1 © Patrick An Introduction to Medicinal Chemistry 3/e Chapter 22 ANTIULCER AGENTS Part 2: Helicobacter pylori

1 © Contents 21.Features of H. pylori (3 slides) 22.Treatment of H. pylori [5 slides]

1 © 21. Features of H. pylori Spiral, curved bacteriumSpiral, curved bacterium Grows best in oxygen concentrations of 5%Grows best in oxygen concentrations of 5% Naturally present in the stomachs of many peopleNaturally present in the stomachs of many people Attaches to a sugar molecule on the surface of the cells lining the stomach wallAttaches to a sugar molecule on the surface of the cells lining the stomach wall The organism secretes proteins and toxins that inflame the stomach liningThe organism secretes proteins and toxins that inflame the stomach lining Responsible for the recurrence of estersResponsible for the recurrence of esters The organism is protected by the mucus layerThe organism is protected by the mucus layer A pH gradient across the mucus layer means that the pH is near neutral at the stomach liningA pH gradient across the mucus layer means that the pH is near neutral at the stomach lining

1 © pH = 2 H. pylori Stomach contents Mucus layer pH = 4 pH = Features of H. pylori

1 © Bacterium produces urease enzymeBacterium produces urease enzyme Neutralises any acid in the local environmentNeutralises any acid in the local environment 21. Features of H. pylori

1 © Triple therapy of a proton pump inhibitor and two antibioticsTriple therapy of a proton pump inhibitor and two antibiotics Antibiotics work better at a higher pH than is normally present in stomachAntibiotics work better at a higher pH than is normally present in stomach The proton pump inhibitor is present to raise the pHThe proton pump inhibitor is present to raise the pHExample Omeprazole AmoxicillinMetronidazole 22. Treatment of H. pylori