Gastro intestinal drugsDrugs for peptic ulcer and Gatroesophageal Reflux Disease

PEPTIC ULCER:- Peptic ulcer occurs in that part of the GIT

which is exposed to gastric acid and pepsin i.e. stomach and

duodenum.

It results probably due to an imbalance between the

aggressive (Acid , pepsin , bile and H.pylori )and the

defensive ( gastric mucus and bicarbonate secretion ,

prostaglandins , nitric oxide , high mucosal blood flow ,

innate resistance of the mucosal cells ) factors.

• Peptic ulcer (especially duodenal) is a chronic remitting and

relapsing disease lasting several years. The goals of antiulcer

therapy are :-

Relief of pain.

Ulcer healing .

Prevention of complication (Bleeding, perforation).

Prevention of relapse.

Approaches for the treatment of peptic ulcer are:-

A. Reduction of gastric acid secretion

1. H2 antihistamines : Cimetidine, Ranitidine,Famotidine,

Roxatidine

2. Proton pump inhibitors :- Omeprazole ,Esomeprazole,

Lansoprazole, Rabeprazole.

3. Anticholinergic drugs:- pirenzepine, Propantheline,

Oxyphenonium.

4. Prostaglandine Analogue:-Misoprostole

B. Neutralization of gastric acid

1. Systemic :- Sodium bicarbonate, Sodium citrate.

2. Nonsystemic :- Magnesium Hydroxide, Mag. Trisilicate , Aluminium hydroxide gel, Magaldrate , Calcium carbonate.

C. Ulcer protectives : Sucralfate , Colloidal bismuth subcitrate (CBS)

D. Anti-H pylori drugs : - Amoxilillin, Clarithromycin, Metronidazole, Tinidazole, Tetracycline