Drugs affecting the esophagus, stomach and duodenum:
* Gastro-esophageal reflux medications.
* Algthianat and Alakieouat drugs.
* Peptic ulcer drugs.
– Drugs affecting the small intestine and the colon:
* Changers intestinal transit time.
* Antispasmodics digestive system.
* Changers intestinal resorption.
Drugs affecting the stomach and duodenum
First, drugs gastro esophageal regurgitation
Gastro-oesophageal result of anatomical or functional injury of the lower sphincter to MRI regurgitation, RealVideo Marri movement driving to an inflammation of the esophagus.
Of the main symptoms of gastro-esophageal regurgitation are: a sense of heartburn and regurgitation and belching and regurgitation can be seen in the course of endoscopy, it can also identify anomalies and associated lesions (diaphragmatic hernia, esophageal mucosal injury).
There are several possibilities for the treatment of gastroesophageal reflux and regurgitation include:
– Dietary guidelines and health (reducing the amount of the meal, to prevent bending forward, prevent lying down after meals, lift the head on a high pillow during sleep to prevent regurgitation at night).
– Medicines include:
1. stimulant drugs for the movement for total esophageal gastric Alafja.
2. counter medications for the secretion of gastric (looking with ulcer drugs).
3. drugs localized influence of anti-acidity and gastrointestinal portfolio, (looking with ulcer drugs).
1. stimulant medication for gastroesophageal reflux movement Total:
This group includes the following medicines: the Cisapride, the Domperidone, and Metoclopramide.
Leads to the liberation of acetylcholine in Alkolanerjeeh fiber in the digestive tube, and this increases the movement in the level of al-Marri, stomach, duodenum and colon minute and intestines, In addition, it increases the pressure in the lower sphincter to MRI opposite so gastro esophageal regurgitation.
Cisapride does not have the adverse effects of dopamine (unlike the rest of the movement of digestive stimulants), but it does receptors Alserotonah 5HT4, which supports the impact Almhai and strengthens the movement.
The Cisapride used mainly in the treatment of gastro-oesophageal reflux and pay attention to prevent its use in the context of the existence of an obstacle to progress morsel organic food industry. Its use can lead to the emergence of intestinal pain (abdominal) and diarrhea, also can alter the kinetics and absorption of other drugs, and does not have the Cisapride central effects (does not cross the blood-brain barrier).
Ataaks do the Cisapride atropine which inhibits Almoskarinih receptors, also Ataaks Balvevan butyl and toxin Alkzazi (proteins containing zinc), as a result of inhibition of acetylcholine liberation of proteins disable the tanker.
Opposite of dopamine, pass the blood-brain barrier with difficulty, so undesirable effects centralized does not happen (within the normal conditions of use).
It strengthens and regulates the motor esophageal infectious duodenal, without alter the digestive secretions.
It is also used to control the effects of the Ldopa peripheral.
Similar to the receptors Alserotonah 5HT4, effects and uses of Domperidone itself owns, but it differs in that the Metoclopramide readily crosses the blood-brain barrier, and thus lead to undesirable neurological Refreshers model effects, especially poor movement sharp (the child), but its effect on receptors 5HT4 partly responsible for the increase intestinal motility.
Compressed, syrup, solution for injection, suppositories
Second: nausea and vomiting drugs
Vomiting is the act of a complex Reflexive, requires a harmonious and coordinated between the effectiveness of the respiratory muscles and the abdominal muscles, and the voluntary muscles in the digestive tube.
The epicenter of vomiting, which adjusts the mutual smooth movements of the muscles involved and muscle planned, an object in the Bassa near the nucleus of infectious pulmonary nerve (vagus).
– Sensitive chemical receptors for the media center in the trigger zone (CTZ), located in the land of the fourth ventricle, which includes the nucleus Almpehmah.
Receives sensitive receptors Chemical Media Center (CTZ) alerts through the blood stream and the way the nervous system, and this sensitive center of chemical alerts an effect that drugs Almqaih Center (apomorphine, morphine), and also the impact of Almqaih liberal factors of doing some counter medications for cancers of the center.
If the CTZ is also responsible for the nausea, the main nerve responsible for vomiting and arguments are: acetylcholine, histamine, serotonin and dopamine.
Classification of drugs affecting the vomit:
Drugs affecting classified into two groups in the vomit
1. Almqaih medicines (emeticology).
2. anti-vomiting medications.
1. Almqaih medicines (emeticology):
Is the use of drugs leads to a Alakieouat include:
– The Ipeca Cuauha, topically affect the stomach (mixed mechanism) and Taatsam by knurled because they contain Emetine and Cephacline.
