A. Drugs used for peptic ulcers 1. Pharmacological effects and clinical uses high affinity for M1-and low affinity for M2-receptors of the smooth muscle of the ileum and urinary bladder. blocking of M1-muscarinic receptors in autonomic ganglia inhibiting HCl secretion 2. Adverse effects Atropine-like effects, especially at larger doses Other drugs .Telenzepine(替仑西平) aTropine: atropine-like effects pRopantheline bromide(溴丙胺太林)
GASTRIN muscarinIc antagonists Li asok Asti M K+ K+ YACh C CCK antagonists CCK2l K HIST HIST H+ K M2ECL cell CAMP-dependent c pathway ATPase X-proton pump NSAIDS EP. inhibitors AC parietal cell H+ X-antacids fatty-PGl2 misoprostol bismuth metronidazole muscarinIc X-tetracyo antagonists clarithromycin H. pylor 80点 amoxicillin mucus ACh Sucralfate protection carbenoxolone pirenzepine 3<ACh superficial epithelial cell HCO Mucous Gastric Layer Lumen H7 h 2
Sucralfate carbonoxolone misoprostol
A. Drugs used for peptic ulcers H2 receptor antagonists Cimetidine西咪替丁 H3C CH2SCH2CH2NHCNHCH3 cimetidine HN、N N—CN西咪替丁 H30 CH2 Ch2SCH2CH2NHCNHCH3 ranitidine C 雷尼替丁 CHNO2
N N N CH2SCH2CH2NHCNHCH3 H H3C CN O N CH2SCH2CH2NHCNHCH3 CHNO2 H3C H3C CH2
A. Drugs used for peptic ulcers 1. Pharmacological effects Blocking H2 receptors decreasing H+ secretion 2. Clinical uses Duodenal and gastric ulcer, reflux esophagitis: relieving symptoms, promoting healing of ulcers and preventing ulcers Zollinger-Ellison syndrome acute stress ulcers, gastroesophageal reflux disease(heartburn)
GASTRIN muscarinIc antagonists Li asok Asti M K+ K+ YACh C CCKa antagonists CCK2l K HIST HIST M2ECL cell CAMP-dependent H+ K ATPase X-proton pump AC NSAIDS EP. c pathway inhibitors parietal cell H+ X-antacids fay→ mIsoprostol bismuth metronidazole muscarinIc X-tetracyo antagonists clarithromycin H. pylor 80点 amoxicillin mucus ACh Sucralfate protection carbenoxolone pirenzepine ACh superficial epithelial cell HCO Mucous Gastric Layer Lumen H7 h 2
Sucralfate carbonoxolone misoprostol