Drugs Affecting the Gastrointestinal System.ppt

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1、DrugsAffectingtheGastrointestinalSystemByCaiyingYeDepartmentofPharmacology,SchoolofBasicMedicine,PekingUnionMedicalCollegeDrugsAffectingtheGastrointestinalSystem分类Antiulcerants消化性溃疡药Digestives助消化药Antiemetics止吐药Purgatives泻药Antidiarrheals止泻药Cholagogues利胆药PepticUlcers常见病，发病率约10%~12%.Pathogen

2、esisofulcersAggressiveFactorsDefensiveFactorsAcid,pepsinBilesaltsDrugs(NSAIDs)H.pyloriMucus,bicarbonatelayerBloodflow,cellrenewalProstaglandinsPhospholipidFreeradicalscavengers溃疡胃酸分泌过多胃、十二指肠粘膜侵蚀，胃蛋白酶和幽门螺旋杆菌升高消化性溃疡治疗目的：Therapyisdirectedatenhancinghostdefenseoreliminatingaggressivefactors;i

3、.e.,H.pylori.PepticUlcersDrugsUsedinPepticUlcersAntacidsInhibitorsofgastricacidproductionH2-receptorantagonistsProtonpumpinhibitorsMuscarinicantagonistsGastrinreceptorantagonistMucosalProtectantsAnti-Helicobacterpylori.drugsDrugsUsedinPepticUlcers代表药物Antacids抗酸药：aluminumhydroxide（氢氧化铝）、ma

4、gnesiumhydroxide（氢氧化镁）等H2-receptorantagonistsH2-受体阻断药：cimetidine（西咪替丁）、ranitidine（雷尼替丁）等MuscarinicantagonistsM-胆碱受体阻断药：atropine（阿托品）等代表药物Protonpumpinhibitors胃壁细胞H+泵抑制剂：omeprazole（奥美拉唑）Gastrinreceptorantagonist胃泌素阻断药：proglumide（丙谷胺）MucosalProtectants胃粘膜保护药：ProstaglandinAnalog(前列腺素衍生物)misop

5、rostol（米索前列醇）Anti-Helicobacterpylori.Drugs抗幽门螺杆菌药：antibioticsDrugsUsedinPepticUlcers抗酸药AntacidsGeneralcharacteristicsAntacidsareweakbasesthataretakenorallyandthatpartiallyneutralizegastricacidandreducepepsinactivity.Antacidsreducethepainassociatedwithulcersandmaypromotehealing.Highdosesar

6、erequiredforhealing:40mEqofbaseseventimesdaily.氢氧化镁magnesiumhydroxide①抗酸作用强，较快，镁离子有导泻作用，与氢氧化铝合用，相互纠正副作用。②小分子Mg2+可被吸收肾排泄肾功能不良的病人血清中Mg2+上升。三硅酸镁magnesiumtrisilicate：起效缓慢，作用持久，在胃内生成胶状二氧化硅，对溃疡具有保护作用。抗酸药Antacids抗酸药Antacids氢氧化铝aluminumhydroxide:抗酸作用强，缓慢，持久，中和胃酸，具有收敛、止血和引起便秘作用。长时间应用影响磷酸吸收。禁止与四环素、

7、地高辛、异烟肼、强的松等合用。碳酸钙calciumcarbonate：抗酸作用强，快而持久，产生CO2气体，进入小肠，促进胃泌素分泌，反跳性胃酸分泌增加。碳酸氢钠sodiumbicarbonate（小苏打）：作用强，快而短暂，产生CO2，碱血症。H2-receptorantagonistsMechanismofactionCompetitivelyblockthehistamine(H2)receptorofacid-producingparietalcellsrenderingcellslessresponsivetonot