《基础医学各论II》课件：消化系统药理学

Drugs Used in the Treatment of Gastrointestinal Diseases

Yun-Bi Lu, PhD

卢韵碧

Dept. of Pharmacology,

School of Medicine, Zhejiang University

yunbi@

1. Hepatic, pancreatic

and biliary disorders

2. Acid-peptic disorders

3.Gastrointesinal motility Disorders

4. Inflammatory

bowel diseases

Gastrointestinal drugs A. Drugs used for acid-peptic A. Drugs used for

disorders(抗消化性溃疡药) B. Modulators of gastrointestinal functions (消化功能调节药)

Symptoms:

Upper abdominal burning or hunger pain

Emesia(呕吐), belching (嗳气)

The feature of peptic ulcer disease:

High incidence, frequent Recurrence, Drug

therapeutics is the main way for treatment. Ulcer complication

Ulcer bleeding (出血)

Ulcer perforation (穿孔)

Pyloristenosis(幽门狭窄)

Canceration(癌变)

Acid-peptic disorders

1)Peptic ulcer disease (PUD)

chronic inflammation due to Helicobacter pylori

2) Drug-induced mucosal injury, especially by

non-steroidal anti-inflammatory drugs (NSAIDs)

3) Acute stress ulcers （应激）

4) Gastroesophageal reflux disease (GERD)

5) Pathologic acid-hyper-secretory conditions (e.g.

Zollinger-Ellison syndrome)

Helicobacter pylori infection

Gastroesophageal reflux disease (GERD)

Abnormal reflux in the esophagus

Peptic ulcer

A.Drugs used for peptic ulcers ▪Antacids 抗酸药

▪Drugs affecting gastric acid secretion

抑制胃酸分泌药

Muscarinic receptor antagonists

H2receptor antagonists

H+-K+ ·ATPase inhibitors (proton pump inhibitors) Gastrin receptor antagonists

▪Antimicrobial drugs (Helicobacter pylori)抗菌药

▪Mucosal protective drugs 黏膜保护药

(Proton pump)

Pharmacological effect

×Antacids

NaHCO 3Mg(OH)2Mg 2S 3O 8Al(OH)3CaCO 3

Sodium (bicarbonate )Salts of magnesium (carbonate, hydroxide,trisilicate )

Salts of aluminum (aluminum hydroxide)Calcium (carbonate )

2. Clinical uses

nonprescription remedies for the treatment of dyspepsia(消化不良) symptom and minor episodes of heartburn.

Antacids

Antacids

3. Adverse effects

•Constipation (salt of aluminum) 便秘•Diarrhea(salt of magnesium ) 腹泻

Combination products such as maalox（氢氧化铝）•Hypercalcium which can cause renal failure(Calcium)•Hypernatremia(sodium-containing antacids)

All antacids are generally regarded as safe in pregnancy.

4.Drug interactions, Administration and dosage •To avoid or reduce drug interaction, other medication should NOT be taken within 1-2 hours of taking an

antacids; (for example, tetracycline四环素),

•Should not be taken continuously for more than 2

weeks.