This document summarizes drugs that affect the gastrointestinal tract. It discusses diseases of the GI tract and how drugs are organized based on the part of the tract they target. Key drug classes covered include H2 blockers, proton pump inhibitors, antacids, antiemetics, antibiotics, and more. The mechanisms and uses of these various drug classes are outlined in detail.
this will give brief about the peptic ulcer and give information about the drug used for peptic ulcer and classification of drugs including drugs and there use adverse effect.
The gastrointestinal tract is an organ system within humans and other animals which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces. The mouth, esophagus, stomach and intestines are part of the gastrointestinal tract
this will give brief about the peptic ulcer and give information about the drug used for peptic ulcer and classification of drugs including drugs and there use adverse effect.
The gastrointestinal tract is an organ system within humans and other animals which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces. The mouth, esophagus, stomach and intestines are part of the gastrointestinal tract
Drugs using for GI system(pharmacology)varsha surkar
INC Syllabus • Antiemetics • Emetics • Purgatives • Antacids • Cholinergic • Anticholinergics • Fluid and Electrolyte therapy • Antidiarrheals • Histamines Composition, Action, Dosage, Route, Indications, Contraindications, Drug Interactions, Side effects, Adverse effects, Toxicity & Role of nurse Proton pump inhibitors
3. Antiemetics •Antiemetics are the Drugs which prevent or control the Vomiting/Nausea.
4. Antiemetics • Antiemetic are the drugs which prevent or control the vomiting/nausea. Classification Ondansetron 5HT3 AntagonistsGranisetron Dolasetron Domperidone Prokinetics / Dopamine AntagonistsOlanzapine Metoclopramide Cyclizine Antihistamines Diphenhydramine Meclozine Promethazine Hydroxyzine Hyoscine & Dicyclomine Anticholinergics
5. Mechanism of action • 5HT3 Antagonists: They block serotonin receptors in CNS and Gastrointestinal tract So they can be used to treat post operative and cytotoxic (Chemotherapy) drugs nausea/ vomiting. • Prokinetics (Dopamine Antagonists): They block the dopamine neurotransmitter also they promote gastrointestinal motility & quicken gastric emptying. • Antihistamines: They block the histamine neurotransmitter and they act by an effect on vomiting center and by producing sedation. • Anticholinergics: An Anticholinergic agents block the neurotransmitter Acetyl choline in central and peripheral nervous system.
6. Drug example and doses S. No. Drugs Doses 1 Hyoscine 200-600mg (SC) 2 Diclomine 40mg 6hourly 3 Cyclizine 50mg 4-6 hour 4 Meclizine 25mg/day. 5 Metoclopramide 10mg 6 Domperidone 10-20 mg 4-6hours 7 Ondansetron 8-16mg
7. Indications / Uses •5HT3 antagonists are used in management of nausea vomiting associated with chemotherapy. •Antihistamine such as diphen hydramine is used for motion sickness and morning sickness. •Metoclopramide is used for gastric emptying in patient’s receiving tube feeding. •Anticholinergic such as hyoscine, Dicyclomine are useful in travel sickness.
8. Contraindication / Precautions •Diphenhydramine is contraindicated in hypertensive patients. •Metoclopramide is contraindicated in suspected gastrointestinal problem. •Use cautiously and reduced dose in renal impairment conditions.
9. Adverse effects •Hypotension. •Constipation. •Dryness of mouth. •Blurred vision. •Pain in IM injection site. •Drowsiness. •Rectal irritation. •Photo sensitivity reaction.
10. Drug interactions •Use antihistamine, other CNS depressants including opioids and sedative – hypnotic drugs causes additive CNS depression. •Metoclopramide affects GI motility and alter GI absorption of other drugs such as salicylates, levodopa, diazepam, lithium, tetracycline.
11. Nursing Responsibilities •Assess the patient for nausea/vomiting and fluid and electrolyte imbalances. •Decrease metoclopramide dose 50% of usual recommended dose if creatinine clearance is less than 40ml/min. •Instruct the patient not to consume alcohol when taking an antiemetic drugs. •Advise the patient to take oral antiemetics 1hour.
