浙江大学医学院：《药理学 Pharmacology》课程教学资源（PPT课件）肠胃药物 Gastrointestinal drugs

Gastrointestinal drugs 3 Weiwei HU Phone:0571-88208226 E-mail:huww@zju.edu.cn

Gastrointestinal drugs Weiwei HU E-mail:huww@zju.edu.cn Phone: 0571-88208226

1. Hepatic, pancreatic and biliary disorders 2. Acid-peptic disorders Pancreas 3. Gastrointesinal motility Small Intestines sorters Rectum 4. Inflammatory bowel diseases

1.Hepatic, pancreatic and biliary disorders 2. Acid-peptic disorders 3.Gastrointesinal motility disorders 4. Inflammatory bowel diseases

Gastrointestinal drugs 1. Drugs used for acid-peptic disorders 2. Modulators of gastrointestinal functions

Gastrointestinal drugs 1. Drugs used for acid-peptic disorders 2. Modulators of gastrointestinal functions

1. Acid-peptic disorders 1) Peptic ulcer disease(PUD,消化性溃疡) 2) Gastroesophageal reflux disease GErD) 3)Drug-induced mucosal injury, especially by non-steroidal anti-inflammatory drugs NSAids) 4)Pathologic acid-hypersecretory conditions(e.g Zollinger-Ellison syndrome) 5)Acute stress ulcers

1. Acid-peptic disorders 1) Peptic ulcer disease (PUD, 消化性溃疡) 2) Gastroesophageal reflux disease (GERD) 3) Drug-induced mucosal injury, especially by non-steroidal anti-inflammatory drugs (NSAIDs) 4) Pathologic acid-hypersecretory conditions (e.g. Zollinger-Ellison syndrome) 5) Acute stress ulcers

Esophagus Mucosa uIcer Submucosa Muscle Duodenum ulcer ulcer Stomach Peptic Ulcer Disease O Medicine Net, Ino

1)

The feature of peptic ulcer disease High incidence, Recurrence frequently, Drug treatment is the main way Symptoms Upper abdominal burning or hunger pain Emesia(呕吐), belching(嗳气) Ulcer complication Icer bleeding(出血) Ulcer perforation(穿孔) Pyloristenosis(幽门狭窄) Canceration(癌变)

The feature of peptic ulcer disease: High incidence, Recurrence frequently, Drug treatment is the main way Symptoms: Upper abdominal burning or hunger pain Emesia (呕吐), belching (嗳气) Ulcer complication Ulcer bleeding (出血) Ulcer perforation (穿孔) Pyloristenosis (幽门狭窄) Canceration (癌变)

2) Gastroesophageal reflux disease(GERD) -Esophagus Lower esophage sphincter.、 Stomach contracted Acid and stomach contents back up into esophagus Abnormal reflux in the esophagus

2) Gastroesophageal reflux disease (GERD) Abnormal reflux in the esophagus

3)Drug-induced mucosal injury, especially by non-steroidal anti-inflammatory drugs Nsaids) aororoooooooncoxxmomonomx Phospholipid (from cell membrane) Corticosteroids OO←[Agh Arachidonic acid NSAIDS“ Prostacyclin(PGl2) PGF2 PGH 5-Lpoxygenase Thromboxane A2 Dipyridamole 5-HPETE see Chapter 20)

3) Drug-induced mucosal injury, especially by non-steroidal anti-inflammatory drugs (NSAIDs)

4)Pathologic acid-hypersecretory conditions(e.g. Zollinger-Ellison syndrome) Tumor Gastrin Gastic acid zollinger- Ellison tumor In pancreas Peptic ulcer Duodenal ulcers due to hyperacidity 9 ADAM Ine

4) Pathologic acid-hypersecretory conditions (e.g. Zollinger-Ellison syndrome) Tumor Gastrin Gastic acid Peptic ulcer

5)Acute stress ulcers 创伤 大手术 全身性感染 应激 休克、低血压、 视丘前部、迷走神经低组织灌流 兴奋 胃黏缺血或淤血 胃黏屏障受损 胃肠道淤胀 炎性介质失控,加重损害 HCO3分泌,胃壁酸化胃黏摸上皮汁逆流 碱潮,血运减少细胞更新,胆盐损伤 黏液,不能将扩散 H感染? H逆扩数H'清除 应激性溃疡 图4应激性溃疡的发病机制

5) Acute stress ulcers