– The Apomorphine, is emetic drug reference, and has tested the effect of other anti-vomiting, affect the CTZ.
– Copper sulphate, topically affect the stomach.
Emeticology uses: s emeticology operates in the following cases:
– Emptying the stomach content in the context of the acute poisonings.
– Anti-emetic drugs tests to determine their effectiveness.
This prevents the use emeticology in:
– Awareness of the disorder.
– Chemical poisoning substances.
– Poisoning petroleum products.
– During swallow foam materials.
2. anti-vomiting medications.
Is incidental materials reduce or eliminate the impact of nausea and vomiting, and should involve other processors Sabbieh. It includes anti-vomiting
1. Anti-dopamine drugs.
2. anti-histamine medications.
3. anti-receptor drugs Almoskarinih.
4. Anti-serotonin drugs.
1. Anti-dopamine drugs:
And it includes: the Benzamides, the Domperidone and derivatives of Phenothiazines.
Is the anti-emetic includes strong, the Alizapride, which is an anti-vomiting opposite dopamine, has the effect to prevent too little nervous, which is free of anti-cholinesterase ability characteristics.
Used in Algthianat and Alakieouat (updated medicines cancer), and lead used to occur: drowsiness, dizziness, headache, insomnia, disorders of extrapyramidal (ill Packer movement or late), endocrine disorders (high blood prolactin, gynecomastia, runny milk, the absence of the menstrual cycle. ..), hypotension Alentsaba (when used with the amounts or large after intravenous, so it must be injected slowly when the patient reclining).
Do not use when pregnant and breastfeeding women and decreases the amount in people with congestive Advanced College, and also prevents its use in patients with adrenal tumors core.
Compressed, granules for injection intramuscular and intravenous.
It is a strong anti-vomiting, opposite dopamine, has a refreshing neurological effects are weak, and the advantage of the impact of anti-regurgitation gastro-oesophageal (alert esophageal motor infectious duodenal), which is free of anti-cholinesterase ability characteristics. Used in all cases that lead to vomiting and nausea, and in the updated Alakieouat cancer drugs, and in demonstrations indigestion associated with digestive disorders of movement.
It can result in large amounts or used for an extended period to: somnolence, extrapyramidal disorders, endocrine disorders, epilepsy relapse in crises.
Its use as the cases of a rare occurrence to headache, dizziness, diarrhea, insomnia and a tendency to depression.
Prevent its use in the core of the adrenal tumors, hemorrhages, obstruction or perforation of the gastrointestinal.
Compressed, syrups, drops, suppositories, granules for injection.
Is an anti strong vomiting is derived from the Butyrophenones, anti-dopamine crosses the blood-brain barrier with difficulty, and the advantage of the impact of anti-regurgitation gastro-oesophageal (alert esophageal movement infectious duodenal), which is free of Aldhadh effects of the ability of choline, used in Algthianat updated medicines cancer and Alakieouat, and in demonstrations indigestion digestion of the origin of the movement of digestive disorders.
Its use in rare cases to the occurrence of extrapyramidal disorders, Tendai absence of the menstrual cycle (high amounts and prolonged treatment).
It prevents its use in tens late movement resulting from the use of nerve Refreshers In hemorrhages and blockage or perforation of the gastrointestinal.
Compressed, granulators sparkling, suspended for drinking
The derivatives Phenothiazines:
The Metopimazine, is a strong anti-vomiting, opposite dopamine, has refreshing characteristics of nervous and contrary to the weak capacity of choline, which is well tolerated in general, used in Algthianat updated and Alakieouat cancer drugs.
It can lead used in rare cases to occur: drowsiness, dry mouth (very rare), constipation, disorders of extrapyramidal, glandular disorders, disorders in conformity, entrapment of poly, hypotension erectile (intravenously), and in very rare cases Olargiaiah disorders.
Portfolio, syrup, points to Lipper, Hbabat for injection
2. anti-histamine medications:
Characterized by anti-H1 receptors Alheistamenah the effects of anti-nausea and vomiting, and most of the preventive treatment, that is, they are most effective if taken before nausea or vomiting, but they also have some control effects of Akieouat Algthianat and when I got.
Do not affect the updated Alakieouat direct impact on the CTZ, but they affect the updated Alakieouat Althah vector, and the nuclei isolated direct impact on the stomach, pharynx to affect the way set out to vomiting center.
