drugs affecting acid secretion Flashcards
what helps reinforce the gastric mucosa ?
epithelial integrity
cell replication and resitution
mucous membrane
Vascular supply
What are aggressive factors in the gastric mucosa ?
acid
Helicobacter pylori
what stimulates parietal cells ?
what is the main stimulant ?
Gastrin (CCK-B0
H2 -histamine - main one
M3- ACh
Name 1 H2 antagonists
Ranitidine
why is there poor adherence to H2 antagonists ?
you have to take bd dose
when should you take a PPI?
why ?
20-30 mins before eating
Pumps activate by attaching to canaliculus when you are eating so the drug needs to be in before this happens
why does PPI take 2-3 days for max efficacy ?
PPI only attach and destroy to activate PP on the canaliculus of parietal cells so inactivate ones remain and another cycle is needed to get the remaining -
use for chronic over acid secretion
what causes Zollinger Ellison syndrome ?
gastrin producing tumour leading to too much acid secretion leading to ulcers in stomach and oesophagus
what is main cause of duodenal ulcers ?
how to tell between Gastric and Duodenal ulcer ?
H pylori
Duodenal ulcers may also cause abdominal pain a few hours after eating or when stomach is empty
name a H2R antagonist
Ranitidine , Cimetidine
name a PPI
what is a side effect?
Esomeprazole, Lansoprazole, Omeprazole
Diarrhoea , C diff infection
How would you treat GORD step up wise ?
if presented at GP Lifestyle Antacids / Alginates H2RA PPI
What is barret’s oesophagus ?
when epithelium changes form squamous to columnar = high risk of malignancy due to GORD
how would you treat Peptic ulcerations?
stop NSAIDs
H2RA/PPI for 6 weeks
H pylori eradication
how to eradicate H pylori ?
2 antibiotics -
Clarithromycin, Amoxycillin
with PPI
