Drugs Affecting Acid Secretion

Question 1

What are the main targets in the treatment of excessive acid production

Answer 1

Basolateral membrane receptors - ACh, CCK-B and H2 receptors

H/K-ATPase on the canalicular membrane

Question 2

Name some H2 receptor antagonists

Answer 2

Cimetidine

Ranitidine

Nizatidine

Famotidine

Question 3

Name some side effects of H2 receptors

Answer 3

Constipation

Diarrhoea

Dizziness

Fatigue

Headache

Question 4

Name the drugs used to treat excessive acid production

Answer 4

H2 receptors

Proton pump inhibitors

Antacids

Alginates

Question 5

Describe proton pump inhibitors

Answer 5

Taken before eating as efficacy decreases with food

Act by destroying the H/K-ATPase

Action is delayed as not all pumps are active all the time so takes a while to have an effect

Question 6

Name some proton pump inhibitors

Answer 6

Omeprazole

Lansoprazole

Rabeprazole

Pantoprazole

Esomeprazole

Question 7

Name some side effects of proton pump inhibitors

Answer 7

Abdominal pain

Constipation

Diarrhoea

Dizziness

Dry mouth

Headache

Nausea

Vomiting

Question 8

Name some antacids and alginates

Answer 8

Antacids - bicarbonate

Alginates - gaviscon

Question 9

Describe the treatment of GORD

Answer 9

GP uses step up treatment: lifestyle -> antacids/alginates -> H2RA -> PPI

Gastroenterologists use step down treatment: PPI -> H2RA -> antacids/alginates -> lifestyle

Question 10

What is the treatment for peptic ulceration

Answer 10

Stop NSAIDs

Give H2RA/PPI for 6/52 and eradicate H. pylori

Question 11

Describe how to eradicate H. pylori

Answer 11

Clarithromycin and amoxycillin - two antibiotcs

Lansoprazole - PPI or H2RA