NM%20-%20Handout%206%20answers

NM%20-%20Handout%206%20answers - BIPN 102 Spring 2010 Ni Mo...

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BIPN 102 – Spring 2010 Ni Mo Week 7: Handout #6 nmo@ucsd.edu Material Covered: Lectures 11 and 12 OH: Friday 10-11am PC East Peptic Ulcers Peptic ulcers can be the result of several factors: 1. Helicobacter pylori – accounts for 90% of causes for peptic ulcers a. How does it protect itself from stomach acid? H. pylori contains an enzyme called urease , which catalyzes the reaction: urea + H 2 O CO 2 + 2NH 3 . The NH 3 then reacts with the H + in stomach acid to make NH 4 + , which acts as a buffer to protect the bacteria. b. Treatment: Use antibiotics with H + pump inhibitor (e.g. Omeprazole, Lansoprazole, Esomeprazole, etc.) 2. Zollinger-Ellison Syndrome a. What is it? It is a condition of excessive acid production due to elevated levels of gastrin secreted b. Treatment: H + pump inhibitors 3. “Stress” a. What is it? It is caused by excessive cortisol, ACTH, or other pituitary hormones, all of which stimulate gastric secretion. b. Treatment:  H + pump inhibitors 4. Iatrogenic a. What does that mean? Iatrogenic basically means it is caused by a medical treatment. In this case, excessive use of NSAIDs such as Aspirin (aka acetylsalicylic acid) is the main cause of ulcer. b. How does it work?  NSAIDs inhibit cyclooxygenases (COX 1, 2, and 3), which are enzymes necessary for the synthesis of prostaglandins. One group of prostaglandins (specifically from COX 1) has the function for production of mucus, which are protective agents against acid. No COX 1 no PG no mucus more susceptible to ulcers. c. Treatment:  Gastric receptor blockers: H + pump inhibitors, cholinergic antagonists (e.g. Atropine or Pirenzepine), or H2-antagonists (e.g. Ranitidine or Cimetidine) Phases of Digestion Last week: Cephalic Phase, Oral Phase, Gastric Phase This week: - Intestinal Phase:  when chyme from stomach enters duodenum and small intestines
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NM%20-%20Handout%206%20answers - BIPN 102 Spring 2010 Ni Mo...

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