Proton Pump inhibitors Flashcards
(24 cards)
Treatment of PUD
Treatment of H. pylori
Suppression of acid secretion
Protective agents
Suppression of acid secretion is done by
Histamine H2-antagonists
Proton pump inhibitors
Antacids
How to diagnose H. pylori
By endoscopy
First line treatment of H. pylori
Clarithromycin triple
Bismuth quadruple
Second line treatment of H. pylori
Levofloxacin triple
Example of histamine H2-antagonists
Cimetidine
Ranitidine (zantac)
Adverse effects of histamine H2-antagonists
Diarrhea Headache Fatigue Myalgias Constipation
Adverse effects of cimetidine
Inhibits androgens Increases prolactin Gynecomastia Galactorrhea Impotence
Examples of PPIs
Omeprazole
Pantoprazole
Action of PPIs
Irreversibly inhibits H/K-ATPase
Site of activation of PPIs
Partial cells
Adverse effects of long term use of PPIs
Elevation of gastric pH
Increase risk of hip, wrist, spine fractures
Increase risk of respiratory infections and enteric infections
Increase serum gastrin
Elevated gastric pH can lead to
Incomplete absorption of
Iron
Calcium carbonate
Vitamin B12
Infections due to prolonged use of PPIs are mainly by this organism
Clostridium diffcile
Increased serum gastrin lead to
ECL hyperplasia
function of antacids
Chemically neutralize HCL
Examples of antacids
Aluminum salts
Magnesium salts
Sodium carbonate
Calcium salts
Uses of antacids
Dyspepsia
GERD
Peptic ulcer
Which types of antacids can cause kidney stones
Calcium salts
Magnesium salts
Action of prostaglandins E2 and I1 on gastric mucosa and acids
Inhibits acids
Stimulate mucus secretion
Stimulate bicarbonate secretion
Dilated mucosal blood vessels
About using antacids with other drugs
Antacids interact with several drugs
Used alone
Examples of Protective agents PUD
Sucralfate
Misopristol
Bismuth
Mechanism of sucralfate
From a gel complex with proteins
Mechanism of action of misoprostol
It’s a PGE1 analogue
