Drugs For Peptic Ulcer & Gerd - II
Drugs For Peptic Ulcer & Gerd - II
Drugs For Peptic Ulcer & Gerd - II
• Pepsin
• Bile
• H.Pylori
Defensive factors
Gastric mucus
Bicarbonate secretion
Prostaglandins
Relief of pain
Ulcer healing
Prevention of complications (bleeding,
perforation)
Prevention of relapse.
• Approaches for the treatment of peptic ulcer
are:
1.Reduction of gastric acid secretion
(a)H2 antihistamines: Cimetidine, Ranitidine,
Famotidine, Roxatidine
(b) Proton pump
inhibitors:
Omeprazole,
Esomeprazole,
Lansoprazole,
Pantoprazole,
Rabeprazole,
Dexrabeprazole
(c) Anticholinergic drugs:
Pirenzepine,
Propantheline,
Oxyphenonium
(a) Systemic:
Sodium bicarbonate,
Sodium citrate
(b) Nonsystemic:
Magnesium hydroxide,
Magnesium trisilicate,
Aluminium hydroxide gel,
Calcium carbonate
3.Ulcer protectives:
Sucralfate,
Colloidal bismuth subcitrate (CBS)
• prototype drug
• Non-ulcer dyspepsia
• Urticaria
Peptic ulcer
• H2 blockers are rarely used for treating peptic ulcer
because PPI acts faster, more complete relive of
pain
• Non-ulcer dyspepsia:
Abdominal fullness & pain
Gas & bloating
Nausea
It is most functional
Bleeding from stress ulcer and erosive
gastritis
• Hepatic coma , severe burns & trauma,
prolonged surgery, prolonged intensive care,
renal failure, asphyxia neonatorum are all
associated with gastric erosion and bleeding
PPI treatment
• Duodenal ulcer – 2 to 4 weeks ( depends )
• Gastric ulcer – 4 to 8 weeks
• Hypergastrinemia
Magnesium trisilicate
Magaldrate
Calcium carbonate
Mag. Hydroxide (1 g → 30 mEq HCl)
H2 blockers
Antacids
Sodium alginate
Prokinetic drugs
Sodium alginate
1. Name the most potent drug for peptic ulcer.
2. Mention the possible drug interactions with
antacids.
3. What is the rationals in giving a
combination of aluminium Hydroxide gel
and magnesium trisibirate.
4. Antacids should not be given along with
sucralfate why?
5. What bacteria is implicated in the etiology
of peptic ulcer?
6. Mention any one therapeutic regiment for
7. What are the advantages fo ranitidine compared to
cimetidine?
8. Which anti ulcer drug is preferred for NSAIDs
induced peptic ulcer.
9. Which anti ulcer drug is contra indicated in a
pregnant women.
10.What are the mechanism of actions of omeprazole
and cimetidine.
11.When should the antacids be given in relation to
the time of food.
12.What is the mechanism of action of misoprostal in
peptic ulcer?
13. Enumerate the uses of anti ulcer drug.
14. Why antacids are not suitable for long term
therapy?
15. Colloidal bismuth subcarbonate is an ulcer
protective and directly kills H. pylori : How
ever its use is restricted. Why?
16. Which of the anti ulcer drug known to
produce gastric cancer in rats on chronic
administration.
17. What is the treatment for stress induced
ulcer?
18. Between duodenal and gastric ulcer which
responds to anti ulcer treatment better?
19. Proton pump inhibitors, inhibit the pump;
inreversibily true or false.