Peptic ulcers are open sores that develop on the inside lining of esophagus, stomach and/or the upper portion of small intestine. Peptic ulcer occur mainly due to imbalance between aggressive and defensive factors in the stomach.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Drugs using for GI system(pharmacology)varsha surkar
INC Syllabus • Antiemetics • Emetics • Purgatives • Antacids • Cholinergic • Anticholinergics • Fluid and Electrolyte therapy • Antidiarrheals • Histamines Composition, Action, Dosage, Route, Indications, Contraindications, Drug Interactions, Side effects, Adverse effects, Toxicity & Role of nurse Proton pump inhibitors
3. Antiemetics •Antiemetics are the Drugs which prevent or control the Vomiting/Nausea.
4. Antiemetics • Antiemetic are the drugs which prevent or control the vomiting/nausea. Classification Ondansetron 5HT3 AntagonistsGranisetron Dolasetron Domperidone Prokinetics / Dopamine AntagonistsOlanzapine Metoclopramide Cyclizine Antihistamines Diphenhydramine Meclozine Promethazine Hydroxyzine Hyoscine & Dicyclomine Anticholinergics
5. Mechanism of action • 5HT3 Antagonists: They block serotonin receptors in CNS and Gastrointestinal tract So they can be used to treat post operative and cytotoxic (Chemotherapy) drugs nausea/ vomiting. • Prokinetics (Dopamine Antagonists): They block the dopamine neurotransmitter also they promote gastrointestinal motility & quicken gastric emptying. • Antihistamines: They block the histamine neurotransmitter and they act by an effect on vomiting center and by producing sedation. • Anticholinergics: An Anticholinergic agents block the neurotransmitter Acetyl choline in central and peripheral nervous system.
6. Drug example and doses S. No. Drugs Doses 1 Hyoscine 200-600mg (SC) 2 Diclomine 40mg 6hourly 3 Cyclizine 50mg 4-6 hour 4 Meclizine 25mg/day. 5 Metoclopramide 10mg 6 Domperidone 10-20 mg 4-6hours 7 Ondansetron 8-16mg
7. Indications / Uses •5HT3 antagonists are used in management of nausea vomiting associated with chemotherapy. •Antihistamine such as diphen hydramine is used for motion sickness and morning sickness. •Metoclopramide is used for gastric emptying in patient’s receiving tube feeding. •Anticholinergic such as hyoscine, Dicyclomine are useful in travel sickness.
8. Contraindication / Precautions •Diphenhydramine is contraindicated in hypertensive patients. •Metoclopramide is contraindicated in suspected gastrointestinal problem. •Use cautiously and reduced dose in renal impairment conditions.
9. Adverse effects •Hypotension. •Constipation. •Dryness of mouth. •Blurred vision. •Pain in IM injection site. •Drowsiness. •Rectal irritation. •Photo sensitivity reaction.
10. Drug interactions •Use antihistamine, other CNS depressants including opioids and sedative – hypnotic drugs causes additive CNS depression. •Metoclopramide affects GI motility and alter GI absorption of other drugs such as salicylates, levodopa, diazepam, lithium, tetracycline.
11. Nursing Responsibilities •Assess the patient for nausea/vomiting and fluid and electrolyte imbalances. •Decrease metoclopramide dose 50% of usual recommended dose if creatinine clearance is less than 40ml/min. •Instruct the patient not to consume alcohol when taking an antiemetic drugs. •Advise the patient to take oral antiemetics 1hour.
Peptic ulcers are open sores that develop on the inside lining of esophagus, stomach and/or the upper portion of small intestine. Peptic ulcer occur mainly due to imbalance between aggressive and defensive factors in the stomach.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Diseases of GI Tract
• The gastrointestinal system is host to an extremely wide range of
diseases and disorders, that include
• Digestive disorders
• GI tract motility issues
• Cancers of GI tract tissues
• Gastroenteritis
• Dyspepsia
• Gastro-esophageal reflux disease (GERD)
• Peptic ulcers
• Infections ( H-Pylori )
• Constipation and
• Inflammatory Bowel Diseases and many others.
3. Drugs That Affect the GI Tract
ORGANIZATION OF CLASS
• The organization of these drugs is based on the
organization of the GI tract. There are drugs that
are used in treating ulcers in the stomach and
duodenum. There are also drugs that affect
motility in the upper GI tract. Then, moving down
to the large intestine, we can divide the agents into
those that enhance motility and those that reduce
motility. Finally, there are agents that specifically
target diseases of the lower GI tract.
