Pharmacology - Chapter 76 - Drugs for Peptic Ulcer Disease Flashcards
Peptic Ulcer Disorder - upper GI disorder characterized by…
varying degrees of erosion of the gut wall.
PUD - caused by…
infection with Helicobacter pylori.
What are some defensive factors ?
Mucus, bicarbonate, blood flow, prostaglandins, etc.
Agressive Factors -
Helirobacter, NSAID’s, Gastric Acid, Pepsin, Smoking.
What are the goals of drug therapy to treat PUD?
Alleviate symptoms, promote healing, prevent complications, and prevent recurrences.
Mucus - forms barriers and…
protect underlying cells from attack of acid and pepsin.
Bicarbonate - secreted by ___ cells of stomach and duodenum, neutralize any ___ ions that penetrate the mucus.
epithelial cells/hydrogen ions.
Blood flow - sufficient blood flow to cells maintain…
mucosal integrity.
Prostaglandins - stimulate secretion of ___ and ____, promote vasodilation, which helps ___ blood flow, suppress secretion of gastric acid.
Mucus/Bicarb, submucosal blood flow.
Helirobacter - bacterial that colonize in the ___ and __.
Stomach and duodenum.
NSAID’s - inhibit biosynthesis of ___, decrease submucosal blood flow, promote ___ ___ secretion.
Prostaglandins/gastric acid.
Gastric Acid - form peptic ulcer by… (2)
Injuring cells of GI mucosa and activate pepsin, a proteolytic enzyme.
Pepsin - injure ___ cells.
Unprotected.
Smoking - delays ___ healing.
Ulcer.
What are the 5 classes of antiulcer drugs?
Antibiotics, antisecretory agents, mucosal protectants, antisecretory agents that enhance mucosal defenses, and antacids.
Antiulcer Drugs - antibiotics. What are they and what do they do?
Amoxicillin, Bismuth (Pepto), Metronidazol (flagyl), Tetracycline. They eradicate the H. pylori infection.
Antiulcer Drugs - antisecretory agents. What is it and what does it do? (MUSCARININ ANTAGONIST)
Pirenzepine (gastrozepine), a muscarinin antagonist. It suppresses acid secretion by blocking muscarinic cholinergic receptors.
Antiulcer Drugs - antisecretory agents. What are they and what do they do? - H2 (Histamin-2) receptor antagonists
Cimetidine (tagamet), Famotidine (pepcid), Nizatidine (axid), Ranitidine (Zantac). They suppress acid secretion by blocking h2 receptors on parietal cells.
Antiulcer Drugs - antisecretory agents. What are they and what do they do? (PROTON PUMP INHIBITORS.)
Lansoprazole (prevacid), Omeprazole (prilosec), Pantoprazole (protonix). They suppress acid secretion by inhibiting H+, K+ - ATPase, the enzyme that makes gastric acid.
Cimetidine (Tagamet) - ___ choice of drug for treating gastric acid duodenal ulcer.
First choice!
Cimetidine - take with food, because absorption will be slowed but effects will be longer. T/F?
True!
Zantac - share many properties of Cimetidine, but ___ potent than Cimetidine.
More potent!
Antiulcer Drugs - Mucosal Protectants - What is the drug and what does it do?
Sucralfate (carafate) - it forms a barrier over the ulcer crater that protects against acid and pepsin.
Antiulcer Drugs - Antisecretory agents that enhance mucosal defense - what is the drug and what does it do?
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.
Antiulcer Drugs - Antacids - what are the drugs, what do they do?
Aluminum hydroxide, calcium carbonate, magnesium hydroxide. They react with gastric acid to form neutral salts.
