PROTON PUMP INHIBITOR (PPI):

long-lasting reduction of gastric acid production Proton pump inhibitors act by irreversibly blocking the hydrogen/potassium adenosine + + triphosphatase enzyme system (the H /K ATPase, or, more commonly, the gastric proton pump) of the gastric parietal cells. Dyspepsia Peptic ulcer disease, Gastrooesophageal reflux disease (GORD), Laryngopharyngeal reflux, Barrett's esophagus. SFX: Allergies, drug hypersensitivity, during pregnancy childhood asthma, HA, nausea, dizziness, abdominal pain, fatigue, diarrhea, vit B12 deficiency, skin rash.
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-Esomeprazole: -Lansoprazole: -Omeprazole: -Pantoprazole:

DRUG ALTERING GUT MOTILITY: -Alverine: ANTISPASMODIC alternative to other drugs. -Dicycloverine: ANTISPASMODIC is an anti-muscarinic drug which also has direct muscle relaxant properties. It is used as an adjunct in the treatment of gastro-intestinal disorders such as irritable bowel syndrome and diverticular disease. It has less marked anti-muscarinic action than atropine, but atropine-like side-effects are common. It is contra-indicated in patients with glaucoma and urinary retention. It should be avoided in patients with oesophageal reflux. -Hyoscine-butylbromide: (injection) is useful during endoscopy and radiology procedures, and as a safe short-acting antispasmodic for abdominal pain -Mebeverine: ANTISPASMODIC is believed to act as a direct relaxant of intestinal smooth muscle and has no anti-muscarinic actions. It is well tolerated. It may be used with bulk-forming agents in irritable bowel syndrome. -Perpemint oil: ANTISPASMODIC has a direct relaxant effect and may be useful for relief of abdominal colic and distension. It may cause heartburn. The capsules should be swallowed whole as peppermint oil can cause

irritation of the mouth or oesophagus. Peppermint oil capsules are more expensive than mebeverine tablets.

LAXATIVE: -Bisacodyl -Docusate -Fybogel:

Bulk-forming laxative: Isphagula husk. Increased faecal volume stimulates peristalsis Constipation; IBS; UC; diverticular disease; haemorrhoids SFX: Flatulence; stomach distension; obstruction if taken with insufficient fluid
-Lactulose -Movicol -Docusate -Regulan -Senna

H2 RECEPTOR ANTAGONIST: block the action of histamine on parietal cells (specifically the histamine H2 receptors) in the stomach, decreasing the production of acid by these cells.

Peptic ulcer disease (PUD), Gastroesophageal reflux disease (GORD), Dyspepsia, Prevention of stress ulcer. SFX: headache, tiredness, dizziness, confusion, diarrhea, constipation, and rash
-Cimetidine: -Ranitidine:

ANTI-DIARRHOEAL: -Codeine

Opioid analgaesic: binds opioid receptors in brain

Mild-mod pain; dry cough; diarrhoea (S-T) Caut: Alcol; Prg/Brf; COPD; liver/kidney/heart/thyroid SFX: Naus/Vom/Abd pain; constipation; dizziness; somnolence; dry mouth; insomnia; HA; mood change; confusion; dysuria; flushing; sweating; rash; pruritus
-Loperamide

ALGINATE: -Gaviscon: heartburn and gastroesophageal reflux disease (GOR) The combination of alginic acid and a bicarbonate forms a layer on the contents of the stomach, which prevents stomach acid from refluxing up into the esophagus. If reflux does occur the protective barrier is the first to contact the esophageal mucosa, instead of gastric contents. DRUG FOR CHRONIC BOWEL DISORDER -Mesalazine: is an anti-inflammatory drug used to treat inflammatory bowel disease, such as ulcerative colitis and mild-to-moderate Crohn's disease. Mesalazine is a bowel-specific aminosalicylate drug that acts locally in the gut and has its predominant actions there, thereby having few systemic side effects SF: diarrhea, nausea, cramping, flatulence ANTIDIABETIC DRUG -Metformin:

Biguanide antidiabetic; suppresses glucose prod. in liver and uptake in GIT; inc. insulin sensitivity & periph gluc uptake; reduces CVSD SFX of DM. Insulin resistance: Type 2 Diabetes; Polycystic ovary syndrome; Non-alcoholic fatty liver disease SFX: Nausea/vomiting/diarrhoea (take full stomach; usually resolves); Loss of appetite; strange taste; abdominal pain; lactic acidosis (rare, serious) -Gliclazide:

Sulfonylurea antidiabetic medicine - increases pancreatic production of insulin by binding to SUR receptors in pancreas specifically. Antiatherogenic effect Type 2 Diabetes mellitus SFX: Nausea/vomiting/dyspepsia/diarr/constip/inc weight; hypoglycaemia shaky/anxious/sweating/ pallor/hunger/dizziness/heart pounding -Insulin: THYROID HORMONE: -Levothyroxine