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Pharmacology Topic Drugs for Peptic Ulcer Antiametic Drugs by: Dr. Nirav Shah, Dr. Prashant M.D.

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Presentation on theme: "Pharmacology Topic Drugs for Peptic Ulcer Antiametic Drugs by: Dr. Nirav Shah, Dr. Prashant M.D."— Presentation transcript:

1 Pharmacology Topic Drugs for Peptic Ulcer Antiametic Drugs by: Dr. Nirav Shah, Dr. Prashant M.D. 1dr prashant's

2 VOMITING Vomiting occurs due to stimulation of the emetic (vomiting) center situated in medulla oblongata. ANTIEMETICS These are drugs used to prevent or suppress vomiting. 2dr prashant's

3 CLASSIFICATION : 1.AnticholinergicsHyoscine, Dicyclomine 2. H1 antihistaminics Promethazine, Diphenhydramine, Cyclizine, Meclozine, Cinnarizine 3. NeurolepticsChlopromazine, Prochlorperazine, Haloperidol etc. 3dr prashant's

4 4.Prokinentic drugsMetoclopramide, Domperidone, Cisapride, Mosapride 5. 5-HT3 antagonists Ondansetron, Granisetron 6. Adjuvant antimeticsDexamethasone, Benzodiazepines, Cannabinoids. 4dr prashant's

5 ANTICHOLINEGRICS 1.most effective drug for motion sickness. 2.brief duration of action. 3.Produces sedation and other anticholinergic side effects. 4.Suitable only for short brisk journies. 5.It acts probably by blocking conduction of nerve impulses across a cholinergic pathway from the vestibular apparatus to the vomiting center. 5dr prashant's

6 6.It is non effective in vomiting of other etiologies. 7.Applied behind the pinna, it suppresses motion sickness while producing only mild side effects. 8.Dicyclomine – It has been used for prophylaxis of motion sickness and for morning sickness. 6dr prashant's

7 H1 ANTHIHISTAMINICS 1.Some antihistaminics are antiemetic. 2.They are useful mainly in motion sickness and morning sickness, postoperative and some other forms of vomiting. 3.Their antiemetic effect appears to be based on anticholinergic, antihistaminic and sedative properties. a.They afford protection of motion sickness. b.They produce sedation and dryness of mouth. 7dr prashant's

8 Cycline meclozine 1.These are less sedative and less anticholinergic. 2.Meclozine is long acting, protects against sea sickness. 3.It is also protective for motion sickness. 4.All antimotion sickness drugs are more effective when taken ½ -1 hour before journey. 5.It is better to avoid them for morning sickness. 8dr prashant's

9 NEUROLOPTICS 1.These are potent antiemetics. 2.Drug induced and postanesthetic nausea and vomiting. 3.Disease induced vomiting: gastroenteritis, liver disease, migraine etc. 4.Radiation sickness vomiting. 5.Morning sickness. 6.They are not effective in motion sickness. 9dr prashant's

10 7.Produce significant degree of sedation. 8.Used primarily as an antiemetic rather than as antipsychotic. 9.Extrapyramidal side effects are the most important limiting features. 10dr prashant's

11 Prokinetic drugs 1.Drugs which promote gastrointestinal transit and speed gastric emptying. 2.Widely used antiemetic. Actions 1.More prominent effect on upper g.i.t., increases gastric peristalsis. 2.Speeds gastric emptying, specially if it was slow. 3.It also increases intestinal peristalsis. 4.But has no significant action on colonic motility and gastric secretion. 11dr prashant's

12 CNS 1.Metoclopramide is an effective antiemetic. 2.Gastrokinetic action may contribute to the antiemetic effect. 3.Not useful as an antipsychotic. 12dr prashant's

13 D2 antagonism 1. Dopamine is an inhibitory transmitter in g.i.t. 2. Normally acts to delay gastric emptying when food is present in stomach. 3.It also appears to cause gastric dilation and LES relaxation. 13dr prashant's

14 4.Metoclopramide blocks D2 receptors and has an opposite effect. 5.Hastening gastric emptying and enhancing LES tone. 6.The central antidipaminergic (D2) action of metoclopramide on CTZ is clearly responsible for its antiemetic property. 14dr prashant's

15 5-HT 4 agonism 1.It acts in the g.i.t. to enhance ACh release. 2.Results from 5-HT4 receptor activation. 3.Which promote ACh release from, 4.The gastric hurrying and LES tonic effects are mainly due to this action. 15dr prashant's

