Gastric Anti Secretary, Antacid and Anti Ulcer Drugs Used for Treatment

1. Antacid are the feeble base that respond with the gastric HCL and structure water and salt. 

2. Multiple ulcers may happen in GIT as in the Zollinger-Ellison disorder, or in the Meckel's' diverticulum. 

3. Gastric corrosive discharge is partitioned into two periods-(1) Interprendia (basal emission) and (2) Postprandial (Stimulated emission during and after feast) 

4. Three period of corrosive yield are perceived (1) cephalic (2) gastric (3) Intestinal or ending stage. 

5. Cephalic stage is interceded by vagouse nerve. 

6. Pepsinogen is latent antecedent of the proteolytic compound pepsin, is integrated, and put away in the central cell of the oxyntic gland region. 

7. Gastric and duodenal ulcer is a consequence of awkwardness among cyto protective and forceful specialist resembles bicarbonate, bodily fluid, and histamine, gastrin, acetylcholine. 

8. Gram-negative microorganisms Helicobacter pylori are additionally liable for the causation of ulcer. Which is gram negative in nature 

9. Classification of antiulcer drugs are as per the following- 

(1) Antimicrobial Drug-Amoxicillin, Bismuth compound, Clarithromycin, Metronidazole, Tetracycline. 

(2) H2-histamine receptor blocker-Cimetine, famotidine, Nizatidine, Ranitidine. 

(3) Proton Pump Inhibitor- Dexlansoprazole, Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole. 

(4) Prostaglandins-Misoprostol 

(5) Antacids-Aluminum hydroxide, Calcium carbonate, Magnesium Hydroxide, Sodium Bicarbonate. 

(6) Mucosal Protective Agents-Bismuth subsalicylate, Sucralfate. 

10. To report disease with Helicobacter pylori endoscopic biopsy of the gastric mucosa or different noninvasive techniques are utilized, including serologic tests and urea inhale test. 

11. 13CO2 is utilized for the dissecting in urea breath test for the affirmation of Helicobacter pylori tainted ulcer. 

12. Gastric corrosive are discharged by parietal cell. 

13. Gastric corrosive discharge is animated by Histamine, Acetylcholine, and Gastrin. 

14. Activation of each of the three receptor brings about initiation of Protein Kinase. 

15. Cimetidine may execrated to drain in lactating lady, and may cross placental boundary. It is regularly discharged through pee. 

16. Warfarin, Diazepam, Phenytoin, Quinidine, Carbamazepine, Theophylline and Imipramine digestion in liver is influenced by the Cimetidine since it influence the microsomal compound P450 in liver and hence the serum level of these medication are expanded in blood. 

17. Galactorrhea (persistent release of pee) is the primary result of Cimetidine. 

18. PPI are prodrugs with a corrosive safe enteric covering to shield them from untimely corruption by gastric corrosive. 

19. Prostaglandin created by gastric mucosa, repress the emission of HCL and invigorate the secretion of bodily fluid and bicarbonate. 

20. Side impact of misoprostol is that produce uterine compression and dislodging of hatchling. 

21. Antacid are the medication which show there activity by the balance of abundance HCL in the GIT. The symptom of Aluminum hydroxide is that it causes clogging, where as magnesium hydroxide cause blockage. 

22. Sucralfate is the complex of aluminum hydroxide and sulfated sucrose tie to the emphatically charged protein in bodily fluid of the GIT and shield from the ulcer. 

23. Antacid are arranged into two kinds (1) Systemic-sodium bicarbonate and sodium citrate (2) Non fundamental these are from insoluble in the small digestive tract or contain a non solvent anions. Models calcium carbonate, magnesium hydroxide, magnesium trisilicate, aluminum hydroxide. 

24. Sodium bicarbonate 1.0g kills the 120 ml of 0.1 N HCl. NaHCO3+HCL NaCl+H2O+CO2 

25. It isn't suggested for long haul use since it causes fundamental alkalosis. 

26. Calcium carbonate-1.0 g kills 200ml of 0.1 N HCL. CaCO3+2HCL 2HCl+CaCl2+ H2O+CO2 

27. Magnesium Hydroxide-1 gm neutralize500 ml of 0.1 N HCL Mg (OH) 2 +2HCL MgCl2+ 2H2O 

28. Magnesium Tricilicate-1g kills 100 ml of 0.1 N HCL. 

29. Aluminum Hydroxide-1 gm kill between 12.5 to 25.0 ml of 0.1 N HCL. AL (OH) 3 + 3HCL ALCl3+3H2O 

30. Aluminum hydroxide is a gentle astringent and a demulcent. This specialist produce stoppage, as the Aluminum phosphate framed loosens up the intestinal smooth muscle. 

31. This stoppage result can be overwhelmed by the expansion of magnesium hydroxide. 

32. Cimetidine contain Imidazole ring. 

33. Cimetidine given in tablet structures 200 mg multiple times day by day and 400 mg each evening for multi week. 

34. Cimetidine is enough ingested orally, through bioavailability is 60-80 % because of the main hepatic digestion. 

35. Antacid diminish assimilation of all H2 Blocker. 

36. Ketoconazole ingestion is decreased by H2 Blocker because of diminished gastric causticity. 

37. Renal disappointment increment the half life and dialysis shortness it. 

38. Ranitidine-it has a Thiazolyl ring. Oral portion is 150 mg offered or 300 mg before sleep time. 

39. Famotidine-It contains a Furan Ring structure. 

40. Nizatidine-it is the most up to date H2 receptor foe. It has a Thiazolyl ring and a side ring indistinguishable from ranitidine. 

41. Helicobacter pylori Eradication regimens-(Multi week routine) 

1. Amoxucycillin 500 mg tid + Metronidazole 400 mg tid + Omeprazole 20 mg bid or 40 mg OD for 7 days. 

2. Clarithromycin 250 mg bid + metronidazole 400 mg (or Tinidazole 500 mg) bid+ omeprazole 20 mg bid or 40 mg OD for 7 days. 

3. Amoxycilin 1 g bid + Clarithromycine 500 mg bid + Omiprazole 20 mg bid or 40 mg OD for 7 days. 

4. Lansoprazole 30mg bid + any two of the amoxiciline 1 g bid or Clarithromycin 250 mg bid, Metronidazole 400 mg for 7 days. 

42. Triple Therapy (2 Week Regimen) 

1. Tetracycline 500 mg tid+ Metronidazole 400 mg tid + colloidal bismuth 120 mg qid for 14 days. 

2. Amoxycilinine 750 mg tid + Metronidazole 500 mg tid + Ranitidine 300 mgf around evening time.

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