Competitive H2 receptor anatagonists

- dose dependent effects

- inhibit basal, food-stim and nocturnal secretions

- duodenal > gastric ulcers

- healing rate >70% within 6-8wks

- ADR: safe, rash, headache 

IV - hypotension, bradycardia

- Drug Interactions: antacids decrease absorption, p450 drugs

H2 blocker

- 1st pass metabolism

- OTC

- Enzyme inhib = p450

- SE: male impotency, gynecomastia, galactorrhea = f

- contraind: pregs

H2 Blocker

- 1st pass, p-450 inhib

H2 blocker

- 1st pass, p450 inhib

H2 blocker

- fastest onset

- NO first pass

-p450 inhib

reduce HCL secretions

- irreversibly inhibit H+/K+ ATPase

- USE: ZE syndrome, GERD, Ulcers

- ADR: headache, rash, liver enzymes, hypergastrinemia

- Examples: omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole

Cytoprotective agent

- sucrose complexed w/ sulfated alum. hydroxide

- when mixed w/ HCL = viscous paste 

- paste binds to proteins in ulcers - topical

- claims to stim mucosal PG synthesis

ADR: N/V, constipation, 

- Drug Interactions: MUST USE ALONE

digoxins, antiocags, phenytoin

PGE1 Analog

- Incr. mucous, NO, HCO3-, cell prolif.

- Decr. acid secretion, stabilizes lysosomes

- USE: prevention/txt of NSAID gastropathy

ADR: diarrhea, gas, cramps, stim SM of GI & Uterus

CONTRAIND: pregnancy

- colloidal prep. of bismuth (not absorbed) and salicylate (absorbed)

- bismuth binds mucus glycoproteins, coats/protects GI to incr mucus, HCO3-, PG synthesis

- USE: dyspepsie and acute diarrhea

- Bacteriocidal: E Coli, H pylori, C diff, B fragilis

- ADR: can stain teeth, black stools

- pepto-bismal QID

- metronidazole

- tetracycline

- amoxicillin

- clarithromycin

** use with PPI bc high pH = increase action of antibiotics**

Prokinetic Drug

muscarinic (M3)

- actions increase LES pressure and GI motility

Prokinetic Drug

antibiotic

-motilin agonist = increases GI motility