Used in the prevention of travel sickness, and the prevention of Algthianat and Alakieouat, can lead used to a drowsiness, dry mouth, constipation, upset conformity, lack of secretions lacrimal, density in secretions bronchial, tachycardia, confusion mental or hyperstimulation.
It prevents their use in patients with glaucoma, and the magnitude of the prostate, and when pregnant and breastfeeding women and children under two years.
3. anti-receptor drugs Almoskarinih:
The Hyoscine, opposite the receptors Almoskarinih, stating in Alakieouat of origin labyrinthine, and in Alakieouat resulting from topical alert in the stomach, which does not help in Alakieouat resulting from an alert on the CTZ, is useful in the prevention of Alakieouat and Algthianat, and shows the impact the maximum after 1-2 hours take it from oral.
Its use Otroppinih effects (drowsiness, blurred vision, dry mouth, entrapment poly).
We recall Ozia of anti-receptors Almoskarinih the Scopolamine and Atropine.
Compressed, solution for injection
Solution for injection under the skin
Solution for injection
4. counter medications for serotonin:
According to the Alakieouat resulting from the use of toxic substances to the cell, increases the liberation of serotonin in the gastrointestinal tract (cancer drugs).
Run counter to alert 5HT3 receptors in the friendly match endings, which exhibits the way upward to the rear area (Area Postrena), causing vomiting. It includes drugs used for 5HT3 Kamadadh of vomiting:
The Ondansetron, the Granisetron, the Tropisetron, the Zacopride, is higher than the effectiveness of anti-vomiting, dopamine antagonists (Metoclopaminde), and their use leads to occurrence of headache, weakness, drowsiness, high blood pressure or on the contrary, low blood pressure.
Compressed, solution for injection.
Compressed, solution for injection.
Portfolio, solution for injection.
Used often leak into a vein to give concurrent with anti-cancer provided that they do not repel each other with each other.
– The Cannabiniods including the Nabilone, contrasts Alakieouat alert resulting from the CTZ, and Ataaks do pal Naloxone (opposite of pure morphine) taken from the oral.
It can happen drowsier use, role, drier in the mouth, down the orthostatic pressure, hallucinations, changes in behavior and maternal symptoms.
– Steroids, do the anti-emetic unknown mechanism Although there are reports and studies already calling for anti-vomiting large amounts of steroids, which Ttsand influence with the Ondansetron. More commonly used steroids are the Dexamethazone, and Methyl Prednisolone.
– Topical drug, numbness ends of the sensory fibers of the vagus nerve infectious, usually used ice and iced drinks and some topical drug conservatively.
Third: infectious duodenal ulcer drugs
Infectious duodenal ulcers, is a limited loss in the mucosa of the stomach or duodenum, may extend to the submucosal layer and sometimes to the muscle layer.
Peptic ulcer affects 10-15% of the world’s population (male> female), are located either in the stomach ulcers (often in the small curvature), or in the duodenum (more frequently of stomach ulcers), and be single or ulcers, which are often multiple.
Pathogenicity mechanism of peptic ulcer:
Gastric ulcers and duodenal produce in general:
– Excessive secretion of acid.
Or – infection of the mucous laced Helicobacter pylori.
Or – poisoning drug (NSAIDs Guy Ralsteroiadah, aspirin)
Still real mechanism for the occurrence of ulcers is well known, and the last thing is put up, upset the balance between the forces of attack (subversive elements of the mucosa), and the forces of defense (the protective elements and preservatives mucosa)
– The secretion of gastric acid
– The secretion of mucous layer of surface cells Alaptlaalah
– Activating Albesenugen
– Bicarbonate secretion of mucous layer.
– Infection Pal H.b. Pylori
– Protector act of the apical surface of the cells of the mucous infectious spread towards the hydrogen ions in the mucous.
– NSAIDs (aspirin) ..
– Alaptlaalah mucous cells in the ability of renewal after injury
– Damage to the inhibition of alert mechanisms for gastrin secretion, hydrochloric acid.
– The establishment of the mucous Broustaglanadinat enjoyed by the markets, and that the preservation of the blood contained and alert mucus secretion and Allbeckroponat.
This can be summarized topical reasons leading to material loss in mucous to:
– Hyperacidity and effectiveness Bbsinojah position.
– Diminutive in localized blood circulation.
– Diminutive in mucus secretion.
– Infection laced the Helico bacter Pylori.
On that ulcers are caused by:
– An increase in the elements of assault with a natural defense elements.
– A decrease in defense elements with the elements of a normal attack.
– An increase in the elements of the attack and a decrease in defense elements.
