L22- GIT Drugs I (diseases) Flashcards
Acute Peptic Disorders: list the corroding factors
- gastric acid
- pepsin
- bile (backwash)
- H. pylori
Acute Peptic Disorders: list the protective factors
- mucus and HCO3- secretion
- blood flow
- mucosal cellular regeneration
- PGs
discuss the role of PGs in the stomach
(inc the functions of protective factors)
- dec gastric acid secretion
- inc mucus and bicarb. secretion
- inc blood flow
GERD Sxs + complications
Sxs: heartburn, regurgitation, water brush (excess saliva), dysphagia
Complications: Barrett’s, esophageal CA
Peptic Ulcer Disease definition
corroding factors overwhelm protective factors, and erosions progressing to ulcers if imbalance is not corrected
PUD:
- (1) gastric main cause and Sx
- (2) duodenal main cause and Sx
1- NSAIDs, epigastric pain worsened by eating
2- H. pylori, epigastric pain relieved by eating
PUD complications
life threatening:
- upper GI bleed
- gastric / duodenal perforation
- gastric outlet obstruction
list the factors that stimulate gastric acid protection or suppression
Note- on parietal cells
(+) Histamine, H2 receptors (Gs)
(+) ACh, M3 (Gq)
(+) gastrin, CCKb
(-) PG-E1 (Gi)
Note- activation or inhibition of protein kinase ==> effects on Proton Pump
H. Pylori main microbial features
Gram(-)
urease(+)
flagellum (highly motile)
H. pylori clinical manifestations
PUD (gastric, duodenal)
chronic gastritis
gastric adenocarcinoma
gastric lymphoma
discuss H. pylori eradication therapy
Triple: antibiotics x2 + PPI
Quadruple: antibiotics x2 + PPI + bismuth subsalicylate
- Both 10-14 day antibiotics
- PPI for 1 month
- <15% recurrence
discuss role of PPIs in H. pylori therapy
- direct antimicrobial properties
- inc gastric pH –> lowers minimum inhibitory concentration of antibioitics needed to clear organism (inc drug survival)
