lesson 14

• Peptic Ulcer Disease (PUD)

  Characterized by epigastric pain, loss of appetite, and weight loss
• Peptic Ulcer Disease


  • Caused by Helicobacter pylori infection or NSAIDs
  • Characterized by inflamed ulcer of mucosa, causing pain when eating due to release of hydrochloric acid
• Gastric acid secretion


  1. Secreted by proton pump hydrogen potassium ATPase in parietal cells

  2. Stimulated by histamine, ACh, and gastrin

  3. Irreversibly blocked by proton pump inhibitors (-azole)

  
• Histamine


  Can be blocked by H2 receptor antagonists like cimetidine, famotidine, and ranitidine
• Prostaglandin


  Inhibits gastric acid secretion and stimulates mucus and bicarbonate secretion

  
• Sucralfate


  Binds to proteins in ulcerated area and exerts a cytoprotective effect
• Antacids


  Neutralize gastric acid (e.g. aluminum hydroxide, magnesium hydroxide, calcium carbonate)
• Drugs for peptic ulcer disease

  • Drugs that eliminate H. pylori
  • Drugs that reduce gastric acidity
  • Drugs with cytoprotective effect
• Histamine, ACh, and Gastrin


  • Principal stimulants of gastric acid secretion
• Reducing gastric acidity


  1. Neutralizing gastric acid with antacids

  2. Inhibiting gastric acid secretion with H2 receptor antagonists
• H2 receptor antagonists


  Potent inhibitors of meal-stimulated and basal gastric acid secretion
• Proton Pump Inhibitors (PPIs)


  Administered orally, can be sustained release or enteric release

  
• Gastric Antacids


  Neutralize stomach acid by increasing GI pH to relieve dyspepsia and acid indigestion, and enable peptic ulcer healing
• Gastric Antacids


  • Aluminum hydroxide
  • Magnesium hydroxide
  • Calcium carbonate