Antiulcer PDF

What is ulcer ? - sores /open wound on the skin/along lining...

What is ulcer ? - sores /open wound on the skin/along lining , of digestive tract due to loss of tissue · ! Type of ulcer 3 - ↓ lend) peptic mouth Genital Esophageal Pressure ulcers sores ulcer ukers ulcers / Cstomach (heartburn ( confined tobed quodenum) Factors (Aggresive · too much acid) imbalance digestive · Helocobacter · Ingestion of NSAIDS Stress fluids (HCl3 pepsin ) pylori b ↓ I ↓ ↓ gastric neutralization Anti-H ulcer. pylovi protective acid of gastric drug aruy secretion acid · Hareceptor blocker · Amoxicillin · Sucralfate (cimetidine , ranitidine · Proton pump · Clarithromycin inhibitors · Metronidazole · Prostaglandin Tinidazole muscarinic Comeprazole analogues · · , antagonists Pantoprazole) · Tetracycline (Misoprotosol ( (pirenzipine Sielen zepine · Antacids · Miscellaneous /systemic sodium bicarbonate drug (non-systemic Magnesium hydroxide) : Hang bak APA Mau Pimati Sana Mai  Drug MOA Adverse reaction Ha antagonist · competitively block He · Headache , dry mouth (parietal cell) CNS confusion · · Famotidine receptor : · Cimetidine inhibit gastric acid secretion) Histamine (Bradycardiac , · Ranitidine · suppress acid (mainly noctural) arrhythmia cardiac arrest) · ↓ acid (by Ach food gastrin , , · Cimetidine (antiadrogenic) Uses barriers ↳ can cross placental gynecomastia galactone - , reach milk , CNS (Cant) ↳ inhibit Cyp - 50 isoenzyme - half life : 1-4hrs · inhibit metabolism of drug hepatic metabolism + glomerular filtra, (Theophylline , metronidazole impramine - , renal tubule secretion phenytoin ↳ Antacid >X absorption H2-block Proton pump · Sulfonamide + sulphenic acid] · Nausea , loose stook, inhibitor /most effective drug) 2 rationic charged bind with headache , muscle pain , (inhibit omepraz de Sulfhydry) (SH)-H+ k ATPase rashes + · o Pantoprazole · gastric mucosal carbonic anhydrase orare - > Gynecomastia , leucopenia · Lansoprazole concentration of protonated Osteoporosis hypergastrinemia , · Esomeprazole omeprazole in acidic compartment Omeprazole ' (metabolism) Inhibit """ · need acid (activation]. · meprazole. > reactive metabolite warfarin , phenytoin formation of enzyme- inditor complex diazepam & cyclosporine Irreversible inhibition pump Lansoprazole rapid onset H,. pulori) · enteric-coated tablet Pantoprazole (Cy9450 less affinity) · 1st line drug shorth = 1-ahrs Rabeprazole (most rapid (4 rate Esomeprazole healing block a of Muscarinic · M, class · incidence (Acetylcholine ( ↓ acid production anticholinergic side effects ↓ meal stimulated HC) antagonist (dry mouth blurred · , · Pirenzepine by block mi receptor vision ( Telenzepine · ↳ not & pH , ↓ volume gastric juice  Drug MOA Adverse effect Prostaglandin · Diarrhea , uterine bleed, analogues ~ NSAID-induced uker abortion , inflammatory · Misoprostol ↑ local · production of mucus/bicarbonate bowel disease ↳ prevent NSAID-induced maintain mucosal blood mucosal injury · 200mg 14x a day) Antacids (weak bases) neutralize acid inhibit pepsin systemic alkalosis · : · safe for pregnancy · discomfort3 blenching ! systemic · rebound acidicity · Sodium Bicarbonate - potent neutralizing capacity > - antacid Hantihypertensive Streat heartburn - pH may raise above 7 drugs ↓ effect Non Aluminum antacid systemic · · Magnesium hydroxide-HCl + MgO-MyC + Hoo ↳ constipation,osteomaicia I · Magnesium trisilicate MgC1 + H1O3 (v HCOs absorption) Mg2 + -osmotic diarrhea · Aluminium Hydroxide · Al + antacid > - aluminum & toxicity encephalopathy miscellaneous drug · Simethicone ↓ surface telision > - ↓ bubble formation (prevent reflux · Alginates · form a layer of foam on top of gastric contents & ↓ reflux · Oxethazine · surface anesthetic  II Sucralfate · polymerises by cross-linking constipation Calumium Salt molecules > - sticky Visions get o hypophosphatemia ↳ of sulfated adhere to ulcer crater Astringent & I · effective than Ha sucrose ( act as physical barrier antagonist 3 - PPI · dietary protein deposited - absorb many drug L frm another coat interfere their absorption Colloidal Bismuth · LBs 3 mucus coated unercrater tongue , stools , dentreses (black) Subcitrate (CBS) · a mucous 3 bicarbonate · osteo dystrophy & encephalopathy · detach H - pylon Kill · diarrhea , headache , dizziness Antibiotics /Eradication of H. pylori Triple theory 12 antibiotics + 1 anticler agent ( Amoxycillin t Tetracycline + Bismuth/PPI · innibit cell wall · inhibit bacterial synthesis protein · best triple therapy regimen Omeprazole/Lansoprazole + Clarithomycin + Amoxycillin/Metronidazole Quadruple therapy Best therapy · Omeprazole/Lansoprazole + Bismuth subalycilate + Metronidazole + Tetracycline  5 S 2 3 4