Clinical scene of the digestive ulcer:
Often precedes digestive disorder (dyspepsia), and clinically manifest ulcers pain, colic or be in Colnj or twisted or hunger is painful, is located in the epigastrium area, and associated radioactivity and spreads vary from one patient to another.
Pain appears after 1.5-2 hours of the meal and the food industry sometimes after 3-4 hours. -ohaana- Be a pain so intense that awakens the disease of sleep (midnight), and nothing to do with the quantity and quality of food, lasts from 1 / 4-1 hour comes stages (2-6 week) separated by periods of rest, ease the pain usually eating or using alkaline materials.
Pain may take the form of non-typical Viazahr a sense of burning, digestion disorder, or swelling, a sense of heaviness, sometimes located in the gallbladder or the dorsal region, has nothing to do with food, on the contrary, sometimes the pain is getting eating.
The diagnosis of ulcers:
Diagnosis of an ulcer on clinical and precedents story depends, and the complementary tests, clinical story reveals a pain (typical or not) and localization and general condition of the physical patient’s mental state, also reveal the precedents family history (genetic) or precedents disease (tuberculosis or respiratory failure), and whether patient alcohol or smoked or deals with some accused of medicines in causing ulcers (NSAIDs), and the complementary examinations depends on endoscopy, which allows access to the biopsy, and can follow the radial photographed to detect the mixing of stenotic, preoperative report (if necessary ).
Ulcer treatment aims to:
– Analgesia colitis.
Or – the restoration of the physical loss mucosa and protection from the occurrence of complications (bleeding, perforation, obstruction, refractory) pain.
Or – maintain the restoration (scarring) and to prevent relapse.
This requires the achievement of the above objectives resort to:
– Amendments gastric hypersecretion.
Or – cover the mucosa of the stomach and duodenum dressing Hafez.
Or – the effect on the basis of the disease colitis (psychological and pathological soil of the patient).
Based on the current approved plans colitis Treatment of the disease on the use of the following means:
First – dietary measures.
Second – Commandments physical health and psychological.
Thirdly – pharmacological means.
Fourthly – surgical means.
First – dietary measures:
It is noteworthy at this time following the inhalers diet, which is based on the following:
– Delete sour foods.
– Induced food to delete gastrin secretion (fried foods, foods rich Balsllowes, materials of spicy pepper and spices and onions and garlic .. warm and foods).
– Eat induced the secretion of the Enterogastrine food, which inhibits gastric secretion (milk, white, fresh cheese, egg yolk, cream, butter ….).
– Prevent alcohol (irritation region Almkarohh and predispose to bleeding, inflammation and intractable, and this is what impedes healing).
– Prevent or reduce coffee, tea, cocoa, cola (increase digestive secretions, and inhibit cholinesterase, responsible for the hydration of acetylcholine).
– Rationing or prevent smoking (nicotine stimulates the vagus, which increases the discharge sour).
It must segmentation daily food contained a small multi-Juba (5-6), because the big meal pylori expand strongly, increasing the pain and secretion.
We must strive to be the diet for a patient with peptic ulcers, be enough to secure the needs of the patient, and be palatable harmless, because the insurance psychological comfort are important in the treatment of disease colitis.
Second – Commandments physical health and psychological:
Referred to a patient with an inspired Egrahih sharp, bed rest periods sufficient (1-2-3 week …), so that does not allow him to leave his bed for a period of hours a day, serving the health needs, but if the attack was a moderate intensity, be sufficient to sleep for a period of 12-14 hours / 24 hours.
Also referred intellectual nerve comfortable, and avoid emotion and anger, and preferably the patient in severe cases isolated in the hospital, where can get away from everything Iwrgah of stress and thinking.
Thirdly – pharmacological means:
Affect medicines currently available, and used in the treatment of peptic ulcer disorders pathophysiological its toll of disease and colitis include:
1. inhibitory drugs or modified to secrete acid:
– Alheistamenah receptor antagonists H2.
– Proton pump inhibitors.
– Anticholinergic ability (Almoskarinih receptor blockers).
– The Octreotide.
– Antacids localized effect.
2. counter medications for Helicobacter Pylori:
3. garrison medicines for gastrointestinal mucosa:
– The Sucralfat.
– The Misoprostol.
– The Carbenoxolone.