4. Drugs That Affect the GI Tract
• H2 Blockers
• PPIs
• Antacids
• Promotility Agents (Metoclopramide)
• Anti emetics Drugs
• Emetics Drugs
• Anti diarrheal Drugs
• Laxatives Drugs
• Probiotics
• Antibiotics (to eradicate H-Pylori infection).
5. Histamine H2 receptor antagonists
• H2 receptor antagonists prevent histamine-induced acid
release. It binds reversibly with H2 receptor and inhibit
acid secretion, it includes:
• Cimetidine
• Ranitidine
• Famotidine
• Nizatidine
• These drugs are easily recognizable by the “-tidine”
ending.
• These drugs are used for the short-term treatment of
gastro esophageal reflux and peptic ulcer disease.
6. Proton Pump Inhibitors
(PPIs)
• Proton pump inhibitors (PPIs) are used to treat
• Gastric and Duodenal ulcers,
• Dyspepsia,
• Gastro-esophageal reflux disease (GERD) and
• NSAID-associated ulcers.
• Combined with anti bacterial, PPIs are used to
eradicate Helicobacter pylori infection.
• Can also be used to reduce the degradation of pancreatic
enzyme supplements in cystic fibrosis patients, and to
control excessive gastric acid production in Zollinger–
Ellison syndrome.
7. Proton Pump Inhibitors
• The “proton pump inhibitors” (the “..prazoles”) inhibit
the irreversibly Hydrogen- potassium adenosine-tri
phosphatase enzyme of the parietal cell of stomach. This
reduces acid secretion.
• Omeprazole
• Esomeprazole
• Dexlansoprazole
• Lansoprazole
• Pantoprazole
• Rabeprazole
• These drugs are superior to H2 antagonists in the
suppression of acid and in the healing of peptic ulcers
8. Prostaglandin Analogue
• The Prostaglandin analogue misoprostol is a synthetic
and approved for the treatment of gastric and duodenal
ulceration and NSAID-associated ulceration and
prophylaxis of NSAID-induced gastric and duodenal
ulcers.
• Misoprostol also induces labor, cause an abortion, and
also to treat postpartum bleeding due to poor
contraction of the uterus.
• It is taken by mouth when used to prevent gastric ulcers
in people taking non steroidal anti-inflammatory drugs
(NSAID). For abortions it is used by itself or in
conjunction with mifepristone or methotrexate.
9. Anti muscarinic drugs & Mucosal
protectants
• Anti muscarinic drugs such as the muscarinic
M1 receptor antagonist pirenzepine were used to
treat peptic ulcer, but are no longer widely used.
10. Antacids
• Antacids are weak bases that react with gastric acid to
form water and a salt to diminish gastric acidity.
• Antacids are used to relieve symptoms in dyspepsia and
in gastro-esophageal reflux disease and usually contain
aluminum or magnesium compounds.
• They should be given when symptoms occur or are
expected, usually between meals and at bedtime. They
may have to be given several times each day.
• Although they may help with ulcer-healing, their impact
is much less than for anti secretory drugs. Liquid
preparations are usually more effective than tablet
preparations.
11. Antacids
• e.g. aluminum hydroxide ( AlOH2), and magnesium
hydroxide Mg(OH)2, calcium carbonate (CaCO3 ) and
trisilicate Sodium bicarbonate, Simeticone and alginates.
• Alginates, added as protectants, may be useful in gastro-
esophageal reflux disease.
• 1. CaCO3 +HCL
• 2. AlOH2 + HCL
• 3. NaOH2 + HCL
• Note : Antacids are taken after meals for maximum
effectiveness.
CO2 + CaCl2
CO2 + AlOH2
NaCL + H2O
12. Mucosal Protective agents
• These are also known as cytoprotective compounds.
They work by a. preventing mucosal injury b. reducing
inflammation c. healing existing ulcers.
• 1.Sucralfate forms a protective coating on the mucosa,
particularly ulcerated areas.
• Constipation is the main side effect of Sucralfate.
• Note : Sucralfate requires acidic PH for activation, it
should not be administered with PPIs, H2 blockers or
antacids.
• 2.Bismuth subsalicylate it inhibits the activity of pepsin,
increases secretion of mucus, and it protects the ulcer
tissues. This agent is used as a component of Quadruple
therapy to heal H-pylori related peptic ulcers.
