1. How does each of the following drugs work treating ulcers? Give an example of each.
    • H2 Antagonists
    • Block the histamine 2 receptors on the parietal cells, reduce acid production in the stomach.
    • Ranitidine (Zantac�)
    • Cimetidine (Tagamet�)
    • Famotidine (Pepcid�)
    • Nizatidine (Axid�)
  2. Anticholinergics
    • block stimulation of these receptors, Stimulation of these receptors causes acid release.
    • Methscopolamine (Pamine�)
    • Propantheline (Pro Banthine�)
  3. H+ Pump Inhibitors
    • block the pump which actually moves acid from the parietal cell into the lumen of the GI tract.
    • Side Effects: Headache, GI distress, Nausea, vomiting, constipation
    • Omeprazole (Prilosec�)
    • Lansoprazole (Prevacid�)
    • Rabeprazole (AcipHex�)
    • Esomeprazole (Nexium�)
    • Pantoprazole (Protonix�)
    • Dexlansoprazole (Dexilant�)
  4. Sucralfate (Carafate�)
    • Is a glycoprotein which actually binds to ulcerated tissue.
    • It dissolves in the stomach and binds to breaks in the gastric mucosa.
    • It thus forms a protective barrier from the gastric enzymes and acids, providing an environment in which the ulcer can heal.
  5. Antacids
    • Neutralize acid that is released from the parietal cells
    • Al(OH)3, Mg(OH)2, or NaHCO3
    • Maalox TC�
    • Mylanta Double Strength�
  6. Antibiotics
    • Helicobacter pylori, may be responsible for ulcer
    • A common regimen includes an antibiotic, bismuth (Pepto-Bismol�) and an H2 antagonist or proton pump inhibitor.
  7. Tritec�,
  8. Helidac�
  9. Prevpac�
  10. Reglan�
    • Metoclopramide
    • Prokinetic agents
    • constrict the lower esophageal sphincter thus causing less acid reflux up the esophagus.
    • increase the motility of the GI tract, clearing the contents of the stomach more rapidly.
  11. GERD
    • Gastroesophageal Reflux Disease
    • In patients with gastroesophageal reflux disease, stomach contents reflux or move back up the esophagus.
    • The acid and enzymes contained in the refluxed gastric juice damage the lining of the esophagus.
    • Patients with GERD experience pain in the stomach and chest area.
    • Antacids
    • Histamine 2 (H2) Antagonists
    • Proton Pump Inhibitors
    • Prokinetic Agents
  12. Parietal Cell
    • produce acid.
    • contain both histamine 2 and cholinergic receptors.
    • Stimulation of these receptors causes acid release by the parietal cells.
  13. The causes of ulcers
    • Excess stress
    • Hypersecretory conditions
    • Eating foods that cause irritation or excess acid secretion
    • Reduced mucus production
    • Helicobacter pylori (bacteria)
    • Drugs (analgesics, steroids)
Card Set