I. inhibitory drugs or modified to secrete acid:
1 receptor antagonists Alheistamenah H2:
This group belatedly found out about the drugs anti-histamine H1, and was the first drug trade is making the Cimetidine then the Ranitidine and Famotidine and finally the Nizatidine
Antihistamines inhibit this; in eclectic Alheistamenah receptors H2, and therefore the most important results of their impact; it is the inhibition of gastric acid secretion (basic, daytime, night meal or raised for food industry)
It seems that the effectiveness of anti-histamine medications H2 neutral in terms of impact of anti-secretion, if used within the recommended conditions.
Ranging vital Readiness for H2 antihistamines between 50% (the Ranitidine, the Famotidine) and 90% of the (Nizatidine), so the therapeutic amounts used, consistent with the Readiness.
These drugs are used to reduce the evening infectious Night acidity, and raised primarily through college.
The Cimetidine inhibits the Cytochrome P-450, while the rest of the individuals minimal impact.
Used anti Alheistamenah H2 receptors in the treatment of the following cases:
– Gastric ulcers and duodenal and esophageal (following acid regurgitation).
– Gastrointestinal bleeding originating high colitis (interstitial) road.
Compressed, solution for injection.
Compressed, solution for injection.
Compressed, solution for injection.
Compressed, solution for injection.
It can lead all anti-receptors Alheistamenah H2, the occurrence of heart attack Btaeh (cancel positive impact in cardiac contraction), and all other unwanted effects are not dangerous.
Has the Cimetidine undesirable effects of model glandular, it increases the concentrations Albulasmih of prolactin, which leads to the occurrence of gynecomastia, runny milky, or adverse effects of androgen happen (removal of the dihydrotestosterone of places to install it), have reported cases of non-sexual ability, added to what has already been Alsamtidin slows down the speed of the liver metabolism of many drugs (inhibition of cytochrome P450): Cal Benzodiazepines, oral anticoagulants, Hasrat β, the Ciclosporine and Theophylline, leading to increased concentrations above the usual boundaries, and thus the appearance of unwanted effects or toxicity.
2. pump inhibitors of the H + / K + ATPase:
A pharmacist resistant includes inhibitors of proton pump of oral acidity period, then suck of the intestine and spread in the total organic, half-vital old Albulasmi hour ranges almost, and lasting impact 24 hours; because the inhibition of the pump is not reversible, and therefore lasting impact until the renewal of the enzyme. There is this drug molecules inhibit Almkhaddh are reversible is still under study.
Inhibits all of the Omeprazole and Lansoprazole and Pantoprazole pump protons are non-reversible, it does not directly affect Pettmasha with infectious mucous, but is absorbed by the intestinal, and spread in the organic unexpectedly homeless, and secreted in the channels parietal cells infectious area.
In the micro-channel (microscopic), where the PH low and equal to 2, has the honor these inhibitors, and turn into an effective molecules, Tkavaah establish links with the SH group of Cysteine to α in the unit under the pump, the pump is Vtthbt is reversible. Necessary for the return of the effectiveness of the pump the synthesis of new pumps, and this requires 18-24 hours, so use enough disincentives single dose / 24 hours.
Effective inhibitors only in acidic medium does not consist, and this explains why they only have minor effects on the pump H + / K + ATPase outside the stomach (in the colon and kidney), if these inhibitors used pharmaceutical forms, is resistant to the acidity of the stomach, it turns into an effective metabolites in the stomach , but you can not reach the level of micro-channels in concentrations sufficient to inhibit proton pump.
Equivalent to the CL- secretion, excretion of hydrogen ions, to give HCL, which is not directly changed inhibitors protons (the CL- secretion is still unknown mechanism and can be linked to secrete the K + which allows recycling of K +).
Inhibition of infectious proton pump leads to a significant increase in the reflectivity of blood gastrin in the rat, while the slight increase in humans.
The increase in gastrin lead to the overgrowth of blood in the manufacture of intestinal cells Alkromavinih.
Proton pump inhibitors used in the treatment of the following cases:
– Gastric ulcers.
– Duodenal ulcer.
– Gastro-oesophageal reflux.
– Zollinger-Ellison syndrome (excess secretion of the authors of the subsequent hypertension gastrin):
Compressed, solution for injection
Note: Do not show duodenal and gastric ulcers continue only if there is an acid secretion authors (without acidity Infectious be the direct cause, due to the presence of infectious Alhelukubakatr pylori in mucous). Therefore, the inhibition of gastric acid secretion allows the healing of gastric ulcer or duodenal, and if inhibition was not associated Elimination of Alhelaukubakatr pylori; it is fear of the return, and the onset of symptoms (relapse) when halt anti treatment of gastric acid secretion. It is eliminated Alheiliopakatr pylori with the participation of two pure bismuth salts and within two weeks.
