Flashcards
BMS13-1058 Pharmacology of gastric acid control
Cards in this deck (21)
- 1What is an ulcer?A chronic lesion/sore in the GI tract
- 2What are the symptoms of ulcers?1. Abdominal pain
Relieved by eating if in duodenum
2. Heartburn
3. Bloating - 3What are 2 complications of ulcers?1. Penetration when ulcer burrows in pancreas/liver
2. Perforation when ulcer opens
3. Upper GI bleeding when ulcer erodes artery - 4What causes ulcers to develop?1. Smoking
2. H. pylori (main cause)
3. Aspirin/non steroidal anti-inflammatory drugs - 5Does acid hypersecretion cause ulcers?Very rarely
- 6In a gastric ulcer, which area is infected with H pylori? What is the main disruption to the balance between mucosal defence and acid/pepsin?The gastric corpus
Normal levels of gastric acid, defect in gastric mucosal resistance - 7In a duodenal ulcer, which area is infected with H pylori? What is the main disruption to the balance between mucosal defence and acid/pepsin?The gastric antrum
Increased secretion of acid/pepsin creates an environment like the gastric mucosa that H pylori can infect - 8Where does H pylori grow and what does it cause?Grows beneath surface of epithelial cells
Causes increased secretion of gastrin/pepsin to damage mucosa - 9What does H pylori secrete to protect itself from gastric acid?Urease that converts urea to bicarbonate/CO2
- 10How can H Pylori be detected?Antigen test in stool samples
Antibody test in blood - 11How does Ach from PNS fibres directly impact the parietal cell?Binds to M3 receptor
Increases Ca2+
Increases activity of H+/K+ pump to increase HCl secretion - 12How does histamine impact the parietal cell?Binds to H2 receptor
Increases cyclic AMP
Increases activity of H+/K+ pump to increase HCl secretion - 13How does gastrin from the G cell impact the parietal cell? (It also stimulates ECl cell)Binds to CCKb receptor
Increases Ca2+
Increases activity of H+/K+ pump to increase HCl secretion - 14How do prostaglandins promote secretion of mucus/HCO3-? How does it inhibit HCl secretion?Binds to EP3 receptor on cells
Binds to EP3 receptor on parietal cell to inhibit HCl secretion - 15How do proton pump inhibitors work? Give an exampleIrreversibly block parietal cell H+/K+ ATPase
Are inactive, converted to sulfenamides at pH<3
Omeprazole - 16How do H2 receptor blockers work? Give an exampleSelectively block parietal cell H2 receptors
Famotidine, ranitidine, cimetidine - 17How does bismuth chelate/sucralfate work? What is sucralfate used to treat mainly?Coats the ulcer to protect it from gastric juices and promote healing
Can also kill H pylori
Stress ulcers - 18What is taken with NSAIDS to prevent ulcers?Misoprostil
- 19What are the 5 main ways to treat ulcers?1. Proton pump inhibitors (Omeprazole)
2. H2 receptor blockers (Famotidine)
3. Improve mucosal protection (bismuth chelate/sucralfate)
4. Misoprostil for NSAIDS caused ones
5. Antimicrobial therapy combined with 1/2 - 20What is gastro-oesophageal reflux disease (GORD)?Reflux of stomach back into oesophagus
causes inflammation, heartburn, tooth erosion - 21How to treat GORD?1. Lifestyle changes
2. Proton pump inhibitors to reduce gastric acidity
3. Antacids/alginic acid neutrallses gastric pH, forms foam raft on top of stomach
4. Gastric motility stimulating agents (eg. Metoclopromide/domperidone)
5. Fluorides etc. to protect teeth
Information
- Description
- LOs to understand: - factors causing ulcers - Role of H pylori in ulcers - Regulation of HCl secretion - Drugs promoting ulcer healing - Treatment for GORD
- Created by
- Evian Chai · Mar 2020
- Updated
- Mar 28, 2020
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