ANTI-ULCER DRUGS

Type Examples Mechanism of Action Indication S/E

1. Antacids a. Na- bicarbonate based Neutralize stomach acid relieveheartburn/ hyperacidity/ > metabolic alkaosis ( Alka-seltzer) gastritis , peptic ulcerb. Ca- carbonate > hypercalcemia,

(Tums) rebound acid increase

c. Mg – hydroxide > diarrhea(Milk of Magnesia)

d. Aluminum hydroxide > constipation, (Amphojel) hypophosphatemiad. Combination

(Maalox, Mylanta,Novaluzid) ALL can cause HYPOKALEMIA & prevent reabsorption of Tetracyclines

2. Histamine 2 (H2) a. cimetidine (Tagamet) block H2 receptors peptic ulcer, gastritis,GERD >Cimetidine - decrease blockers b. famotidine (Pepcid) excretion of crea,

c. nizatidine (Axid) anti-androgenicd. ranitidine (Zantac)

3. Proton Pump a. omeprazole (losec) inhibits acid production peptic ulcer, gastritis, GERD >nausea, diarrhea ,colic Inhibitors b. lansoprazole (Prevacid) in parietal cells of stomach belching

c. esomeprazole (Nexium) d. rabeprazole (Pariet) e. pantoprazole (Pantoloc)

4. Miscellaneous a. Sucralfate (Iselpin) forms polymers in acidic peptic ulcer disease (PUD) > drowsiness, constipation

environment &coats peptic stress- ulcer prophylaxis ulcer from further acid attack

b. Bismuth subsalicylate (Pepto- Bismol) coats esophagus & acts as PUD, GERD > nausea, diarrhea barrier to gastric acids

Tetracycline & Metronidazole eradicate Helicobacter pylori

c. Misoprostrol (Cytotec) secrete gastric mucous barrier prevent NSAID-induced peptic ulcers > diarrhea, stimulates uterus