Gastrointestinal pharmacology Drugs used in Peptic ulcer

 

peptic-ulcer-in-children-1

Definition:An ulceration of the mucous membrane of the oesophagus,stomach or duodenum caused by the action of the gastric juice/caused by acid-pepsin digestion.

Sites:

1)      1st part of duodenum.

2)      Stomach(lesser curvature,antrum).

3)      Lower end of oesophagus.

4)      At the site of gastro-jejunostomy.

5)      Meckel’s diverticulum.

List the drugs used in peptic ulcer:

      Cause
1.Antacids ·         Mg tri-silicate.

·         Al

·         NaH

·         CaC

To neutralize the secreted HCL and thus reduction of intragastric acidity.
2.Anti-histamines ·         Ranitidine.

·         Cimetidine.

·         Famotidine.

·         Nizatidine.

Reduction of acid secretion by blocking  receptors
3.Proton pump inhibitors ·         Omerprazole

·         Lansoprazole

·         Esomeprazole

·         Pantoprazole

·         Rabeprazole

Inhibit –  ATPase leading to drcreased  secretion in the lumen.
4.Antimuscurinic drugs ·         Pirenzepine

·         Telezepine

Inhibit Ach secretion that potentiates HCL secretion.
5.Mucosal resistance enhance(ulcer healers) ·         Prostaglandin analogs

(misoprostol)

·         Sucralfate(Al sucrose sulfate)

·         Bismath collidal subcitrate(BCS)

Chelate the protein material in the ulcer base & protecting it from acid pepsin.
6.Antibiotics ·         Amoxycillin.

·         Ciprofloxacin.

·         Doxycycline.

·         Metronidazole

To kill H.pylori that may cause ulcer.
7.PG Misoprostol 1.↑mucous &  secretion.

2.↓gastirc acid secretion.

3.↑blood flow.

Principles of treatment of peptic ulcer:

[A]Relieve of pain by raising gastric  (alkalization):

a) Neutralization of gastric acid by antacids.

b) Inhibition of gastric secretion by-

  1.  blocker.
  2. Anti-cholinergic drugs.

iii.            PGE.

c) Surgical removal-gastrectomy(in chronic case)

[B]To prevent complication.

[C]To promote healing:

a) Bed rest & secretion-Diazepam.

b) Use of ulcer healer drugs-Simethocane,Sucralfate.

[D]To prevent recurrence:

a) Regular diet.

b) Avoid ulcerogenic drugs-Aspirin,Steroids.

c) Avoid smoking,alcohol,tea coffee.

Why antacids are used in peptic ulcer because Antacids are used in peptic ulcer to relive pain caused by nerve irritation & tissue destruction in ulcer by HCL.

The benefits of antacids are:

1)      Antacid reduces or neutrilizes gastric acidity.

2)      More than  5 of gastric content inactivates the pepsin.

3)      Al &Mg directly inactive the pepsin.

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