The use of proton pump inhibitors may lead to the emergence of some undesired effects the following:
* Growth and development of some germs.
* Digestive disorders (constipation or diarrhea)
* Mental confusion (rare).
* Blood Disorders.
* Disturbances in vision and hearing (after using the Omeprozole interstitial).
This is still causing mechanisms for the emergence of the previous undesired effects unknown, it is not advisable to use these drugs during pregnancy, especially in the first trimester (the absence of clinical data).
3. anticholinergic ability:
The anticholinergic ability used in the past as anti infectious secretions in the treatment of peptic ulcers (atropine, the Pirenzepine), but now it has neglected to use, due to the availability of other drugs more quality in the treatment of peptic ulcers and more tolerant (antihistamine H2, inhibitors proton pump).
4. The Octreotide:
Artificial similar for Somatostatine, most peptide hormones inhibits the rotation:
– Secretions of the pituitary growth hormone.
– Glandular secretions pancreatic (insulin, glucagon, CR peptide Albankerayash).
– Gastrointestinal secretions (gastrin, serotonin, the Cholecytokinine, the Motiline, the Enteroglucagone, the VIP).
– Foreign glandular secretions gastrointestinal and pancreatic and bile.
Solution for injection
5. pharmaceutical topical anti-ulcer:
This group includes the impact of topical medicines, specialized personnel to one or more of the following effects:
– Anti-effects of acidity.
– Inhibitory effects of pepsin.
– Protective effects and portfolio of gastrointestinal mucosa.
– Generating mucus, saliva effects.
– Anti-inflammatory effects.
– Analgesic effects of pain.
The following groups can be distinguished from localized impact of drugs:
1. topical acidity.
2. gastrointestinal portfolio.
3. The Sucralgat.
4. The Bismuth.
1. antacids topical:
These drugs decrease the acidity of infectious amending hydrogen Bhward and discourage pepsin, which owns the occasional topical analgesic effects
Often used for additional processors in the gastro-intestinal ulcers, and epigastric pain relief (the hot and sour). This reduces the acidity of the digestive absorption of antibiotics; most of the drugs and used them to participate in synchronous with the digestive route (spaces between the drugs and took her to participate at least two hours). It includes antacids topical following salts:
– Aluminum salts.
– Magnesium salts.
– Calcium salts.
– Sodium salts.
This is different chemical modification of infectious acidity depending antimatter used for acidity speed, for example, all of the calcium carbonate affect oxide of aluminum and sodium bicarbonate quickly, where leaves 50% of the amount used stomach after 30 minutes, and thus the impact of the article used a limited period a time of gastric emptying.
– Aluminum hydroxide: possesses significant and long-lasting modified capacity.
– Aluminum phosphate: have a counter-effect of the acidity slow to emerge, and has the effect of welding protective mucous membrane of the gastrointestinal, which does not occur (as opposed to the rest of the aluminum salts) Afraga food phosphate.
– Glesnaat aluminum: anti-acidity and Terozenat weak and characterized by particularly good disinfectant.
– Basic aluminum carbonate: anti-acidity, with a fast and short-term effect.
– Aluminum silicate: long-term counter antacid, which is also heated and protective infectious mucosa.
The average amount of therapeutic ranges for aluminum salts between 2.5 and 9 g / 24 hours, divided in three doses, and result in the use of aluminum salts to the occurrence of constipation.
– Magnesium hydroxide, an antacid, a fast and short effect.
– Tri-silicate and magnesium carbonate, anti-acidity with a long-term impact.
The amount of the average user of magnesium salts 3 g / 24 hours divided in three doses, magnesium salts and lead to the occurrence of diarrhea.
It is a good counter antacid, each 1 g of calcium carbonate amends more than 20 milliseconds equivalent of hydrogen ions.
Calcium carbonate characterized as having fast and long effect, they do not absorb or a few of absorption through digestion, only the fear of its creation constipation.
CaCO3 + 2HCL CaCL2 + H2O + CO2
Neglected to use at the present time due to the bring about systemic effects, as a result of absorption of the gastrointestinal (Tgulwn metabolic), a quick and transient effect (return secretion of acid), leading to increased sodic load in membership, and an increase in coal gas which extends the wall of the stomach production, has leads to bleeding.
