Pharmacology of ulcers and inflammation Flashcards
Appreciate the features and causes of ulcers
and factors which protect or attack mucosal
integrity
Features of Ulcers:
Pain in the affected area
Bleeding or discharge
Swelling or inflammation
Tenderness or sensitivity to touch
Causes of Ulcers:
Infection with the bacterium Helicobacter pylori (H. pylori)
Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs)
Smoking
Alcohol abuse
Stress
Genetics
Other medical conditions such as Crohn’s disease, ulcerative colitis, or Zollinger-Ellison syndrome
Factors that protect mucosal integrity:
The secretion of bicarbonate, mucus, and prostaglandins that protect the stomach lining from the corrosive effects of stomach acid
A healthy and diverse microbiome that supports the immune system and prevents the overgrowth of harmful bacteria
Good blood flow to the stomach lining, which helps to deliver nutrients and oxygen to the cells and remove waste products
Adequate nutrition, including vitamins A and C, zinc, and iron, which are important for the repair and regeneration of the mucous membrane
Factors that attack mucosal integrity:
H. pylori infection, which can damage the mucous membrane and cause inflammation and ulcers
NSAIDs, which inhibit the production of prostaglandins and can cause erosions and ulcers in the stomach and small intestine
Alcohol and smoking, which can irritate the mucous membrane and impair blood flow to the stomach lining
Stress, which can increase the production of stomach acid and slow down the healing of ulcers
Poor nutrition, which can impair the repair and regeneration of the mucous membrane
understand how gastric acid can be neutralised
using different types of acid-modifying drugs
Antacids: Antacids are medications that directly neutralize stomach acid. They typically contain compounds such as calcium carbonate, magnesium hydroxide, or aluminum hydroxide, which react with the acid to form salts and water. Antacids are usually fast-acting and provide immediate relief for symptoms such as heartburn or indigestion.
H2 blockers: H2 blockers are medications that block the action of histamine on the parietal cells in the stomach, which reduces the production of acid. Examples of H2 blockers include ranitidine (Zantac) and famotidine (Pepcid). H2 blockers are effective at reducing the amount of acid that is produced, but they may take longer to work than antacids.
Proton pump inhibitors (PPIs): PPIs are medications that block the proton pump in the parietal cells, which is responsible for the production of acid. Examples of PPIs include omeprazole (Prilosec) and esomeprazole (Nexium). PPIs are very effective at reducing acid production, and they are often used for the treatment of conditions such as GERD (gastroesophageal reflux disease).
Prostaglandin analogs: Prostaglandin analogs such as misoprostol (Cytotec) are medications that stimulate the production of mucus in the stomach lining, which helps to protect against the harmful effects of acid. Prostaglandin analogs are often used to prevent gastric ulcers in patients who are taking NSAIDs (nonsteroidal anti-inflammatory drugs).
drug therapies which are used
to treat ulcers
Antibiotics: If the ulcer is caused by an H. pylori infection, a combination of antibiotics is usually prescribed to eliminate the bacteria. The most commonly used antibiotics for this purpose include amoxicillin, clarithromycin, and metronidazole.
Proton pump inhibitors (PPIs): PPIs such as omeprazole, lansoprazole, and esomeprazole are medications that reduce the amount of acid produced by the stomach. PPIs are highly effective at healing ulcers and preventing their recurrence. They are often used in combination with antibiotics to treat H. pylori infections.
H2 blockers: H2 blockers such as ranitidine and famotidine are medications that reduce the production of stomach acid. They are less potent than PPIs, but can be effective in treating mild to moderate ulcers.
Antacids: Antacids such as calcium carbonate, magnesium hydroxide, and aluminum hydroxide can help neutralize stomach acid and relieve symptoms of ulcers. They are typically used for short-term relief of mild symptoms.
Sucralfate: Sucralfate is a medication that forms a protective barrier over the ulcer, allowing it to heal. It is often used in combination with other medications to treat ulcers.
Misoprostol: Misoprostol is a medication that helps to prevent ulcers in people who are taking NSAIDs. It works by reducing the amount of acid produced by the stomach and increasing the production of protective mucus in the stomach lining
To know about the current treatments for IBD
(inflammatory bowel disease)
Medications: Several types of medications are used to treat IBD, including anti-inflammatory drugs (such as corticosteroids and 5-aminosalicylates), immunomodulators (such as azathioprine and methotrexate), biologic agents (such as infliximab and adalimumab), and Janus kinase (JAK) inhibitors (such as tofacitinib).
Surgery: Surgery may be necessary in some cases of IBD, such as if there is a bowel obstruction, perforation, or severe bleeding. Surgery may involve removing the affected part of the intestine or creating an ostomy.
Nutritional therapy: Some people with IBD may benefit from nutritional therapy, which involves modifying the diet to improve symptoms and reduce inflammation. This may involve using specialized formulas or supplements.
Lifestyle changes: Lifestyle changes, such as stress management and regular exercise, can also help manage IBD symptoms and improve overall health.
