drugs treatment of peptic · drugs treatment of peptic ulcer disease by dr. nizamuddin utmani mbbs,...
TRANSCRIPT
Drugs Treatment of Peptic
Ulcer Disease
By
Dr. Nizamuddin Utmani MBBS, MCPS(Medicine), FCPS(Medicine)
MPH, CHPE, M.Phil(Pharma), Ph.D Pharma(Scholar)
Consultant Physician
Assistant Professor Pharmacology
• LOs.
• Classify the drugs used in Peptic ulcer
disease.
• Describe the mechanism of action of
drugs used in Peptic ulcer
Peptic ulcer
• Localised loss in gastric or duodenal mucosa,
exposing the submucosal structure.
Stomach Ulcers
Duodenal Ulcer
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Drugs for the treatment of peptic Ulcer
Disease
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• Mucosal Protective agents.
• H2 Blocker.
• PPI
Mucosal Protective Agents
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we have three main compounds in this group.
1.Sucralfate and other antacid.
2. Misoprostol.
3. Bismuth compound
Mucosal Protective Agents
• Sucralfate
• Combination of Sucrose and
Aluminium.
• In acidic PH, it is converted
into -ly Charged Sucrose
sulfate and Aluminium.
• The basic mechanism is
basically the binding of this -
ly Charged Sucrose sulfate
to +ly Charged Protein in
base of the Ulcer and thus
making a barrier.
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Pharmacokinetic, Dose
Mucosal Protective Agents
• 2. Misoprostol
• Gastric Mucosa secret PGE2
and Prostacyclin.
• Both decrease intracellular
cAMP and acid production.
• Misoprostol is an PGE1
analogue, which produce the
same effects in the stomach.
• Best drug for the prevention
of NSAIDs induced ulcer.
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• NSAIDs cause ulcers in 10-20% of the
user.
• Misoprostol decrease it to 3%.
• decrease ulcer complication by 50%.
• only popular in NSAIDs induced ulcers.
Mucosal Protective Agents
Mucosal Protective Agents
• 3.Bismuth
Compound
• There are two compound.
1. Bismuth Subsalicylate.
2. Bismuth Substrate
Potassium
• Bismuth Subsalicylate is
available in combination
with Metronidazole and
Tetracycline for H-Pylori
Eradication..
18
Mucosal Protective Agents
• 3.Bismuth Compound
• Its is given for the Ulcer
prevention and Treatment.
• it can be given in watery
Diarrhoea, as Salicylate
decrease PG and Chloride
secretion, thus decrease the
water portion in secretory
diarrhoea.
• Bismuth also act directly as
antimicrobial, so kill the
microorganism in infective
diarrhoea.
• it also kill H-Pylori directly
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PPI
• Omeprazole. Safe
• Esomeprazole. Effective one.
• Rabeprazole. Safe in pregnancy
• Pantoprazole and dexlansoprazole. Safe in CV
Patients
Mucosal Protective Agents
• H-Pylori Eradication
Regimens
1. Standard.
PPI+Amoxycilline+Clarithr
omycin (Or Metronidazole
for 14 days (All BD).
2. PPI(BD)+ Bismuth
Subsalicylate(262mg-2
Tablets
QID)+Metronidazole(QID)+
Tetracycline(QID) for 10-
14 days.
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