NaHCO3 + HCL CaCL + H2O + CO2
Salt which is formed in the stomach
Are the dissolution of salt
Entrapment of fluids
Milky syndrome alkalinization
AL (OH) 3
Decreased blood phosphate
Mg (OH) 2
High blood magnesium in patients with renal failure
2. gastrointestinal portfolio:
Used to prevent gastrointestinal mucosa, and some of them have the ability of anti-acidity (Argiles).
Resist infectious acidity, and run counter to the liquid Alvjee biliary reflux interaction with alkali, and counteract the effects of irritating food as well as medicines. Used in the palliative treatment of episodic epigastric pain include:
The Argiles and Mchabhattha:
It is aluminum silicate and / or magnesium extracted or manufactured. Used in the demonstrations Alolmah resulting from esophageal lesions – infectious – duodenal and prevents their use in pest gentlemen of the digestive tube.
The effective elements of the user is the dimeticone or the Polysilane, is the protector of the gastrointestinal mucosa, does not have a counter-effect of the acidity, which is counter to the stomach to be bloated used in infectious pain, flatulence and intestinal.
3. The Sucralgat:
It is a salt of the compound free from the effectiveness of anti-secretion of aluminum, or antacid. Topically affects the ulcers induced protective and alerts the synthesis Albroostaglandnaat internal infectious. Poses in ulceration area in the middle acid sticky adhesive (Sucralfat Polyanion) which latch by an electric link magnetic and is eclectic on Exfoliative proteins from the nozzle ulcers, Vtazl ulcers for stomach content, and this helps to scarring Alfoa (the effectiveness of this article draw with the effectiveness of antihistamines H2 However the (Pirenzepine).
Sucralfat leads to inhibition of the effectiveness of the enzyme pepsin absorbed as a result of the face, and prevent it from ulcerative link protein on the other hand. Leads to adsorption, and empty the bile salts in the digestive tube.
Use of oral, and it reflects the digestive tract without being absorbed and it raises through the stool.
Using the Sucralfat in the treatment of the following cases:
– Advanced duodenal ulcer (ulcer leads to scarring in 75% of cases after four weeks and 85-90% of cases, treatment after treatment 6-8 weeks.
– Advanced gastric ulcers.
– Prevention of duodenal ulcer recurrence.
Sometimes it leads to the use of the Sucralfat occurrence of constipation (aluminum salt) and dry mouth (rarely) and Akieouat and Gthianat and rashes, dizziness and fear of a force of organic phosphate from the prolonged use.
Not advisable to use when pregnant and breastfeeding women (insufficient clinical data).
4. The Bismuth:
Bismuth is a heavy element, present in small quantities in a very organic, blood concentrations less than 1 mcg, liters, does not know any physiologic role for him. Eetmaz bismuth following characteristics:
– Useful in protecting cell membranes (increased secretion of mucus and HCO3- and increase Sntaa the PGs).
– Inhibits the effectiveness of pepsin.
– Accumulates more eclectic in the nozzle ulcers.
– Does not have sufficient capacity to counter infectious acidity.
– The advantage of doing the opposite of HP.
It owns bismuth salts by proteins in the ulcer; leading to the formation of welding barrier against the spread of acid digestion Albbsina.
According to heal ulcers in the gastrointestinal (similar to Simitdan), and be effective in the prevention of ulcer recurrence.
Used only in peptic ulcer duodenal (to eliminate the HP), and must be a period of use intermittent (used for a month and then stop for two months and so on.), It is absorbed very little when given the oral (1%), and half-life is vital for this section Absorber meager 5 days and poses of through saliva, urine and bile, its use can lead to a number of undesirable effects, especially if used large amounts: Hzaa, encephalopathy, the poorly manufactured in the bone.
Can watch two phases of brain disorders:
– Upgrade predictor: Quality few disturbances, weakness, memory loss, insomnia, headache.
– Acute phase: neurological disorders, dysarthria, muscular twitching, trouble walking, atrial confusion, delirium and convulsions.
Bismuth is missing vital Readiness for tetracycline and is available as:
Bismuth Subcitrate, Bismuth Salicylate.
Second-counter medications for Helicobacter pylori (Helico bacter Pylori):
The Helicobacter Pylori (HP), Gram-negative bacilli, colonize the mucous on the surface of the Amaa Abtellom contagious.
The incidence of these bacilli lead to a contagious infection, which can be attributed to gastric ulcers and lymphoma and Adenocarcinoma.
Have sepsis these bacilli widespread afflicts 20% at the age of 30 years (the white race), and be more widespread when the black race and the Spaniards, and the increasing incidence with age.
