Download Chapter 48 Antidysrhythmic Drugs

Chapter 73
Drugs for Peptic Ulcer
Disease
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Drugs for Peptic Ulcer
Disease
• Peptic ulcer disease
– Upper GI disorders
– Degrees of erosion of the gut wall
• Cause
– Imbalance between mucosal and
aggressive factors
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Pathogenesis of Peptic Ulcers
• Defensive factors
– Mucus
– Bicarbonate
– Blood flow
– Prostaglandins
Copyright (c) 2004 Elsevier Inc. All rights reserved.
• Aggressive factors
– Helicobacter
– NSAIDs
– Gastric acid
– Pepsin
– Smoking
Classes of Antiulcer Drugs
•
•
•
•
Antibiotics
Antisecretory agents
Mucosal protectants
Antisecretory agents that enhance
mucosal defenses
• Antacids
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Helicobacter pylori
• Test: breath test or serum
• Treatment—(two antibiotics are prescribed)
– Bismuth
– Clarithromycin
– Amoxicillin
– Tetracycline
– Metronidazole
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Histamine-2 Receptor
Antagonists
•
•
•
•
•
Cimetidine (Tagamet)
Ranitidine (Zantac)
Ranitidine bismuth citrate (Tritec)
Famotidine (Pepcid)
Nizatidine (Axid)
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Proton Pump Inhibitors
• Omeprazole (Prilosec)
– Inhibits gastric secretion
– Short half-life
– Used for short-term therapy
• Adverse effects
– Headache
– Gastrointestinal
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Sucralfate (Carafate)
• Protective barrier up to 6 hours
• Uses
– Acute ulcers
• Adverse effects
– Constipation
• Drug interactions
Copyright (c) 2004 Elsevier Inc. All rights reserved.