Peptic ulcers occur in the stomach and duodenum where gastric acid and pepsin are present. They result from an imbalance between aggressive factors like acid and protective mucosal defenses. Peptic ulcers are chronic diseases that last for years. Treatment goals are relieving pain, healing ulcers, preventing complications like bleeding and perforation, and preventing relapse. Therapies include reducing gastric acid with H2 blockers, proton pump inhibitors, anticholinergics, or prostaglandin analogs. Neutralizing gastric acid with systemic or nonsystemic agents. Ulcer protectives like sucralfate or bismuth subcitrate. Treating H. pylori infection with antibiotics.

1. Gastro intestinal drugs
Drugs for peptic ulcer and Gatroesophageal Reflux Disease
PEPTIC ULCER:- Peptic ulcer occurs in that part of the GIT
which is exposed to gastric acid and pepsin i.e. stomach and
duodenum.
 It results probably due to an imbalance between the
aggressive (Acid , pepsin , bile and H.pylori )and the
defensive ( gastric mucus and bicarbonate secretion ,
prostaglandins , nitric oxide , high mucosal blood flow ,
innate resistance of the mucosal cells ) factors.

2. • Peptic ulcer (especially duodenal) is a chronic remitting and
relapsing disease lasting several years. The goals of antiulcer
therapy are :-
 Relief of pain.
 Ulcer healing .
 Prevention of complication (Bleeding, perforation).
 Prevention of relapse.

3. Approaches for the treatment of peptic ulcer are:-
A. Reduction of gastric acid secretion
1. H2 antihistamines : Cimetidine, Ranitidine,Famotidine,
Roxatidine
2. Proton pump inhibitors :- Omeprazole ,Esomeprazole,
Lansoprazole, Rabeprazole.
3. Anticholinergic drugs:- pirenzepine, Propantheline,
Oxyphenonium.
4. Prostaglandine Analogue:-Misoprostole

4. B. Neutralization of gastric acid
1. Systemic :- Sodium bicarbonate, Sodium citrate.
2. Nonsystemic :- Magnesium Hydroxide, Mag. Trisilicate ,
Aluminium hydroxide gel, Magaldrate , Calcium carbonate.
C. Ulcer protectives : Sucralfate , Colloidal bismuth
subcitrate (CBS)
D. Anti-H pylori drugs : - Amoxilillin, Clarithromycin,
Metronidazole, Tinidazole, Tetracycline