Pharma - 11 peptic ulcer disease

Question 1

11. Peptic ulcer disease - drugs inhibiting HCl production

Answer 1

peptic ulcer:
- aggressive factors
- protective factors

1. antisecretory agents: proton pump inhibitors + H2 antagonist + antimuscarinics
2. antacids
3. mucous membrane protection
4. antibiotics - 3therapy: proton pump inhibitor + 2 antibiotics (clarithromycin + amoxicillin for 10-14 days) or 4therapy: PPI/H2 blocker + 2 antibiotics + bismuth

antisecretory indication: peptic ulcer + GERD + prevention of peptic ulcer

antisecretory SE: diarrhea, constipation, allergy, hepatic complication, muscle pain, anticholinergic effect (dry mouth)

PPI (H+/K+ATPase): omeprazol + esomeprazol + lansoprazol

H2-blocker: cAMP down –> H+/K+ATPase down

H2-blocker: Ranitidine + famotidine

Antimuscarinics: M1/M3 inhibition –> H/K ATPase down

Antimuscarinics: not for gastric ulcers (slower emptying + GERD)

Question 2

3. Inhibitors of proton pump – treatment of peptic ulcer disease

Answer 2

PPI:
- prodrug
-