13. Mucosal protectants
• Mucosal protectants such as sucralfate may be
used to manage benign gastric and duodenal
ulceration and chronic gastritis, and as a
prophylactic for stress-induced ulcers.
• Sucralfate aids healing by forming a viscous,
protective layer on the ulcer's surface, but does
not prevent new ulcer formation.
14. Probiotics
• Probiotics are defined by the World Health
Organization as living microorganisms that have
health benefits when ingested in adequate
amounts.
• The most widely studied probiotics for
gastrointestinal conditions are from
the Lactobacillus and Bifido bacterium genus.
• E.g Enterogermina ampules
16. Anti Emetic Drugs
• Causes Of nausea & Vomiting :
• Motion sickness
• Pregnancy
• GI illness
• Gastritis
• Chemotherapeutic agents
• Severe pain of the body organs
17. Mechanisms that trigger vomiting
• Two brain stem sites have a key role in the vomiting reflex
pathway.
• 1. chemoreceptor trigger zone (CTZ)
( end of the fourth ventricle )
• 2. Vomiting center
• chemoreceptor trigger zone is located in the area postrema. It is
outside of the blood brain barrier. It can respond directly to
chemical stimuli in the blood or CSF.
• The vomiting center is located in the lateral reticular formation of
the medulla, coordinates the motor mechanisms of vomiting.
• The vestibular system functions mainly in the motion sickness.
• Dopamine receptor type 2 & Serotonin type 3 (5-HT3)
19. 1. Phenothiazine
• Drug name : Prochlorperazine
• It acts by blocking the dopamine receptor in the
CTZ.
• It is affective against low or moderately emeto
genic causing agents, although increasing the dose
improves antiemetic activity & adverse affects are
dose limiting.
20. 2. 5-HT3 receptor blocker
• Dolasetron
• Ondasetron ( ONSET )
• Granisetron
• Palonosetron
• These agents selectively block 5HT3 receptors
in the periphery & in the CTZ.
This class of agents is important in treating
CINV ( chemotherapy induced nausea &
vomiting), because of their superior efficacy &
longer duration of action.
21. 2. 5-HT3 receptor blocker uses
• Prior to Chemotherapy
• All grades of emetogenic therapies
• Management of post operative nausea and
vomiting.
• These are extensively Metabolized in liver,
however ondasetron require dose adjustments in
patients with hepatic insufficiency.
• Excretion via kidney in urine.
• Side effect : QT prolongation
22. 3. Substituted Benz amides
• Drug name : Metoclopramide
• It causes inhibition of dopamine in the CTZ.
• It enhances GI motility and is useful for patient with gastropresis.
Metoclopramide has both peripheral and central effects.
Centrally, it is a dopamine antagonist and has produced
extrapyramidal side effects. Peripherally, it stimulates release of
acetylcholine
• 4. Butyrophenones
• Droperidol & haloperidol both act by blocking dopamine
receptors. These are moderately effective antiemetic drugs.
• Side effect : QT prolongation
23. 5.Benzodiazipines
• Lorazepam & alprazolam
• Low antiemetic effect
• Sedative, anxiolytics & amnestic properties.
• 6. Corticosteroids
• Dexamethasone & methyl prednisolone
• Used alone are effective against mild to moderate
vomiting.
• Commonly used in combinations with other agents
, antiemetic mechanism is unknown but it may
cause blockade of prostaglandins.
24. 7. Substance P/ Neurokinin-1
receptor blocker
• Apripetant
• Netupitant
• Rolapitant
• These drugs targets the neurokinin receptor in the
vomiting center and blocks the action of substance
P.
Usually used in combinations with other antiemetic
drugs.
25. 8. Combination regimens
• Antiemetic drugs often used in combinations to increase
efficacy or to decrease toxicity.
For examples
• Dexamethasone & ondasetron
• Dexamethasone, diphenhydramine, droperidol &
metoclopramide.
• Dexamethasone, diphenhydramine & metoclopramide.
• Dexamethasone, Lorazepam & metoclopramide
26. Anti obesity agents
• Orlistat is a lipase inhibitor being used to treat
obesity.
• Orlistat binds to pancreatic and gastric lipase and
inactivates the enzyme.
• This reduces the absorption of dietary fat by about
30%.
• Adverse effects include flatulence, oily spotting,
and fecal urgency.