Drugs for Treatment of Ulcers PDF

for Treatment of Ulcers Drugs Acid Secretion in stomach > - In response to food , stomach distention ,...

for Treatment of Ulcers Drugs Acid Secretion in stomach > - In response to food , stomach distention , or CNS stimuli , the antral cells of the stomach release hormone peptide gastrin ↳ I main actions : ① stimulate enterochromafin-like cells to secrete m histamine (which asts on H, receptors on parietal m um cells to semaid) ② directly act on parietal cells by binding to gastron receptors and stimulating acid secretion Acid > - Controlling active process Secretion protons (H') > - transferred into stomach for pottassium (le ) + are exchange in ↳ carried out by proton pump (HT le"ATPase) , in parietal cells function of digesting > - acid into = convert protein enzyme pepsinogen pepsin - and acid uker if the protective pepsin can cause an barriers of the stomach are reduced Natural Defenses to Acid · Lower Esophageal Sphincter (LEs) ↳ prevents acids from the refluxing back up into esophages · Musous Neck Cell ↳ secrete that forms the surface a mucous a protective layer on of the stomach &secrates bicarbonate to neutralize acid lining near the mucosal surface - nonsteroidal anti inflammatory drugs that inhibit · Prostaglanding prostaglandin synthesis can inhibit this and cause peptic ulcers > - can also inhibit acid secretion by acting on prostaglandin receptors, protecting against ulcers in the stomach lining Druge that Control Acid · Antacids ↳ neutralize acid in the stomach · Histamine - 2 (H2) receptor antagonist Ha receptor antagonists prevent acid stimulation by > - histamine · Muscarinic receptor antagonists these drugs acid stimulation iduced > - inhibit by the nervous system · Proton pump Inhibitors > - block the actual acid secretory process Antacids alleline substance (calcium aluminum , magnesium salts ↳ are m , ↳ these wh asid the stomach the acid , react , being in reducing Irritation of gastric mucosa ↳ by decreasing acid , pepsin also decreases - enzyme that digests protein - fast acting (15 minutes) but duration of releif only 2 his ↳ used for excess acid often caused by over eating or drinking ↳ use for peptic ular disase and more so for acute heartburn ↳ classes of antacids : Systemic absorbed into the body · : - - sodium bicarbonate : Increases - sodium in take ↳ because excess sodium BP contributes Go , not be used itd ↳ calcium carbonate : can Animation cause (adverse effect)  · Non-systemic antacids : not absorbed into body ,man systemic > - (milk of magnesial magnesium hydroxide ↳ rapidly neutralizes stomach L combined to usually dea /adverse ↳ mu give laxitive is causes rapid and slow and effect) ↑ neutralizing effects ↳ aluminum hydroxide to ↳ neutralizes acid balence incidence of constipation effectively and diarned ↳ causes constipation (adverse mu effect) Muscarinic Antagonish parietal reduces inflce of nerve on acid blocking muscarin receptors cells rague > - on , Secretion 0% and histamine can reduce Am play greater > - as gastrin roue In stimulating acid secretion > - limited role in acid suppression He Antagonists > - the histamine B reptendingPralls ↳ histamine has Amule in acid secretion ↳ can suppress acid secretion by a - 70 % and they suppress and that's secreted at night > - 1-2 his last up to 12 are suppression occurs within , can > - relatively safe drags were the mainstay peptic alour therapy but have been replaced by > - once of , more effective proton pump inhibitor ex. Cimetidine limited clinical ase due to inhibition of P450s , 1 causing biotransformation of other drugs  Proton Pump Inhibitors > - effective mags most ~ Imore than H , agonists" by they inhibit the final step of acid > - Secretion permanently - bind the proton pump ↳ of activity pump can only be restored w/ synthesis of new protein For the pump reduce acd secretion 90 by > - % or more num > - all drage in this clase end in "-prazole" (ex. omeprazole acid for be effiction proton pumps actively secreting mumm drag to > - ↳ administration or = tonal Clinical Use of Proton Pump Inhibitors > - treatment of aler disease > - gastic > - Stress related alcre > - NSAID induced ulcers conditions where gastric acid suppression required > - ~ 2-5 %1. of patients > - adverse effects (low frequency d diarrhed considered of the safest drags for > one - headache Inhibiting acid secretion > - > - abdominal pain > - musel soreness > - shin rashe Consequences of Decreasing Acid · people that chronically reduce acid may become anemic (require B12 supplements > - add needed to release vitamin B12 from food for Salmonella and Shigella infections because acid needed to prevent colonization · risk is and infection in stomach · decreased acid loweve absorption of some drugs (ex, cardiac glycoside digoxin