Pharmacology - Chapter 76 - Drugs for Peptic Ulcer Disease

Question 1

Peptic Ulcer Disorder - upper GI disorder characterized by…

Answer 1

varying degrees of erosion of the gut wall.

Question 2

PUD - caused by…

Answer 2

infection with Helicobacter pylori.

Question 3

What are some defensive factors ?

Answer 3

Mucus, bicarbonate, blood flow, prostaglandins, etc.

Question 4

Agressive Factors -

Answer 4

Helirobacter, NSAID’s, Gastric Acid, Pepsin, Smoking.

Question 5

What are the goals of drug therapy to treat PUD?

Answer 5

Alleviate symptoms, promote healing, prevent complications, and prevent recurrences.

Question 6

Mucus - forms barriers and…

Answer 6

protect underlying cells from attack of acid and pepsin.

Question 7

Bicarbonate - secreted by ___ cells of stomach and duodenum, neutralize any ___ ions that penetrate the mucus.

Answer 7

epithelial cells/hydrogen ions.

Question 8

Blood flow - sufficient blood flow to cells maintain…

Answer 8

mucosal integrity.

Question 9

Prostaglandins - stimulate secretion of ___ and ____, promote vasodilation, which helps ___ blood flow, suppress secretion of gastric acid.

Answer 9

Mucus/Bicarb, submucosal blood flow.

Question 10

Helirobacter - bacterial that colonize in the ___ and __.

Answer 10

Stomach and duodenum.

Question 11

NSAID’s - inhibit biosynthesis of ___, decrease submucosal blood flow, promote ___ ___ secretion.

Answer 11

Prostaglandins/gastric acid.

Question 12

Gastric Acid - form peptic ulcer by… (2)

Answer 12

Injuring cells of GI mucosa and activate pepsin, a proteolytic enzyme.

Question 13

Pepsin - injure ___ cells.

Answer 13

Unprotected.

Question 14

Smoking - delays ___ healing.

Answer 14

Ulcer.

Question 15

What are the 5 classes of antiulcer drugs?

Answer 15

Antibiotics, antisecretory agents, mucosal protectants, antisecretory agents that enhance mucosal defenses, and antacids.

Question 16

Antiulcer Drugs - antibiotics. What are they and what do they do?

Answer 16

Amoxicillin, Bismuth (Pepto), Metronidazol (flagyl), Tetracycline. They eradicate the H. pylori infection.

Question 17

Antiulcer Drugs - antisecretory agents. What is it and what does it do? (MUSCARININ ANTAGONIST)

Answer 17

Pirenzepine (gastrozepine), a muscarinin antagonist. It suppresses acid secretion by blocking muscarinic cholinergic receptors.

Question 18

Antiulcer Drugs - antisecretory agents. What are they and what do they do? - H2 (Histamin-2) receptor antagonists

Answer 18

Cimetidine (tagamet), Famotidine (pepcid), Nizatidine (axid), Ranitidine (Zantac). They suppress acid secretion by blocking h2 receptors on parietal cells.

Question 19

Antiulcer Drugs - antisecretory agents. What are they and what do they do? (PROTON PUMP INHIBITORS.)

Answer 19

Lansoprazole (prevacid), Omeprazole (prilosec), Pantoprazole (protonix). They suppress acid secretion by inhibiting H+, K+ - ATPase, the enzyme that makes gastric acid.

Question 20

Cimetidine (Tagamet) - ___ choice of drug for treating gastric acid duodenal ulcer.

Answer 20

First choice!

Question 21

Cimetidine - take with food, because absorption will be slowed but effects will be longer. T/F?

Answer 21

True!

Question 22

Zantac - share many properties of Cimetidine, but ___ potent than Cimetidine.

Answer 22

More potent!

Question 23

Antiulcer Drugs - Mucosal Protectants - What is the drug and what does it do?

Answer 23

Sucralfate (carafate) - it forms a barrier over the ulcer crater that protects against acid and pepsin.

Question 24

Antiulcer Drugs - Antisecretory agents that enhance mucosal defense - what is the drug and what does it do?

Answer 24

Misoprostol (cytotec) - it protects against NSAID induced ulcers by stimulating secretion of mucus and bicarbonate, maintaining submucosal blood flow, and suppressing secretion of gastric acid.

Question 25

Antiulcer Drugs - Antacids - what are the drugs, what do they do?

Answer 25

Aluminum hydroxide, calcium carbonate, magnesium hydroxide. They react with gastric acid to form neutral salts.