GI DRUGS.pdf - Objectives • • • • GI Medications Trim II 2016/ew/Pharm II/NRSG 232 Describe Ulcer healing drugs Describe Laxatives and

GI DRUGS.pdf - Objectives • • • • GI Medications...

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7/17/2016 1 GI Medications Objectives Describe Ulcer healing drugs Describe Laxatives and antidiarrheals Describe Antiemetics Describe Drugs for gallbladder and pancreatic diseases 2 Trim II 2016/ew/Pharm II/NRSG 232 3 Trim II 2016/ew/Pharm II/NRSG 232 4 Trim II 2016/ew/Pharm II/NRSG 232 Pathological states Mouth Systemic diseases Mechanical trauma Nutritional deficiencies Dental disorders Pharynx Inflammation (sinusitis) Esophagus Heartburn (GERD) Inflammation (esophagitis) Dysphagia (difficulty swallowing) 5 Trim II 2016/ew/Pharm II/NRSG 232 Pathological states Stomach Acute gastritis Chronic gastritis Peptic ulcer disease Liver Viral hepatitis Cirrhosis carcinoma Gallbladder Cholecystitis Cholelithiasis 6 Trim II 2016/ew/Pharm II/NRSG 232
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7/17/2016 2 Pathological states Pancreas Pancreatitis Carcinoma Diabetes Small intestine Diarrhea constipation Large intestine Diarrhea Constipation Diverticular disease Ulcerative colitis carcinoma 7 Trim II 2016/ew/Pharm II/NRSG 232 Ulcer healing drugs Peptic ulcer arise when there is either disturbance in the hydrochloric acid produced ie if its high or when there is a disturbance in the gastric mucosal barrier. Consequently, drugs are used to either reduce the hydrochloric acid produced or to bolster the gastric mucosa barrier. There are several classes of drugs used for treating peptic ulcers: H2 receptor antagonist proton pump inhibitors prostaglandin analogues antimuscarinics and chelates and complexes. 8 Trim II 2016/ew/Pharm II/NRSG 232 Physiology of Gastric Secretion Parietal cell Primary acid producing cell Located in body & fundus of stomach H + /K + ATPase pump (adenosine triphosphatase) Generates largest ion gradient known in vertebrates Influenced by: Acetylcholine, Histamine, Gastrin, Prostaglandins 9 Trim II 2016/ew/Pharm II/NRSG 232 Lower esophageal sphincter (LES) Duodenum Esophagus Fundus Antrum Body (Corpus) 10 Trim II 2016/ew/Pharm II/NRSG 232 Physiology of Gastric Secretion Normal stomach pH: Basal acid: approx 1-2 Post prandial: 4-5 (x 1 hour) Which in turn stimulates greater acid production 11 Trim II 2016/ew/Pharm II/NRSG 232 Gastric Defense Tight junctions Between gastric epithelial cells Mucin layer Overlying cells Bicarbonate ion Secreted into mucin layer Prostaglandins Stimulate mucus production, bicarb, mucosal blood flow 12 Trim II 2016/ew/Pharm II/NRSG 232
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7/17/2016 3 Drugs For Control of Gastric Acidity Antacids Cytoprotectants H-2 receptor antagonists Proton pump inhibitors 13 Trim II 2016/ew/Pharm II/NRSG 232 Antacids Mechanism: Local neutralization of acid Increase gastric pH Components: Aluminum hydroxides; Al(OH) 3 Magnesium hydroxides; Mg(OH) 2 Magaldrate (eg, Riopan) Calcium carbonate; CaCO 3 Sodium bicarbonate; NaHCO 3 14 Trim II 2016/ew/Pharm II/NRSG 232 Antacids
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