Discuss about anti ulcer drug

1. ANTI-ULCER DRUGS
By
Sourav chauliya
B.PHARM ,3rd YEAR, 6th SEMESTER
ROLL NO:-18901916002
REG NO:-161890220011 of 2016-2017
Under the guidance
Dr. SHYAMSHREE S.S. MANNA
DR. B. C. ROY COLLEGE OF PHARMACY & A.H.S, Durgapur

2. A peptic ulcer is an excoriated area of stomach or intestinal
mucosa caused principally by the digestive action of gastric juice
or upper small intestinal secretions.
The cause of ulceration is the imbalance of aggressive factor and defensive factors.
Aggressive
factors
Defensive
factors

3. Symptoms
 Abdominal pain classically epigastric with severity
relating to mealtimes, after around, hours of taking a
meal.
 Loss of appetite and weight loss.
 Nausea, and copious vomiting.

5. Classification Of Antiulcer Agent
1) Reduction of gastric acid secretion
H2 antihistamines : Cimetidine, ranitidine, famotidine, etc.
Adverse Effects : skin rash, stomach pain, low fever, nausea etc.
PPI’s : Omeprazole, lansoprazole, pantoprazole, etc.
Adverse effect : Stuffy nose, sore throat, mild diarrhea, etc.
Anticholinergics : Pirenzepine,propantheline.
Adverse effect : dry mouth and blurred vision.
Prostaglandin analogues: Misoprostol
Adverse effect : teratogenicity, pyrexia, shivering, etc.

6. 2) Neutralization of gastric acid by antacids-
Systemic : Sodium bicarbonate, sodium citrate
Adverse effect : vomiting, weakness.
Nonsystemic : Magnesium hydroxide, Magnesium trisilicate,
Aluminium hydroxide gel, calcium carbonate.
Adverse effect : muscle weakness, slow heartbeat etc.
3) Ulcer protectives: Sucralfate, CBS ( Colloidal Bismuth Subcitrate)
Adverse effect : constipation, insomenia etc.
4) Anti-H. pyloric drugs: Amoxicillin, clarithromycin, metronidazole,
tinidazole, tetracycline
Adverse effect : nausea, vomiting, rashes.

7. H2 antagonist
Inhibition of Histamine Release (Paracrine hormone)
H2 antagonist
Ranatidine
Cimetidine
Famotidine
Nizatidine HCl
• H2 receptors are present at basolateral membrane of parietal cells
• Basal secretion is suppressed
Highly effective in inhibiting nocturnal acid secretion
Effective in duodenal ulcers

8. PROTON PUMP INHIBITORS
 Inhibition of H+/K+ ATPase Pump
Omeprazole
Pantaprazole
Rabeprazole
Lansoprazole
Adverse effect of ppi’s drugs : headache, diarrhea, constipation,
abdominal pain, nausea, vomiting etc.

9. Ulcer Protective's – Sucralfate:
 It a basic aluminium salt of sulphated sucrose, a drug of its own
kind.
 It has no acid neutralising action, but delay’s gastric emptying,
 it’s own stay in stomach is prolonged.
 It is minimally absorbed after oral administration, action is
 entirely local.
 It promotes healing of both duodenal and peptic ulcer, efficacy
 has been found similar to cimetidine at four weeks.
 It is considered to be superior in patients who continue to
smoke.
 These are infrequently used now of need for large well timed
 daily doses and the availability of simpler H2 blockers/PPI.

10. Anti Helicobacter pylori drugs
 H pylori: Spiral- shaped, pH-sensitive, gram
negative bacteria.
 It attaches to the surface epithelium beneath the
mucus, has high urease activity
 Antimicrobials found clinically effective against
H.pylori : Amoxicillin, clarithromycin,
metronidazole.
 Single drugs rapidly develops resistance
(metronidazole).
 CBS is active against H.pylori and resistance does
not develop to it.

11. Referance-
1)Essentials of Medical Pharmacology by K.D. Tripathi
2)Introduction of Pharmacology by S.K. Kulkarni