56.6% of Malaysians were affected by H. pylori induced gastritis.
The pH Scale
- Ranges from 0 to 14
- 0 to 6.9: Acidic
- 7: Neutral
- 7.1 to 14: Alkaline
- Common examples of substances on the scale are shown:
- Battery (0)
- Lemon (-)
- Tomato
- Milk (+)
- Blood (+)
- Stomach Tablets
- Soap (-)
- Drain Cleaner (-)
GIT is part of the digestive system
- Nervous and endocrine systems work together
- Controlling gastric secretions and motility
- Movement of food throughout the GIT
Where gastric secretion starts
- Food triggers digestive juices secretion.
- Stomach releases gastrin to promote stomach acid production.
- Intestine releases secretin and cholecystokinin to stimulate pancreatic juice and bile secretion
Gastric Acid Secretion Mechanism
- Acetylcholine (ACh) signal from the vagus nerve activates parietal cells.
- Activating enterochromaffin-like cells (ECL) cells.
- Activation of G-cells.
- G and ECL cells further activate parietal cells
Parietal Cell Mechanism
- Active transport of H+ ions from the cell occurs in exchange for K+ ions.
- Cl- ions are secreted into the lumen by simple diffusion
- Stomach's acidic environment (HCl) is crucial for digestion.
Mechanism of gastric acid secretion
- Acetylcholine (ACh) from vagus nerve activates parietal cells.
- Gastrin-releasing peptide (GRP) releases gastrin which activates parietal cells.
- Histamine from ECL cells activates neighboring parietal cells.
Causes & risk factors of peptic ulcer
- Factors that stimulate gastric acid secretion:
- Stress
- Alcohol
- Caffeine
- Smoking
- Spicy foods
- Oily foods
- Factors that cause the breakdown of the protective layer
- H. Pylori infection
- Medications
- Steroids
- NSAIDs (Nonsteroidal anti-inflammatory drugs)
Causes and risk factors that contribute to ulcer
- A bacterium (Helicobacter pylori) lives in the mucous layer.
- Pain relievers (NSAIDs) irritate or inflame the stomach lining.
- Other medications with NSAIDs.
- Smoking increases the risk of peptic ulcers, particularly in people infected with H. pylori.
- Alcohol irritates, erodes the stomach’s lining. Increased stomach acid production.
- Untreated stress
- Spicy and oily foods
Helicobacter pylori
- Gram-negative, flagellated, spiral bacterium
- Infection does not always cause illness
- Chronic infection can cause inflammation, leading to peptic ulcers.
- Treatment includes triple-drug therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin for 14-21 days.
Gastric Acid Secretion Mechanism (Pathophysiology)
- H. pylori produces urease, neutralizing gastric acid, damaging the mucosa
Factors that cause the breakdown of the protective layer of stomach
- NSAIDs inhibit cyclooxygenase (COX) enzyme.
- Inhibiting the production of prostaglandins, which are crucial for mucosal protection.
Peptic Ulcers Signs and Symptoms
- Common symptoms include: Nausea, vomiting, hematemesis (vomiting blood), coffee-ground vomit, indigestion, dyspepsia, epigastric discomfort, iron deficiency anemia, melena (tarry black stools), dull stomach pain.
Peptic Ulcers Signs and Symptoms
- Symptoms (further details on types of pain, possible improvement with food or antacids, and other symptoms like weight loss.)
Diagnosis of Peptic Ulcer
- Medical history
- Physical exam
- H. pylori tests (Urea breath test)
- Endoscopy and biopsy.
- X-rays (barium swallow)
Peptic Ulcer Diagnosis
- Laboratory testing for H. pylori.
- Endoscopy (upper digestive tract examination using a scope).
- Upper gastrointestinal (GI) series X-rays (barium swallow).
Types of Peptic Ulcer Disease
- Duodenal ulcers
- Esophageal ulcers
- Gastric ulcers
Peptic Ulcer Management
- Non-pharmacological treatment
- Avoiding spicy and oily foods, alcohol, smoking.
- Encouraging small, frequent meals, eating healthy and green vegetables and fruits
- Avoiding ulcerating drugs (e.g., NSAIDs, corticosteroids)
- Managing stress
15 Foods to Avoid if you have a Stomach Ulcer
- List of foods to avoid
Pharmacological treatment of Ulcer & GERD
- Systemic vs. Non-systemic medications.
MOA: Non-systemic anti-acids
- Antacids work by neutralizing gastric acid.
What is gastroesophageal reflux disease (GERD)?
- Stomach acids, food and fluids flowing back into the esophagus.
- Issues like inflammation that can lead to esophageal cancer
- Respiratory problems (asthma, fluid in lungs, chest congestion), damaging the teeth.
E.g. of Non-systemic anti-acids
- Different types of anti-acids, including Maalox and Gaviscon
Dimethicone (Simethicone)
- Anti-foaming agent, reducing bloating or excessive gas.
How about peptic ulcer long-term treatment
- Reducing gastric acid secretion
- Protecting stomach mucosa
- Conditions like peptic ulcers, GERD, and Zollinger-Ellison syndrome.
MOA: Systemic anti-acids
- Reduce gastric acid secretion by preventing the stimulation of parietal cells.
- Prostaglandin analogues, proton pump inhibitors, and H2 receptor antagonists.
Antiacid classes
- Systemic and Non-systemic antacids
- Antacids, H2 receptor antagonists, proton pump inhibitors
- Adjunct medications
- Prokinetics, bismuth chelates
- Types of medications used
Antibiotic medications for H. pylori
- Medications to kill bacteria
- Amoxicillin, Clarithromycin, Metronidazole, and Levofloxacin
- Combining PPI with Antibiotic
Histamine-2 (H2) receptor antagonists (H2 blockers)
- Cimetidine, Famotidine, and Ranitidine.
- Different dosages for different illnesses.
Proton pump inhibitors (PPIs)
- Omeprazole, Pantoprazole, Dexlansoprazole.
- Different dosages for different illnesses, depending on the illness or procedure.
Mucosal Protective Agents
- Sucralfate and Bismuth subsalicylate
- Effectiveness as a protective agent.
Treatment and drugs action in ulcer
- Antibiotics for H. pylori infection
- Medications to block acid production
- Medications that reduce acid
- Medications that protect the stomach lining
Complications of untreated ulcers
- Perforation of the stomach
- Bleeding
- Scarring and stricture.
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Description
Test your knowledge on the cellular mechanisms involved in gastric acid secretion and its regulation. This quiz covers key concepts such as the role of proton pump inhibitors and demographic factors relating to gastritis prevalence. Perfect for students studying human physiology and gastroenterology.
