1. Copyright (c) 2004 Elsevier Inc. All rights reserved. Drugs for Peptic Ulcer Disease Chapter 73

2. Copyright (c) 2004 Elsevier Inc. All rights reserved. Drugs for Peptic Ulcer Disease Peptic ulcer disease –Upper GI disorders –Degrees of erosion of the gut wall Cause –Imbalance between mucosal and aggressive factors

3. Copyright (c) 2004 Elsevier Inc. All rights reserved. Pathogenesis of Peptic Ulcers Defensive factors –Mucus –Bicarbonate –Blood flow –Prostaglandins Aggressive factors –Helicobacter –NSAIDs –Gastric acid –Pepsin –Smoking

4. Copyright (c) 2004 Elsevier Inc. All rights reserved. Classes of Antiulcer Drugs Antibiotics Antisecretory agents Mucosal protectants Antisecretory agents that enhance mucosal defenses Antacids

5. Copyright (c) 2004 Elsevier Inc. All rights reserved. Helicobacter pylori Test: breath test or serum Treatment—(two antibiotics are prescribed) –Bismuth –Clarithromycin –Amoxicillin –Tetracycline –Metronidazole

6. Copyright (c) 2004 Elsevier Inc. All rights reserved. Histamine-2 Receptor Antagonists Cimetidine (Tagamet) Ranitidine (Zantac) Ranitidine bismuth citrate (Tritec) Famotidine (Pepcid) Nizatidine (Axid)

7. Copyright (c) 2004 Elsevier Inc. All rights reserved. Proton Pump Inhibitors Omeprazole (Prilosec) –Inhibits gastric secretion –Short half-life –Used for short-term therapy Adverse effects –Headache –Gastrointestinal

8. Copyright (c) 2004 Elsevier Inc. All rights reserved. Sucralfate (Carafate) Protective barrier up to 6 hours Uses –Acute ulcers Adverse effects –Constipation Drug interactions