Digestive System Drugs Topics Peptic ulcer H pylori

Digestive System Drugs

Topics Peptic ulcer H. pylori infection Constipations Diarrhea Emesis Digestion

Peptic Ulcer Factors increase the Acidity in stomach 1 - pepsin 2 - acidic agents in stomach 3 - HP. pylori 4 - Smoking

Drugs used for treating Peptic ulcer Drugs neutralizing acid ( antacids) 1 - Systemic antacids example : Sodium bicarbonate USES : neutralize the acidity in the stomach , very fast quick action It last for 2 -3 hr Disadvantage: its action live is short , if there is any problem in kidney it will produce alkalosis. 2 - none systemic drugs : Aluminum or Magnesium Hydroxide (Moxal ) Uses : neutralize the acidity in the stomach , very fast quick action do not produce alkalosis

Drugs reduce gastric acid secretion 1 - Anticholinergics (pirenzepine ) : Uses : M 1 blocker its action like Atropine but less side effect in CNS it cause decreasing in the secretions. Disadvantages : it cause 40 -50% reduction of secretion than Atropine. 2 - H 1 Receptor blocker (Ranitidine ) USES : reduce secretion of HCL Adverse Reaction : cough , headache. 3 - Protein Pump inhibiter ( Omperazole , Esomeprazole ) Uses : These drugs bind to the H + ions enzyme and inhibit it there for reduce the HCL secretion Adverse Reaction: Diarrhea , headache , nausea , anorexia

Drugs reduce gastric acid secretion (cont. . ) 4 - Analogues of prostaglandins drugs : ( Misoprostol) Uses : reduce HCL secretions help in heal gastric ulcer in 4 -6 weeks Adverse effect: Diarrhea , headache. Ulcer protectives Colloidal Bismuth: its inhabited pepsin Activity and increase mucus secretion Adverse effect: Staining of Oral mucosa, Osteodystrophy. Drugs Promoting ulcer healing Carbenoxolone : it cause healing to gastric ulcer with onset slow action Adverse reaction : Fluid retention , increase in the body weight , heart failure.

H. pylori infection H. pylori can be diagnosed by the carbon-13 -urea breath test. This involves fasting for about 6 hours and then drinking a solution of 13 C-urea in water. Breath samples are then taken at intervals. If H. pylori is present, 13 Curea is broken down to 13 CO 2 by urease and will be measurable in the expired breath. Treatment of H. pylori Combination drug are recommended for patients who test positive for H. pylori. Antibiotics and Proton pump inhibitor Metronidazole, Esomeprazole. – Triple therapy: Proton pump inhibitor(Esomeprazole ) plus clarithromycin or metronidazole or tetracycline plus amoxicillin for 2 weeks

Constipations To treat constipations we used Purgatives : these drugs promote the passage of stool Classification of Purgatives : 1 - Bulk purgatives : a- Saline purgatives : milk of magnesia and magnesium striate it work as holding water and increase bulk in large and small intestine it produce watery evacuation. Side effect: dehydration , magnesium toxicity b- Natural Purgatives or cellulose : these neither digested or absorbed but adsorb water and stimulate the bowel to evacuate its contents.

Constipations 2 - lubricant Purgatives : a- Liquid Paraffin : mineral oil from petroleum its used as a softens Side effect: Unfavorable taste , if use for long time it cause vitamin deficiency b- Docusate : its wetting and soften agent. 3 - Irritant Purgatives : (caster oil) it induce rabid peristalsis and produce fluid stool It can be given to pregnant women to induce labor

4 - Suppositories ( Bisacodyl , glycerin) These agents produce an effete within one hour 5 - Enema : it used for systemic effect , these produce distending the bowel and increasing it mobility. they are used before surgery or radiological examination. Disadvantage : 1 - patient not prefer enema 2 - they are habit forming 3 - require time and equipment

Diarrhea may due to various diseases : 1 - infection 2 - irritant food 3 - acute anxiety 4 - Malabsorption therapy of diarrhea is to treat the cause , some drugs do not affect the cause but give some symptomatic relief. These drugs called antidiarrheal. They classified to: 1 - Adsorbent 2 - Demulcents 3 - Opiates

Diarrhea 1 - Adsorbent : (Kaolin). Activated Charcoal) it adsorbing toxic substance (gases , toxin and microorganism ). 2 - Demulcents : these agents have high molecular weight they reduce irritation and produce soothing effect. 3 - Opiates : Opium with morphine and codeine. They reduce the activity of the Powel Emetics Drugs produce Vomiting either by acting on CNS or irritation in GI tube. Receptors involved in vomiting histamine receptors H, D receptors

Emetics there are some Drugs produce vomiting as an adverse effect : 1 - anticancer 2 -Morphene 3 - Aminoglycoside 4 - Alkaloids 5 - Levodopa Disadvantages of emetics : should be not used in unconsciousness should not be used in corrosive poisoning

Antiemetic Vomiting is a symptom is associated with disease if we remove the cause it will stop , But some times we use antiemetic's if vomit led to imbalance classifications of antiemetic drugs : 1 - Anticholinergic drugs : (Atropine) disadvantage it cause sedation so not fit with workers. 2 - Antihistamines : Promethazine it produce sedation as well. 3 - Nonspecific blockers of D 1 and D 2 : chlorpromazine , in effected in Morphine poisoning adverse effect : Drowsiness and Sodium retention. 4 - Miscellaneous ( Pyridoxin) used in morning sickness Precautions : it is Toxic drug.

Digestion 1 - Salivary Glands Parasympathetic nerve stimulate and increase the watery Salvia. Stimulation of sympathetic nervous system control flow and the thickness of saliva. 2 - Appetizers : (Vitamins ) Substance which are used to stimulate appetite like with Patients of anorexia.

Digestion 3 - Digestants : agents promote the process of digestion like ; Hydrochloric acid: 10%solution of this acid is given to the patient help him to digest food. Pepsin : natural enzyme of the stomach pancreatic enzyme : these agent are given in coated capsule because they destroyed form acid they are for treating chronic pancreatitis and bile salt.