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Alkaline compounds that are used to neutralize an acidic gastric environment
What is used to treat the S/Sx of GERD?
What does activation of the M3 receptors do?
- Increase GI secretions
- Increase tone and motility
- Increase salivations
What is the anti-cholinergic drug not used in the US used to treat GI problems?
What are 4 defensive factors in the stomach?
- Continuous secretion of mucus
- Bicarbonate to neutralize acid
- Blood flow to increase secretions and prevent ischemia
What are the roles of prostaglandins in the stomach?
- Promote vasodilation
- stimulate secretion of mucus and bicarb
- suppress gastric acid secretion
What factors aggravate the formation of stomach ulcers?
- Increased gastric acid injures cells and activates pepsin
- Pepsin injures unprotected cells
- Smoking vasoconstricts
- NSAIDs block prostaglandin production
What is difficult about pharmacological treatment of stomach ulcers?
- Lots of drugs
- May take 2-3 at a time
- Side effects can include N/V/D
Drugs used to treat GERD
H2 receptor blockers
Where is H2 and what does it do?
- It is in the parietal cells of the stomach
- Increases the secretion of gastric acid
What do H2 receptor blockers do?
Suppress the secretion of gastric acid
What was the first H2 blocker?
What are the side effects of Tagamet?
What are three H2 receptor blockers?
- Ranitidine (Zantac)
- Famotidine (Pepcid)
- Nizatadine (Axid)
What is the most important thing to remember when passing an H2 receptor blocker IV?
Give it slowly, otherwise it may cause hypotension
What are the most effective drugs for treatment of gastric acid secretion?
Proton pump inhibitors
What is the action of Proton Pump Inhibitors?
Prevents basal and stimulated gastric acid release because they are irreversible
What is the risk of long term use of PPIs?
What is the PPI used to treat Zollinger-Ellison Syndrome?
This is a gastrin secreting tumor treated by Rabeprazole (Aciphex)
- Creates a barrier in the stomach between the acid and the epithelium
- May impede the absorption of other drugs
Who would not get Cytotec?
A pregnant women, it can cause ripening of the cervix
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