Lecture/ seminar on MUCLecture_2021_101328341.pptx

immunization

1. AL-MUSTAQBAL UNIVERSITY COLLEGE DEPARTMENT OF ANESTHETIC TECHNOLOGY Drugs used for treatment of GIT disease DONE BY : DR. ABDULLA K RAHEEM

2. Drugs used for treatment of GIT disease peptic ulcer drugs adsorbent, antiflatulent , and digestive drugs antidiarrheal and laxative drugs antiemetic and emetic drugs

3. peptic ulcer drugs Peptic ulcer drugs are aimed at either eradicating H. pylori or GI mucosal defense. These drugs include: 1-systemic antibiotics 2- antacids 3- Histamine-2 (H2) receptor antagonist 4- proton pump inhibitor 5- other peptic ulcer drugs, such as misoprostol and sucralfate .

4. Systemic antibiotics H . pylori is a gram-negative bacterium that’s thought to be a major causative factor in the formation of peptic ulcers and gastritis (inflammation of the stomach lining). Eradication of the bacteria helps to heal ulcers and decrease their recurrence . amoxicillin clarithromycin metronidazole tetracycline They are indicated for H. pylori eradication to reduce the risk of a duodenal ulcer. For this reason they may be used in conjunction with other medications such as proton pump inhibitors. Successful treatment plans use at least two antibiotics and a proton pump inhibitor for 14 days and then use a proton pump inhibitor for 6 more weeks to help reduce acid in patients with a peptic ulcer.

5. Antacids Antacids are medications that are used as adjunct therapy to treat peptic ulcers. They include: • aluminum carbonate gel • calcium carbonate • magnesium hydroxide and aluminum hydroxide - Antacids work locally in the stomach by neutralizing gastric acid . They don’t need to be absorbed to treat peptic ulcers. - The acid-neutralizing action of antacids reduces the total amount of acid in the GI tract, allowing peptic ulcers to heal.

6. H2-receptor antagonists H2-receptor antagonists are commonly prescribed antiulcer drugs in the United States. They include: • cimetidine, famotidine and ranitidine H2-receptor antagonists block histamine from stimulating the acid secreting . - H2-receptor antagonists are used therapeutically to: • promote healing of duodenal and gastric ulcers • provide long-term treatment of pathologic GI hypersecretory conditions such as Zollinger -Ellison syndrome • reduce gastric acid production and prevent stress ulcers in the severely ill patient and in the patient with reflux esophagitis.

7. Proton pump inhibitors Proton pump inhibitors disrupt chemical binding in stomach cells to reduce acid production, lessening irritation and allowing peptic ulcers to better heal. They include esomeprazole • lansoprazole • omeprazole • pantoprazole • rabeprazole .

8. Proton pump inhibitors Proton pump inhibitors are given orally in enteric-coated formulas to bypass the stomach because they’re highly unstable in acid. When in the small intestine, they dissolve and are absorbed rapidly . Proton pump inhibitors block the last step in the secretion of gastric acid by combining with hydrogen, potassium, and adenosine triphosphate in the parietal cells of the stomach

9. Pharmacotherapeutics of BPI Proton pump inhibitors are indicated for: • short-term treatment of active gastric ulcers • active duodenal ulcers • erosive esophagitis symptomatic GERD unresponsive to other therapies • active peptic ulcers associated with H. pylori infection, in combination with antibiotics • long-term treatment of hypersecretory states such as Zollinger - Ellison syndrome.

10. Other antiulcer drugs • misoprostol (a synthetic form of prostaglandin E1) • sucralfate Misoprostol protects against peptic ulcers caused by NSAIDs by reducing the secretion of gastric acid and boosting the production of gastric mucus, a natural defense against peptic ulcers Sucralfate works locally in the stomach, rapidly reacting with hydrochloric acid to form a thick, paste like substance that adheres to the gastric mucosa and, especially, to ulcers. By binding to the ulcer site, sucralfate actually protects the ulcer from the damaging effects of acid and pepsin to promote healing. This binding usually lasts for 6 hours.

11. 2- Adsorbent , antiflatulent , and digestive drug Adsorbent, antiflatulent , and digestive drugs are used to fight undesirable toxins, acids, and gases in the GI tract, aiding healthy GI function Adsorbent drugs Natural and synthetic adsorbents are prescribed as antidotes for the ingestion of toxins, substances that can lead to poisoning or overdose. The most commonly used clinical adsorbent is activated charcoal, a black powder residue obtained from the distillation of various organic materials . Antiflatulent drugs Antiflatulents disperse gas pockets in the GI tract. They’re available alone or in combination with antacids. A major antiflatulent drug currently in use is simethicone .

12. Digestive drugs Digestive drugs (digestants) aid digestion in the patient who’s missing enzymes or other substances needed to digest food. Digestants that function in the GI tract, liver, and pancreas include: • pancreatin • pancrelipase • lipase • protease • amylase (pancreatic enzymes).

13. 3- Antidiarrheal and laxative drugs Diarrhea and constipation are the two major symptoms related to disturbances of the large intestine - Antidiarrheals act systemically or locally and include: • opioid-related drugs • kaolin and pectin Opioid-related drugs Opioid-related drugs decrease peristalsis in the intestines and include: • diphenoxylate with atropine • loperamide .

14. Laxatives stimulate defecation and include: • hyperosmolar drugs • dietary fiber and related bulk-forming substances • emollients • stimulants • lubricants . Hyperosmolar laxatives Hyperosmolar laxatives work by drawing water into the intestine, thereby promoting bowel distention and peristalsis. They include: • glycerin • lactulose

15. Dietary fiber and related bulk-forming laxatives A high-fiber diet is the most natural way to prevent or treat constipation. Dietary fiber is the part of plants not digested in the small intestine. Stimulant laxatives Stimulant laxatives, also known as irritant cathartics, include: • bisacodyl • castor oil • senna .

16. 4- Antiemetics and emetics Antiemetics and emetics are two groups of drugs with opposing actions. Antiemetic drugs decrease nausea, reducing the urge to vomit . Emetic drugs, which are derived from plants, produce vomiting Antiemetics The major antiemetics are : • antihistamines, including buclizine , cyclizine , dimenhydrinate , diphenhydramine, hydroxyzine hydrochloride and meclizine. • phenothiazines , including chlorpromazine, prochlorperazine maleate and promethazine. • serotonin 5-HT3 receptor antagonists, including dolasetron , granisetron , and ondansetron

17. Emetics Emetics are used to induce vomiting in a person who has ingested toxic substances. Ipecac syrup is used to induce vomiting in early management of oral poinsoning or drug overdose. Ipecac syrup induces vomiting by stimulating the vomiting center located in the brain’s medulla.