Download - DrugsAffectingtheGastrointestinalSystem
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Dru sAffectin theDru sAffectin the
GastrointestinalSystemGastrointestinalSystem
CaiyingYECaiyingYE
Departmentof
Pharmacology,
Department
of
Pharmacology,
SchoolofBasicMedicine,SchoolofBasicMedicine,
PekingUnionMedicalCollegePekingUnionMedicalCollege
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ep c
cersep c
cers
ommon sease nc ence ra e: .
Pathogenesis of ulcers
ggress ve ac ors e ens ve ac ors
Acid e sin Mucus,bicarbonatelayer
Bilesalts Bloodflow,cellrenewal
Drugs(NSAIDs)
H.pylori
rostag an ns
Phospholipid
Freeradicalscavengers
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Mostcommondisorderoftheeso ha us
Characterizedby
regurgitation
of
gastric
contents
intotheesophagus
Occursmostoftenafterameal
Worsewhen
recumbent
Causedbyincompetentloweresophagealsphincter
Foods
that
cause
relaxation
include:
caffeine,
fats,
, ,medications(betaadrenergicblockers,calciumchannelblockers,nitrates)
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EsophagusEsophagus isis notnot equippedequipped toto handlehandle stomachstomach acidacid=>=> scaringscaring
UsualUsual symptomsymptom isis heartburn,heartburn, anan uncomfortableuncomfortable
burningburning sensationsensation behindbehind thethe breastbonebreastbone (MI(MI oftenoftenm s a enm s a en oror
MoreMore severesevere symptomssymptoms:: difficultydifficulty swallowing,swallowing, chestchest
RefluxReflux intointo thethe throatthroat cancan causecause soresore throatthroat
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esophagealesophageal ulcerulcer andand narrowingnarrowing ofof thethe esophagusesophagus(esophageal(esophageal stricture)stricture)
InIn somesome patients,patients, thethe normalnormal esophagealesophageal lininglining oror
epitheliumepithelium maymay bebe replacedreplaced withwith abnormalabnormalarre sarre s ep e umep e um.. ss con oncon on arre sarre s
esophagus)esophagus) hashas beenbeen linkedlinked toto cancercancer ofof thethe
..
PrimaryPrimary treatmenttreatment :: protonproton pumppump inhibitorsinhibitors
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PepticUlcersPepticUlcers
Therapy Purpose
Therapyis
directed
at
en anc ng os e enseor
eliminatingaggressive
. .,
.
.
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DrugsUsed
in
Peptic
UlcersDrugs
Used
in
Peptic
Ulcers
Inhibitorsof
gastric
acid
production
Proton
pump
inhibitors
Gastrinreceptorantagonist
AntiHelicobacterpylori.drugs
Acid PumpAcid Pump
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aluminumhydroxide
magnesiumhydroxide
H2 rece tor anta onists
cimetidine
ranitidine
Muscarinicanta onists
atropine
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DrugsUsed
in
Peptic
UlcersDrugs
Used
in
Peptic
Ulcers
Protonpump
inhibitors
Gastrinreceptor
antagonist
MucosalProtectants
AntiHelicobacterpylori.Drugs
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AntacidsAntacids
General characteristics
Antacids are weak bases that are taken orally
and that partially neutralize gastric acid and
reduce pepsin activity. Antacids reduce the pain associated with ulcers
and may promote healing. High doses are
times daily.
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Magnesium hydroxide (constipation)
um num y rox e
Sodiumbicarbonate
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22
Competitively block the histamine (H2) receptor of
rendering cells less responsive to not only histamine
gastrin.
gastrin stimulated acid secretion.
com lete inhibition has not been shown
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22
Four
FDA
approved:Cimetidine Ta ametRanitidine Zantac amot ne epc Nizatidine AxidRoxatidine
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HH22receptor
antagonistsreceptorantagonists
Therapeutic effects: Promote the healin of astric and
duodenal ulcers
Upper GI bleed [GIB]
May be effective in stress ulcers &
peptic esophagitis
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H2H2receptor
antagonistsreceptorantagonists
Overalllow