Patho-physiology of acid peptic disease and drugs for management

- Dr. Pragna Patel

Acid peptic disease

Disorders associated with gastric acid and pepsin Include
Hyperacidity Gastroesophageal reflux disease Stress induced mucosal erosion Peptic ulcer

Peptic ulcer- gastric & duodenal ulcer

Symptoms
Abdominal pain Heart burn Nausea/vomiting Epigastric tenderness

Disease burden
Lifetime prevalence- 12% in male; 10% in females 15,000 deaths per year Economical burden Morbidity associated

Drugs effective in management of acid peptic disease

Reduction in gastric acid secretion
H2 antihistaminics
Cimetidine, ranitidine, famotidine, nizatidine

Proton pump inhibitor

Omeprazole, pantoprazole, lansoprazole,rabeprazole

Anticholinergics
Pirenzepine, telenzepine

Prostaglandin analogoue
Misoprostol, enprostil

 Neutralization of gastric acid(Antacids)

Systemic: sodium bicarbonate, sodium citrate Nonsystemic: MgOH2, CaCO3, Al(OH)3, Mg trisilicate, magaldrate

Ulcer protective
Sucralfate, colloidal bismuth subcitrate

Ulcer healing
Carbenoxolone sodium

Anti H- Pylori drugs

Amoxicillin, clarithromycin, metronidazole, tinidazole, tetracycline

Thank you