Acid Secretion Flashcards
What are inflammatory streaks of the oesophagus indicative of?
GORD
What are the defensive factors of the gastric mucosa?
Epithelial integrity, cell replication and restitution, mucous membrane barrier, vascular supply
What are the aggressive factors affecting the gastric mucosa?
Acid, helicobacter pylori, drugs
Which receptors are present on the basolateral membranes of parietal cells?
ACh, cholecystokinin B, histamine 2
How long is the half life of H2 receptor antagonists?
Very short - requires twice daily dosage
What is the main function of parietal cells?
The proton pump (H+/K+ exchanger)
When do proton pump inhibitors bind?
When the pump is active - thus must be taken with food
How long do PPIs take to achieve full coverage?
2-3 days
Restoring acid production requires de Novo synthesis
What are the main classes of drugs for peptic disorders?
Antacids, alginates, H2 antagonist, PPI
What are the potential side effects of PPIs?
Generally considered safe, but diarrhoea is possible. Affects calcium absorption (potential osteoporosis), may increase c. difficile risk.
What are the potential side effects of H2 antagonists?
Generally safe, free from interactions and side effects. BUT, possible gynecomastia.
What are the principles of treatment for GORD?
Symptom control and healing of any oesophagitis
Which H2 antagonist is first line treatment?
Ranitidine
Alternatively give cimetidine, nizatidine, famotidine
What are alginates?
Drugs which adhere to the walls of the stomach to confer protection to the gastric mucosa
What lifestyle changes help relieve GORD symptoms?
Eating several smaller meals a day rather than a smaller number of large meals
Wait 2-3 hours before lying down after eating
Stop smoking
Reduce alcohol intake
Stop eating spicy foods
Lose weight
Do not wear tight clothing around the stomach, avoid placing pressure around the stomach
