Pharmacological Treatments for DYSPEPSIA, GASTRITIS & PEPTIC ULCER

Pharmacological Treatments for DYSPEPSIA, GASTRITIS & PEPTIC ULCER

1. Acid Suppression

   • Histamine (H2) Receptor antagonist
     • MOA: Inhibits the action of Histamine ay H2 receptor on Parietal Cells
     • Administration
       • Twice Daily
       • Single dose at night for 4-8 weeks
     • Side effects
       • Diarrhoea
       • Altered Liver Function Test
       • Headache
       • Dizziness
       • Rash
       • Tiredness
   • Proton Pump Inhibitor
     • MOA: Inhibit H+/K+ dependent ATPasse proton pump, degreasing gastric acid secretion
       • Better than H2 antagonist as H2 only inhibit Histamine component, PPI inhibit the proton Pump
     • Examples
       • Omepraozole
       • Esomeprazole
     • Side Effects
       • GI distrbances
       • Headache
       • DIzziness
     • Caution
       • Gastric Cancer
       • Liver disease
       • Pregnancy & breast feeding

2. Antacids

   • Types
     • Magnesium
       • Diarrhoea
     • Aluminium
       • Contipation
     • Calcium
       • Hypercalcemia
   • MOA: Neutralize Gastric Activity
     • Increase In stomach and duodenal pH
     • Inactivation of pepsin
   • Alginate-containing
     • Forms a raft that floats on the surface of the stomach content

3. Prokinetics

   • MOA: Dopamine antagonist
     • Stimulate gastric emptyping & small intestinal transit
     • Enhance strength of esophageal spinchter contration
   • Examples
     • Metoclopramide
     • Doperidone
   • Side Effects
     • High blood prolactin level
     • Enlargement of breast in male
     • Abnormal production of breast milk

4. Cytoprotectives

   • Chelates
     • Unknown MOA
     • Examples
       • Tripotassium Dicitratobismuthate
       • Rinitidine bismuth citrate
   • Misoprostol
     • Uses
       • Older Frail People
       • prevention of gastric ulcer in patients requiring long tern non-steroidal or aspirin therapy
     • MOA: Antisecretory, inhibit basal & noctonal gasric acid secretion by parietal cells
   • Complexes
     • Sucralfate
       • MOA: activated by acid, forms viscous adherent gel that bind to ulcer crater
         • inhibit pepsin, absorbs bile salts
     • Side effects
       • Constipation, diarrhoea
       • Nausea
       • Gastric Discomfort

5. H.pylori Eradication

   • Recommended regimen

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