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19 Cards in this Set
- Front
- Back
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Control of saliva - stimulus - ANS |
stimulus: smell, sight, taste
sympathetic: small amount / mucus-rich parasympathetic: large amount/ alpha amylase rich
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Control of acid secretion - endocrine - paracrine - neural |
endocrine: gastrin
paracrine: histamine (EC-like cells)
neural: - cephalic phase - vagus > preganglionic parasympathetic > submucosal plexus - gastric phase - sensory receptors > local reflex |
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Drugs affecting parietal cell function - list 3 acid stimulants |
histamine
betazole - H2 agonist
pentagastrin - similar to gastrin's C terminus |
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GI ulcer treatment - list 3 mechanism reducing acid secretion |
1 M1 blocker (pirenzepine)
2 H2 blocker (cimetidine, ranitidine, famotidine)
3 proton pump inhibitor (omeprazole) |
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Pirenzepine |
M1 blocker - reduce acid - anti-spasmogenic - reduce histamine, ACh - low CNS penetration
(GI ulcer treatment) |
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Cimetidine Ranitidine Famotidine |
competitive H2 blocker - reduce food/gastrin-stimulated acid secretion - also used for gastric reflux
(GI ulcer treatment) |
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Omeprazole |
Proton pump inhibitor
mechanism: omeprazole absorbed from duodenum > accuulates in canaliculi (liver > converted to sulphenamide > irreversible inhibition of H/K ATPase
(GI ulcer treatment) |
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Drugs for protecting mucosa - list 3 |
carbenoxolone sodium
sucralfate
misoprostol
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carbenoxolone sodium |
increase mucus viscosity and secretion
(mucosa protection) |
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sucralfate |
crosslinks at low PH > coats ulcer
increase prostaglandin
increase mucus
(mucosa protection)
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misoprostol |
increase mucus, bicarbonate
reduce acid
increase mucosal blood flow
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Antacids - list 3 |
Sodium carbonate
Aluminium hydroxide - protect ulcer, neuralize H+
Magnesium trisilicate - absorbs pepsin and H+
they provide symptomatic relief, also treat gastric reflux
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H pylori - mechanism |
H Pylori creates ulcer crater > oxidative stress, neutrophils + potentiate pain and bleeding
H pylori secretes enzymes and ammonia > kill somatostatin-secreting cells > increase gastrin release from G cells (due to reduced inhibition by somatostatin) > more H+ from parietal cells + more pepsin from chief cells |
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Bismuth Chelate (= colloidal bismuth subcitrate) (= tripotassium dicatratobismuthate) |
- toxic to H pylori - coats ulcer base - absorbs pepsin - increase prostanglandin - increase bicarbonate |
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Triple therapy
(2 antibiotic + 1 gastric protective drug) |
1 amoxycillin / metronidazole
2 clarithromycin
3 bismuth / omeprazole |
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Peptic ulcer gastric reflux
use what? |
H2 blocker - cimetidine, ranitidine, famotidine |
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Peptic ulcer gastric reflux Zollinger-Ellison syndrome (excessive gastin)
use what? |
proton inhibitor - omeprazole |
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Dyspepsia Symptomatic relief for ulcer/gastric reflux
use what? |
Antacids - sodium bicarbonate - aluminium hydroxide - magnesium trisilicate |
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Long term steroid / NSAID
use what? |
Mucosa protective drugs
carbenoxolone (mucus, viscosity ) sucralfate (crosslinks, PG, mucus) misoprostol (mucus, bicarbonate, reduce acid, increase mucosal bloodflow) |
