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  2. GROUP MEMBERS Mwiti Evans Muthomi- BCM/K/0011/2021 Benedicto S Liyayi- BCM/K/0029/2021 Okoyo Judith Auma- BCM/K/0506/2019 Scolar Chepkoech- BCM/K/0501/2021 Kecha Daniel Kiplangat- BCM/K/0517/2021
  3. INTRODUCTION TO GASTROINTESTINAL PHARMACOTHERAPY • Pharmacotherapy is the treatment of health conditions using drugs. • Gastrointestinal conditions that require medical attention include: i. Peptic ulcers disease ii. Acid reflux disease.
  4. PEPTIC ULCER DISEASE DEFINATION • Peptic ulcer disease is a break in the inner lining of the stomach, the first part of the small intestine or sometimes the lower esophagus • An ulcer in the stomach is called a gastric ulcer.
  5. • An ulcer in the first part of the intestines is a duodenal ulcer. CAUSES • Helicobacter pylori • Non-steroidal anti-inflammatory drugs • Underlying health conditions.
  6. SIGNS AND SYMPTOMS o Abdominal pain o Bloating and abdominal fullness o Nausea and vomiting o Loss of appetite and weight loss o Melena- foul smelling feaces
  7. MANAGEMENT OF PEPTIC ULCERS (i) Eradication therapy Applicable in the cases of H.Pylori Involves first line and second line treatment. (ii) Proton pump inhibitors Used in management of ulcers that are induced by NSAIDs Omeprazole, lanzoprazole, esomeprazole are used.
  8. (iii) Antacids They ease the symptoms but for a short time. They affect the action of antibiotics hence precaution should be taken. (iv) Antibiotics For treatment of bacterial induced ulcers.
  9. ACID REFLUX DISEASE DEFINATION • A disease of the upper gastrointestinal tract in which stomach content persistently flow up into the esophagus. • This normally has serious consequences and complications
  10. CAUSES Poor closure of the lower esophageal sphincter. SIGNS AND SYMPTOMS o Dental corrosion o Dysphagia o Heartburn o regurgitation
  11. o Odynophagia- pain when swallowing. o Non cardiac chest pain DIAGNOSIS • Monitoring of pH • Endoscopy • Esophageal manometry but only prior to surgery
  12. TREATMENT (i) Antacids Used for infrequent symptoms of reflux. (ii) Histamine blockers They help lower acid secretion. (iii) Proton pump inhibitors They block the pathways of acid production. (iv) Prokinetic agents- they act on smooth muscles.
  13. LAXATIVES AND CATHARTICS LAXATIVES These are agents that treat and prevent constipation TYPES OF LAXATIVES • Bulk forming laxatives They increase the weight of stool • Emollient laxatives They soften stool by adding water and fats.
  14. • Lubricant laxatives Coat the stool with slippery lipids • Hyperosmotic laxatives Draw water into the bowel • Stimulant laxatives Alter water and electrolyte secretion.
  15. CATHARTICS They accelerate defecation Examples: • Vegetable oils- they are indirect acting. • Emoclin- an irritant glycoside acting on the large intestines.
  16. ANTIEMETIC AND ANTIDIARRHEAL AGENTS ANTIDIARRHEAL AGENTS Non specific agents They do no influence underlying cause. They include: a) Adsorbent agents They adsorb bacterial toxins to ease the condition
  17. b) Bulk forming agents They increase the weight of the stool c) Antimotility and antisecretory agents They slow the movement in the tract. d) Anticholinergic agents They manage abdominal pain associated with diarrhea
  18. Specific antidiarrheal agents • Used to treat underlying cause of diarrhea • They correct malabsorption syndromes • They include antibiotics such as ampicillin and cotrimazole • Agents are selected carefully for specific cases.
  19. ANTIEMETIC AGENTS Are used to control nausea and vomiting CLASSIFICATION OF ANTIEMETICS 1. Cannabinoids- used when patients are unresponsive to other agents. Include nabilone and dronabilone. 2. Benzodiazepine- most effective when in combinations
  20. 3. Lorazepam- active for nausea and can be combined with selected medications. 4. Steroids- dexamethasone normally given in low doses 5. Dopamine antagonists- they act on the brainstem and treat vomiting associated with cancer
  21. Side effects of antiemetics. • Altered state of perception • Indigestion and increase appetite • Dry mouth and nasal passage • Ringing in ears • Fatigue • Constipation.