GORD/peptic ulcer disease Flashcards
What are examples of NSAIDs?
ibuprofen, naproxen, diclofenac
What is the primary mechanism of action of NSAIDs?
inhibit the enzyme cyclooxygenase 2 which is the rate limiting step for production of all prostanoids (prostaglandins and thromboxane) from arachidionic acid
What enzyme results in side effects of NSAIDs?
inhibition of cycloozygenase 1
What are the main side effects of NSAIDs?
gastric irritation ulceration and bleeding reduced creatinine clearance nephritis bronchoconstriction skin rashes hypertension chronic reneal failure
What NSAID inhibits platelet aggregation?
aspirin
What are examples of proton pump inhibitors?
omeprazole
lansoprazole
What is the mechanism of action of proton pump inhibitors?
irreversible inhibitors of h+/k+ ATPase in gastric parietal cells
they are weak acids and accumulate in the acid environment of the canaliculi of parietal cells -
they inhibit basal and stimulate gastric acid secretion by over 90%
What is the drug target of NSAID?
cyclooxygenase
What is the drug target of proton pump inhibitors?
H+/K+ ATPase the proton pump
What are the side effects of proton pump inhibitors?
headache diarrhoea bloating abdominal pain rashes
What drug does omeprazole interact with?
clopidogrel
Why does omeprazole interact with clopidogrel?
omeprazole inhibits cytochrome p2C19 and reduces the activity of clopidogrel when platelet activity is monitored
How are PPI’s administered with regards to their chemistry?
they are administered as pro drugs which convert into a reactive species and react with sulphydryl group in the proton pump of parietal cells
they are given in capsules with enteric coated granules
What are examples of histamine (H2) receptors antagonists?
ranitidine
Which class of drugs does ranitidine belong to?
histamine receptor antagonist
