gastrointestinal drugs

to treat GERD & peptic ulcers

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Last updated: May 26, 2023

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First submitted	May 26, 2023
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what is the pathophysiology of gastroesophageal reflux disease (GERD)?	what is the pathophysiology of peptic ulcers?	what causes it? (GERD top box, ulcers bottom box)
occurs when contents of stomach and duodenum backflow into oesophagus, causing inflammation of the oesophageal mucosa (oesophagitis)	an ulcer in an area where the mucosa is saturated in HCl and pepsin of the gastric juices	if there is too much pressure on the stomach or the sphincter muscle is dysfunctional
		bacteria (H.pylori) or overuse of NSAIDs
what are the drug types used to treat GERD & peptic ulcers?	what is an example of each?	what is the mechanism of action of each?
antacids	lots of over-the-counter drugs	neutralises stomach acid, thereby increasing pH of stomach and allowing mucous layer time to repair itself
proton pump inhibitors	omeprazole, lansoprazole, etc	irreversibly inhibits the hydrogen-potassium ATPase proton pump that controls H+ secretion from parietal cells, reducing gastric acid production
H2 receptor antagonists	cimetidine, ranitidine, etc	competitively blocks H2 histamine receptors, which stimulate gastric acid secretion from parietal cells, to reduce stomach acidity
M1 muscarinic receptor antagonists	pirenzepine, hyoscyamine, etc	M1 muscarinic receptor antagonism, blocking acetylcholine
prostaglandins	misoprostol	binds to E1 G-protein coupled receptors on parietal cells, inhibiting adenyl cyclase and decreasing cAMP, blocking acid production
mucosal strengtheners	sucralfate, bismuth chelate, etc	polymerise in the acid environment of the stomach, then binds to the damaged tissue and forms a protective coating over the ulcer beds