16 PHARMACOKINETICS 1.Metoclopramide is rapidly absorbed orally, crosses placenta and is secreted in milk. enters brain, 16dr prashant's

17 INTERACTIONS 1.It hastens the absorption of many drugs, e.g. aspirin, diazepam. ADVERSE EFFECTS 1.Extrapyramidal side effects,diarrhoea, muscle dystonias are the main side effects. 2. parkinsomism and gynaecomastia. 3.It should not be used lactation. Though the amount secreted in milk is small, but suckling infant may develop loose motions, dystonia, myoclonus. 17dr prashant's

18 USES 1.Antiemetic. 2.Gastrokinetic 3.Dyspepsia. 4.Gastroesophageal reflux disease. 18dr prashant's

19 CISAPRIDE 1.cisapride-It is a prokinetic 3.Facilitates motility throughout g.i.t. including colon. 19dr prashant's

20 4.Oral bioavailability of cisapride is ~33%. 5.Cisapride is a prokinetic drug without antidopaminergic side effects, but abdominal cramps and diarrhoea can occur. 6.Primary indication of cisapride has been GERD. 20dr prashant's

21 5-HT 3 ANTAGONISTS Ondansetron 1-It controls cancer chemotherapy/radiotherapy induced vomiting. 2-highly effective in postoperative nausea and vomiting as well. 21dr prashant's

22 Pharmacokinetics Oral bioavailability of ondansetron is % due to first pass metabolism.. 22dr prashant's

23 CARMINATIVES These are drugs which promote the expulsion of gases from the. GIT and give a feeling of warmth and comfort in the epigastrium. DIGESTANTS These are substances intended to promote digestion of food. As appetite stimulants and health tonics. 23dr prashant's

24 Q.1Name three H2 Antihistaminic drugs? A. Cimitidine, Ranitidine, Roxatidine, Loxatidine, Femotidine. Q.2Name three Proton pump inhibitor drugs? A.Omeprazole, Lensoprazole, Pantoprazole, Robeprezole. Q.3Name two Anticholinergics used in treatment of Peptic ulcer? A.Piranzepine, Oxypnenonium. 24dr prashant's

25 Q.4Name of two Prostaglandin Analogues used in Peptic ulcer? A.Misoprosol, Enprostil, Rioprostil. Q.5Name two systemic Antacids? A.Sodium bi carbonate, sodium citrate. Q.6What is Magaldrate? A.Nonsystemic antacids. 25dr prashant's

26 Q.7Name one Ulcer healing Agents ? A.Carbenoxolone sod. Q.8Name three drugs regime for H.pylori treatment ? A.Tebacudine, Tenidacole, rnetrunidawle, Arnaxialin, claritnromvcin Q.9Name two side effects of cimetidine A. Headache, dry mouth, rashes dizziness CMS effect conational state convulsion coma. 26dr prashant's

27 Q.10 Name two Ulcer prote ctive drugs ? A.Collidal Bismuth Subcitrate, Sucral Fate Q11.Name five uses of H.Blockers ? A. Tetracycline Tenedazole Amoxycylene Q12.Name two drawbacks of Magnesium Antacids ? A.Poorly absorbed, in soluble, diarhhoea 27dr prashant's

28 Q13.Name two side effects of Aluminum Antacids ? A.Weak & slowly reacting Q14.Name two side effects of Colloidal Bismutli Sub citrate ? A.Diarrhoea, dizyness, Headache Q15.Name two contraindications of Emetics? A.Acid Poisoning, CNS stimulant 28dr prashant's

29 Q16.Name two emetics ? A.Epomorphin Q17.Name two Antichrolinergic ? A.Hyoscine, dicyclomine Q18.Name two Antihistaminic Anticmetic ? A.Promethazine, cyclizine 29dr prashant's

30 Q19.Name two Narcoleptics ? A.Chlorpromazine, Haloparidol Q20.Name two Prokinetic drugs ? A.Metoclopramide, Domperidon Q21.Name two 5HT 3 Antagonists ? A.Granisetrom, Ondancitron 30dr prashant's

31 Q22.Name DOC of Motion sickness ? A.Hyosine, Q23. What is the mechanism of action of metoclopromide ? A.D 2 antogonism, 5HT 4 & 5HT 3 antogonism Q24.DOC for chemotnerapy induced vomiting ? A.Ondansetron. Q25.Name two gall stone dissolving drugs ? A.Chemodiol, Ursodiol 31dr prashant's

32 We thank our students who attend our classes in large numbers and motivate/encourage us to learn and teach better. You can also send any study material suitable for undergrads to us at

33 Our other websites our other websites dr prashant's 33

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