acid peptic ulcer disease drugs Flashcards
cells in cardia that secrete mucus
foveolar cells
fundus and body of stomach contains _ cells?
parietal and enterochromaffin-like cells
antrum and pyloric part of stomach contains what cells?
G-cells
receptors on parietal cells
- m3 r for ach
- h2 r for histamine
3.cck r for gastrin
inhibiton - sst-r for somatostatin
5.pge2 r for prostaglandin
stomach expansion activates - leading to release of ach
vagus nerve
g cells activated by - and releases
partially digested protein, gastrin
+ of enterochromaffin cells by- and they release-
gastrin and ach, histamine
mechanism of hcl production
- activationof m3, cck2,h2 r lead to co2 and h20 being converted to
- h ions and hco3 by carbonic anhydrase
- h ions pumped out into the lumen along with cl
moa of ppi
forms covalent disulfide bonds with h/k ATPase irreversibly (effect last till these pumps regenerate)
ppi’s 3 oral medications?
omeprazole
lansoprazole
dexlansoprazole
ppi’s iv medication?
pantoprazole
esomeprazole
ppi’s are - line of treatment for reducing -
1st, acid secretion
indications for ppi
Gastroesophageal reflux disease
Peptic ulcer disease
zollinger-ellison syndrome
H pylori-associated ulcers(weak antibacterial effect)
NSAID-associated ulcers
Prevention of rebleeding from peptic ulcers
Nonulcer dyspepsia
Prevention of stress-related mucosal bleeding
Gastrinoma and other hypersecretory conditions
days for ppis to reduce acid secretion
3-4 days
se of ppis
- gi disturbances like nausea, abdominal pain, diarhea
- nutritional def (bec the acid is needed for digestion)- ivxm- iron, vb12, calcium, magensium
- ecl hyperplasia
- respiratory(pnemonia) and enteric infection (no acid so loss of protective effect)
- headaches, rashes, osteoporosis
ppis reduce absoption of
- digoxin
2.ketocanozole - atazanavir
4.itraconazole
omeprazole and esomeprazole impair metabolism of
warfarin, diazepam, phneytoin
omeprazole inhibits liver enzyme that reduce activation of
antiplatelet drug- clopidogrel
h2 r antagonist moa
competetively bind to h2 receptors.
reduce mainly noctural acid secretion as well as food-stimulated acid secretion.
h2 antagonsist works within - hr of ingestion
1 hour
h2 antagonists names
cimetidine, ranitidine, famotidine, and nizatidine.
h2 antagonists indications?
peptic ulcers,
prevention of ulcers and stress ulcers, gastroesophageal reflux disease (GERD)
Zollinger-Ellison syndrome,