It can be isolated bacilli (Helicobacter Pylori) when 70-90% of patients with duodenal Balegrahat infectious, and leads stamp out these bacilli to a decrease in the recurrence of ulcers.
As a result of clinical and experimental studies that show the following:
* Increases the judiciary on the HP Mwaguet with the use of H2 receptor antagonists of the ulcer healing rate compared to the use of H2 antagonists alone.
* Result in the elimination of HP, to heal better than if they used the drug Almohm.
* Lead opposite quality mechanism of injury and damage Pal updated HP to stop the updated impact of the ulcer.
* Result in the elimination of the post HP and treatment of anti-acid secretions to reduce the incidents of relapse.
* Treatment leading to the elimination of the HP to be alone, is insufficient and ineffective, and lead to resistance of these bacilli.
Yet all this can not be considered the HP only responsible for the occurrence of ulcers, but involve any treatment for ulcer with treatment for the elimination of the HP.
This is the eradication of HP and successfully, with the participation of some antibiotic excretion with some antibiotics:
– The Clarithromycine and Amoxicilline or the Clarithromycine derivatives Alaimidasulah participation of Lansoprazole or the Omeprazole.
– The Clarithromycine and Metronidazole (or the Tinidazole) or Clarithromycine and Tetracycline idolatress with the Ranitidine.
The bismuth has been mentioned with topical anti-heartburn drugs.
III garrison medicines for gastrointestinal mucosa:
1. bismuth stated previously mentioned.
2. The Sucralfat stated previously mentioned.
3. The Misoprostol.
4. The Carbenoxolone.
The Misoprostol (similar to the PG E1):
Is a made-up similar for PG E1 has a counter-effect of the secretion; slightly less than the effect of antihistamines H2, but no more than Anacaccia of blood gastrin, and is characterized by the influence of protective of the mucosa (protects the mucous digestive gastrointestinal infection factors irritating: such as alcohol, tobacco, aspirin and NSAIDs) . It proved the impact of the anti-Misoprostol secretion experimentally and clinically, it goes against secretions Alfoah day and night and induced Balheistamen and Pentagastrine and meal rich in protein and coffee, as well as demonstrated the protective effect of the protector mucosa experimentally and clinically.
Quickly absorbed through the digestive system of Xtam = 30 minutes, half the vital hour and a half old, put 73% of it through college (56% of them during the 8 hours) and 15% of the intestine through.
Misoprostol is used in the treatment of the following cases:
* Gastric ulcer or duodenal advanced.
* Infectious intestinal lesions updated anti-inflammatory steroid in the elderly> 65 years old and people with ulcerative precedents, or when those who can not tolerate NSAIDs (when the lengthy treatment may be necessary).
Effects is Almargoah:
It can result in the use of Misoprostol to a non Almargoah the following effects:
– Diarrhea moderate and transient (5-39% of cases), and sometimes it leads to cessation of treatment in 1-5% of cases.
– Gthianat transient (rare) and Akieouat, abdominal pain, headache and dizziness.
– Olargiaiah reactions (very rare).
– A significant reduction in infectious acidity, leads to the growth and reproduction of bacteria; Lantana what happens or an increase in carcinogenic nitrosamines.
It prevents the use of Misoprostol in the following cases:
– The presence of excess prior Sense of Misoprostol.
– At the age of women in the reproductive activity, which do not use effective contraception.
A compound extracted from licorice acid disodium for the glycirrhetic, restored him to do an anti-inflammatory, increases the secretion of mucus and even-numbered, prolongs the life of epidermal cells, and detract from the promises of the proliferation of hydrogen ions.
Some of the undesirable effects that go back to his own steroid happens, anti-generation (edema, weight gain, high blood pressure).
Fourthly – surgical means to address infectious duodenal ulcers:
When drug treatment fails, health food and measures to resort to surgical treatment:
1. Cut part of the stomach in the secretion of gastrin area (and are Bmphagrh contagious gastrointestinal or duodenal), can leave some effects (turn, digestive function disorder).
2. Cut infectious pulmonary nerve (vagus), and manufacture of the doorman, which can lead to stagnation infectious spasm doorman, Vicherk then cut preparers Afja to accelerate gastric emptying, or resort to selective cutting of vague with the doorman manufacturing (cut Myofibrellar contained to the stomach in the space cardia ), but it leads to the same effects Giralmargobh.
3- or resort to 1 +2.
4. conducted attempts to remove the bottom blindfolded or impregnating nerve visceral Balbrookaian, or impregnating the frontal lobe Balbrookaian, (the connection between the brain and nerve centers peel with optical bed).