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chemicals that stomach secretes
- hydrochloric acid
- bicarbonate
- pepsinogen
- intrinsic factir-absorption of vitamin b12
- mucus
- prostaglandins-antiinflamatory and protective function
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what gerd could lead to?
- erosive esophagitis
- barrett esophagus
- precancerous condition
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what can cause hypersecretory disorder such as peptic ulcer?
- fatty meals
- alcohol
- emotional stress
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parietal cell receptors
- acetylcholine
- histamine
- gastrin
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antacids containing magnesium should be avoided in patients with what kind of disorder?
renal failure
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what does many antacid contain?
antiflatulent drug simethicone which reduces gas and bloating
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how does antacid works?
they neutralize gastric acidity. they do no prevent the overproduction of acid instead they neutralize acid secretions. it is also believed that antacids promote gastric mucosal defensive mechanism especially at lower dose. they do this by stimulating the secretion of mucus, protaglandins and bicarbonate from the cells inside the gastric glands.
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prevent histamine from binding to its corresponding parietal cell receptor, which inhibits the production of adenylate cyclase.
prostaglandins
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antacids indications
antacids are indicated for the acute relief symptoms associated with peptic ulcer, gastritis, gastric hyperacidity, and heartburn
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antacid that can cause diarrhea
magnesium antacids
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antacids that can result in constipation?
aluminum and calcium containing formulation
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excessive use of antacids may result in what?
systemic alkalosis
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calcium antacids may also cause what?
kidney stones
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chronic use of high-dose calcium containing antacids or use in renal failure can cause syndrome known as?
milk-alkali syndrome
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what are the symptoms of milk-alkali syndrome?
- headache
- nausea
- alkalosis
- hypercalcemia
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antacids intercations
- 1. adsorption-of other drugs to antacids, which reduces the ability of the other drug to be absorbed
- 2. chelation-chemical inactivation of other drugs that produces insoluble complexes
- 3. increased stomach PH- increase absorption of basic drugs and decrease the absorption of acidic drugs
- increased urinary PH- increase the excretion of acidic drugs and decreases the excretion of basic drugs
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drugs whose effect may be chemically enhanced by the presence of antacids
- benzodiazepines
- sulfonylureas
- sympathomimetics
- valproic acid
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antacids are safe for pregnant women if prolonged usage is avoided
pregnant women should consult dr before taking antacids
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antacids that are often recommended for patients with renal compromise because they are easily excreted than other antacids
aluminum-and sodium-based antacids
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antacids that produce gas and bleching
calcium carbonate
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drugs that are H2 receptors antagonist
- cimetidine
- ranitidine
- famotidine
- nizatidine
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effect of H2 receptor antagonist drugs
reduced hydrogen ion secretion from the parietal cells which results in increase in the PH stomach
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H2 receptors antagonist therapeutic uses
- treatment of GERD
- peptic ulcer
- erosive esophagitis
- treatment of Zollinger-Ellison syndrome
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H2 receptors antagonist adverse effect
CNS- confusion and disorientation in older adults
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cimetidine may induce?
impotence and gynecomastia
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ranitidine and famotidine adverse effect
thrombocytopenia
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h2 receptor antagonist drug that raise the blood concentrations of certain drugs
cimetidine
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all H2 receptors antagonist may inhibit the absorption of certain drugs such as?
ketoconazole that require an acidic GI environment for gastric absorption
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habit that decrease effectiveness of H2 antagonist
smoking
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h2 antagonist should be taken 1 to 2 hours before antacids for optimal results
.
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currently indicated as first line therapy for erosive esophagitis, symptomatic GERD that is poorly responsive to other medical treatment such as therapy with h2 antagonist
proton pump inhibitor
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can be used in combination with antibiotics to treat patient with H. pylori infections
all PPIs drugs
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PPI adverse effects
- clostridium difficle infections
- risk for wrist, hip, and spine fractures
- pneumonia
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PPI interactions
- 1. bleeding in patients who are taking both PPI and warfarin
- 2. interference with the absorption of ketoconazole, ampicillin, iron salts, and digoxim
- 3. when given with clopidogrel, may increase death if the patient has acute coronary syndrome.
- 4. sucralfate may delay absorption of PPIs
- 5. food may decrease absorption of PPIs. PPIs should be taken with an empty stomach
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drug used as a mucosal protectant in the treatment of active stress ulcerations and in long term therapy for peptic ulcers disease
sucralfate
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reduce the incidence of gastric ulcers in patient taking NSAIDs
misoprostol
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misoprostol adverse effect
- headache
- GI distress
- vaginal bleeding
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is used to reduce the discomforts of gastric gas and aid in its release via the mouth and rectum. It is antiflatulent drug
simethicone
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types of antacids
- aluminum salts
- magnesium salts
- calcium salts
- sodium bicarbonate
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antacids OTC formulations
- cap and tab
- powders
- chewable tab
- suspensions
- effervescent granules and tab
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H2 antagonist drugs
- cimetidine
- nizatidine
- famotidine-pepcid
- ranitidine-zantac
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PPIs durgs
- lansoprazole-prevacid
- omeprazole-first
- rabeprazole
- pantoprazole-IV form available
- esomeprazole-nexium
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