Pharmacology B. Lin, I-Yao. A 43y/o male CEO of a multinational company experienced severe burning pain one and a half hour after a sumptuous lunch. This is accompanied by mild nausea and vomiting. He was given a glass of milk and some cookies which apparently provided some relief.
Sign and symptoms:
NaHCO3, Mg(OH)2, Al(OH)3.
Proton-Pump inhibitors: Omprazole, Lansoprazole.
H2 – Antagonists: Cimetidine, Ranitidine.
Sucralfate, Bismuth chelate, Prostaglandins
Omprazole + Clarithromycin + Amoxillin/ Metronidazole
1. Proton-Pump inhibitors: Omprazole, Lansoprazole.
-inhibits gastric parietal cell proton pump H+/K+ ATPase, dercease gastric acid secretion.
2. H2 – Antagonists:
-blocker H2-receptor and reduce cAMP which inhibit gastric acid secretion.
Cimetidine-confusion, reversible gynecomastia.
The H2-receptor antagonist can’t combined with PPI inhibitor which the H2-receptor antagonist even inhibit omeprazole.
-selective binding to necrotic ulcer tissre and act as barrier to acid, pepsin, bile.
-requires acid pH to be activated, there fore should not be used with antacid, H2 antagonist or proton pump inhibitors.
2. Bismuth chelate
-binds and ulcer tissue, coat it and protectit from acid and pepsin.
-inhibits secretion of HCl and stimulates secretion of mucus and bicarbonate (cytoprotective effect).