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OV pharm > Anti-Ulcer Drugs > Flashcards

Anti-Ulcer Drugs Flashcards

1
Q

What are the two types of peptic ulcer?

A

Gastric ulcer

Duodenal ulcer

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2
Q

Describe how gastric ulcers and duodenal ulcers can be distinguished based on their symptoms.

A

Gastric ulcer – pain at meal times when gastric acid is secreted
Duodenal ulcer – pain relieved by a meal as the pyloric acid closes –pain -3 hours after a meal

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3
Q

What are the protective factors that protect the stomach lining from damage?

A

Mucous lining the stomach
Bicarbonate produced by cells in the stomach
Prostaglandins facilitate a good blood flow in the stomach, increasemucous and bicarbonate production and inhibit acid secretion

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4
Q

Which cells produce stomach acid?

A

Parietal cells

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5
Q

Explain how the parasympathetic nervous system affects gastric acid production.

A

The parasympathetic nervous, via the vagus nerve, stimulates histamine production by H cells
Histamine then stimulates an increase in acid production by parietal cells

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6
Q

What are the effects of gastrin?

A

They trigger the release of histamine from H cells

They also directly trigger acid production by the parietal cells

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7
Q

What do D cells release?

A

Somatostatin

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8
Q

Give an example of a proton pump inhibitor.

A

Omeprazole

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9
Q

What is the mechanism of action of PPIs?

A

Irreversible inhibitors of H+/K+ ATPase

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10
Q

What are the effects of PPIs?

A

Inhibits basal and stimulated gastric acid secretion from the parietal cells by >90%

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11
Q

Pathophysiology of peptic ulcers

A

H pylori dissolves mucus layer causing epithelial cell death from increased exposure to acidic environemnt -> ulcer

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12
Q

Investigations for peptic ulcer

A

Carbon urea breath test

Stool antigen test

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13
Q

Features of h pylori

A

Gram negative
Motile
Microaerophilic

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14
Q

How does h pylori increase gastric acid formation

A

Increase the production of gastrin and reduce that of somatostatin

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15
Q

How does h pylori cause gastric metaplasia

A

increased exposure to acid causes cell transformation

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16
Q

Defence factors downregulated by h pylori

A

epidermal growth factors

bicarbonate

17
Q

How is h pylori virulent

A

Produces urease which catalyses urea into ammonium chloride and monochloramine. These are what can damage the epithelial cells

18
Q

How can h pylori cause inflammation

A

Urease is antigenic which evokes an immune response

19
Q

Exotoxins produced by h pylori

A

CagA-> is antigenic so increases immune response

VacA-> cytotoxic increasing intensity of tissue inflammation

20
Q

Treatment for H pylori positive peptic ulcers

A

Anitbiotics against H pylori

Proton pump inhibitor

21
Q

Anti-biotics against H pylori

A

Amoxicillin and clarithomycin

22
Q

Treatment for chronic peptic ulcer where first line treatment hasnt worked

A

Quinalone and tetracycline

Chelating agents like bismuth and sucralfate

23
Q

What else increases number of proton pumps

A

Increased cytoplasmic Ca2+ which increases cAMP which leads to translocation of secretory vessels which proton pumps inside to apical membrane of parietal cells

24
Q

What is alternative cause of peptic ulcer to H pylori infection

A

NSAID use

For example people taking asprin for heart conditions

25
Q

Pathophysiology of NSAID causing peptic ulcer

A

Directly cytotoxic as reduces mucus production

26
Q

Treatment of NSAID causing peptic ulcer

A

Remove NSAID
Proton pump inhibitor
Histamine receptor antagonist

27
Q

Example of histamine receptor antagonist

A

Ranitidine

28
Q

How do histamine receptor antagonists work

A

Block H2 receptor

29
Q

4 things regulating gastric acid regulation

A

Ach
Prostaglandins
Histamine
Gastrin

30
Q

How does Ach affect acid secretion

A

Ach from neurones acts on M3 receptors to increase Ca2+ conc

31
Q

How do prostaglandins affect gastric acid secretion

A

local cells release prostaglandins which act onEP3 receptors which reduces cAMP

32
Q

How does histamine affect gastric acid secretion

A

Histamine from ECL cells acts on H2 receptors to increase cAMP

33
Q

How does gastrin from G cells affect gastric acid secretion

A

Acts on CCK-B receptors

34
Q

How does somatostatin decrease gastric acid secretion

A

Inhibits G cells, ECL cells anf parietal cells

OV pharm (34 decks)

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