Drugs as digestants and carminatives.

Pharmacology of digestants and carminatives.

1. Drugs as Digestants and Carminatives . Miss Snehal S. Chakorkar (M.pharm) Dept Of Pharmacology 1

2. 2 Introduction: Digestants Definition: “ These are substances intended to promote digestion of food .” A number of proteolytic , amylolytic and lipolytic enzymes are marketed in combination formulations and are vigorously promoted for dyspeptic symptoms, and as appetite stimulants or health tonics. They are occasionally beneficial, only when their elaboration in g.i.t . is deficient. 

3. 3 Their routine use in tonics and appetite improving mixtures is irrational. 1. Pepsin May be used along with HCl in gastric achylia due to atrophic gastritis, gastric carcinoma, pernicious anaemia , etc . 2. Papain It is a proteolytic enzyme obtained from raw papaya . Its efficacy after oral ingestion is not known. 3. Pancreatin It is a mixture of pancreatic enzymes obtained from hog and pig pancreas. It contains amylase, trypsin and lipase, and is indicated in chronic pancreatitis or other exocrine pancreatic deficiency states.

4. 4 Fat and nitrogen content of stools may be reduced and diarrhoea/ steatorrhoea may be prevented . It has to be used as enteric coated tablets or capsules to protect the enzymes from being themselves digested in stomach by pepsin. Nausea, diarrhoea and hyperuricaemia are the occasional side effects . 4. Diastase and Takadiastase These are amylolytic enzymes obtained from the fungus Aspergillus oryzae . They have been used in pancreatic insufficiency, but efficacy is equivocal .

5. 5 Brand name Preparation Dosage form ARISTOZYME Fungal diastase 50 mg, pepsin 10 mg, simethicone 50 mg Capsule, Liquid DIGEPLEX: Diastase 62.5 mg, pepsin 20 mg Tablet ENTOZYME Fungal diastase 50 mg, pepsin 10 mg Syrup LUPIZYME Pepsin 125 mg, fungal diastase 18.75 mg, thiamine 2 mg, riboflavine 1 mg, pyridoxine 1.5 mg, vit B12 1 μg , nicotinamide 15 mg Capsule/ Syrup PANZYNORM Pancreatine 100 mg, bile ext. 40 mg Tablet UNIENZYME Fungal diastase 20 mg, papain 30 mg, simethicone 50 mg, nicotinamide 25 mg, activated charcoal 75 mg Tablet

6. 6 Methyl polysiloxane ( Dimethyl polysiloxane , Simethicone , Dimethicone ) It is a silicone polymer , a viscous amphiphilic liquid—reduces surface tension and collapses froth, ‘ antifoaming agent ’. It is not absorbed from g.i.t . and is pharmacologically inert . Added to antacid, digestant and antireflux preparations, it is briskly promoted as a remedy for ‘gas’, a very common gastric complaint. It is also claimed to coat and protect ulcer surface, to aid dispersion of antacids in gastric contents, and to prevent gastroesophageal reflux. However clinical efficacy is equivocal .

7. 7 carminatives . Definition: “ These are the agents which Promotes expulsion of gases from the Gastro intestinal tract and give a feeling of warmth and comfort in the epigastrium ” Various drugs used for the purpose are Sod. bicarb , Oil peppermint, inc. Cardamom Co., oil of dil , Tincture ginger . Uses of Digestants and carminative; Dyspepsia Discomfort in the upper abdomen Gas formation Feeling of fullness Burning sensation

8. 8 Reference: Rang H.P. and Dale M.M.: Pharmacology, Churchill Livingstone, Edinbergh . Katzung B.G.: Basic and Clinical Pharmacology, Lange Medical Publications, California. Craig C.R. and Stitzel R.E.: Modern Pharmacology, Little Brown and Co., Boston. Bowman W.C. and Rand M.J.: Textbook of Pharmacology, Blackwell Scientific Publications, Oxford. P.N Bennett & M J Brown: Clinical Pharmacology, Churchill Livingstone, Edinburgh. Tripathi K.D.: Essentials of Medical Pharmacology, Jaypee Brothers, Medical Publishers, New Delhi.

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