Peptic ulcer - Classification,mechanism of action,antacid

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 PEPTIC ULCER  - Part 1 

  • Peptic ulcer is result from imbalance between acid pepsin secretion and mucosal defense factor
  • Stomach secrete 2.5 litre of gastric juice daily

MECHANISM OF ACTION:
  • Chief cell secrete pepsinogen
  • Parietal cell secrete hydrochloric acid and intrinsic factor
  • Gastric acid secretion regulated by 
  • Acetylcholine   - muscarinic receptor
  • Gastrin - g receptor
  • Histamine- h2 receptor
  • Acetylcholine and gastrin act on parietal cell
  • Act indirectly on enterochromaffin cells releasing histamine
  • Mucosa secretes mucus which forms the protective layer ,bicarbonate and prostaglandin
  • Prostaglandin stimulate mucus and bicarbonate that leads to vasodilation and thereby inhibit gastric secretion 

CLASSIFICATION :

  • DRUG FOR PEPTIC ULCER :
  • A) GASTRIC ACID SECRETION INHIBITOR :
H2 antihistamine - CIMETIDINE,RANITIDINE

Proton pump inhibitor - OMEPRAZOLE,LANSOPRAZOLE

  • B) GASTRIC ACID NEUTRALIZER :
Systemic - sodium bicarbonate,sodium citrate

Non systemic - magnesium hydroxide,calcium hydroxide 

  • C) ULCER PROTECTIVE - Sucralfate,CBS
  • D) ANTI H PYLORI DRUG- Amoxicillin,metronidazole
ANTACID:

  • Antacid is a basic substance 
  • Its given orally ,neutralize gastric acid ,rise ph of gastric content 
  • Types of antacid : 1) Systemic ,2) Non systemic 




  • 1) SYSTEMIC : 
Rapid ,short acting
Carbon dioxide is released in stomach and get absorbed to intestine and result in systemic alkalosis 
It used with other drug 
systemic antacid is sodium bicarbonate 
  • 2) non systemic :
Insoluble compound 
React with hydrochloric acid to form chloride salt and water
non -systemic antacid - aluminum hydroxide ,magnesium hydroxide ,calcium carbonate 
Its astringent and demulcent form protective coating over ulcer
binds with phosphate and prevent absorption



USES 

Antacid is used as adjuvant in hyperacidity peptic ulcer 

DRUG INTERACTION;

Antacid form complex with ranitidine,fluoroquinolone,digoxin 
Its to be taken either 2 hours before or after food 

AIM OF THIS POST ;
Vanakam , hope you all are doing fine today we have learnt about peptic ulcer we started with a small introduction,mechanism of action,classification we moved on to learn in detail about antacid where in we focused firstly on systemic antacid then on non systemic antacid and finally we finished it by learning uses and drug interaction of antacid ,hope this post helped you all the next post will be continuation of peptic ulcer drug we will be focusing on proton pump inhibitor .

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