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

基础医学各论Ⅱ Gastrointestinal drugs

基础医学各论II

ANATOMICAL STRUCTURES SURROUNDING THE ABDOMINAL AORTIC ANEURYSM SITE Hepatic, pacreatic and biliary uLcer disorders disorders aBnormal mobility CORONAL VIEW OF ABDOMINAL CAVITY ADAM A D.A.M. Software Inc darcom

Gastrointestinal drugs 1. Drugs used for peptic ulcers 2. Modulators of gastrointestinal functions

Gastrointestinal drugs Peptic ulcers Pathogenesis of Treatment peptic ulcers approaches Infection with gram- Eradicating H. pylori negative Helicobacter infection pylori Increased gastric acid Reducing secretion of secretion gastric acid or neutralizing the acid Inadequate mucosal Protecting the gastric defense against gastric mucosa from damage acid

GASTRIN muscarinIc antagonists RsoH N M K+ K+ YACh C CCK antagonists CCK2l K HIST HIST H+ K M2ECL cell CAMP-dependent ATPase X-proton pump inhibitors AC NSAIDS EP. c pathway parietal cell H+ X-antacids fatty bismuth PGl2 misoprostol metronidazole muscarinIc X-tetracyo antagonists clarithromycin H. pylor 80点 amoxicillin mucus ACh . Sucralfate protection carbonoxolon pirenzepine ACh superficial epithelial cell HCO Mucous Gastric Gastric structure related to peptic ulcer Layer Lumen H7 h 2

日Reps n channe ETC Parietal cell ITC acetycholine umina membrane M ATP histamine H →cAMP EDEH, K-ATPaseL> Gastric lumen gastrin Ca on channels call bonbon rane Gastric acid secretion and regulation

A. Drugs used for peptic ulcers 1. Antacids 2. Drugs affecting gastric acid secretion Muscarinic receptor antagonists H 2 receptor antagonists H+-K+-ATPase inhibitors(proton pump inhibitors) Gastrin receptor antagonists 3. Mucosal protective drugs 4. Antimicrobial drugs(Helicobacter pylori)

A. Drugs used for peptic ulcers Features of antacids Basic substances that reduce gastric acidity by neutralizing HCl o The hydroxide is the most common base but trisilicate carbonate and bicarbonate ions are also used aLuminium, magnesium or sodium

GASTRIN muscarinIc antagonists RsoH N M K+ K+ YACh C CCK antagonists CCK2l K HIST HIST-H H+ K M2ECL cell CAMP-dependent ATPase X -proton pump AC NSAIDS EP. c pathway inhibitors parietal cell H* X-antacids fatty- PG2 misoprostol bismuth metronidazole muscarinIc X-tetracyo antagonists clarithromycin H. pylor 80点 amoxicillin mucus ACh . Sucralfate protection carbonoxolon pirenzepine ACh superficial epithelial cell HCO Mucous Gastric Layer Lumen H7 h 2

A. Drugs used for peptic ulcers Drugs affecting gastric acid secretion Muscarinic receptor antagonists Pirenzepine哌仑西平 N COCH - CH3

N N N COCH2 CH3 H O N N---