ANTIULCER DRUGS

Peptic Ulcer- is abroad term for an ulcer occurring in the esophagus, stomach or
duodenum.
-hypersecretion of hydrochloric acid (HCL) and pepsin which erode the
gastric mucosal lining

Predisposing Factors:
1. Hypersecretion of acid and pepsin
2. Inadequate gastric mucosal lining (GMB)
3. Incompetent cardiac or pyloric sphincter
4. Hereditary
5. foods containing caffeine, fatty, fried, highly spiced, alcohol and nicotine
products
6. stressful situations
7. pregnancy
8. trauma
9. major surgery
10.H. pylori
11.NSAIDS (aspirin, ibuprofen), corticostiroids (cortisone, prednisone)

Types of Peptic Ulcers

1. Duodenal Ulcer- caused by hypersecretion of acid from the stomach that

passes to the duodenum because of:
a. insufficient buffers to neutralize gastric acids
b. incompetent pyloric sphincter
c. hypermotility of the stomach
2. Esophageal Ulcer- results from reflux of acidic gastric secretion into the
esophagus as a result of incompetent cardiac sphincter
3. Gastric Ulcer-due to breakdown of the GMB
4. Stress Ulcer

Nursing Interventions:
 Avoid tobacco and alcoholic beverages
 avoid hot, spicy and greasy foods
 take NSAIDs with food

7 ANTIULCER DRUGS

1. Tranquilizers- has minimal effect

MOA: reduce vagal activity, decreases anxiety
ex. Librax

2. Anticholinergics
MOA: Decreases GI motility and secretion by inhibiting acethylcholine
and blocking histamine and hydrochloric acid.
-Taken a.c (before meals)- to decrease gastric secretions that occurs
with eating.
ex.
  gastrozepine
 belladonna tincture
 librax
 robinul
 pro-banthine
 pathilon
Side Effects:
constipation, retention, dry mouth, blurred vision, tachycardia

3. Antacids
MOA: promotes healing of ulcers by neutralizing hydrochloric acid and
redusing pepsin activity.
-taken 30 mins-2 hours after meal
ex.
a. Systemic Antacids
 sodium bicarbonate- 1st antiulcer drug
1. bromo-seltzer
2. alka-seltzer
 calcium carbonate-most effective antacid
• aluminum hydroxide
• aluminum carbonate
• magnesium hydroxide
• magnesium carbonate
• magnesium trisilicate
• magnesium phosphate
*magnesium hydroxide has greater neutralizing power than aluminum hydroxide
*magnesium compound- can cause diarrhea
*aluminum & calcium- can cause constipation

4. Histamine2 Blockers- most popular

MOA: Prevent acid reflux in the esophagus by blocking the H2 receptors of
the parietal cells in the stomach thus reducing gastric secretion and concentration.
ex.
 cimetidine (tagamet)-1st H2 blocker
 ranitidine (zantac)
 famotidine (pepcid)
 nizatidine (axid)
Side Effects:
• headache
• dizziness
• constipation
• pruritus
• skin rash
• gynecomastia
• decrease libido
• impotence

5. Proton Pump Inhibitors (PPIs)

 MOA: suppresses gastric acids by inhibiting the hydrogen/potassium ATPase
enzyme system located in the gastric parietal cells
ex.
 omeprazole
 lanzoprazole (prevacid)
 rabeprazole (aciphex)
 pantoprazole (protonix)
 esomeprazole (nexium)

6. Pepsin Inhibitors (Mucosal Protective Drug)

ex. sucralfate
MOA: promotes healing by adhering to the ulcer surface
-given 1 g, four times a day, administered at ac & at HS

7. Prostaglandin Analogue Antiulcer Drugs

MOA: suppress gastric secretions and increases cytoprotective mucus
ex. misoprotol