止吐药和促动力药_2015V1.PPT

3. Laxatives that decrease absorption Liquid petrolatum ( Lubricate the fecal mass, prevent excessive dehydration of the material , and may inhibit water reabsorption by coating the gut wall) Modulators of gastrointestinal functions Proton pump inhibitors are administered as inactive prodrugs. Within the acidified compartment the prodrug rapidly becomes protonated and is concentrated 1000-fold within the parietal cell canaliculus. There, it rapidly undergoes a molecular conversion to the active, reactive thiophilic sulfonamide cation. The sulfonamide reacts with the H+/K+ ATPase, forms a covalent disulfide linkage, and irreversibly inactivates the enzyme 影响药物分布 ?药物的理化性质； ?局部的血流量； ?体液的pH值； ?生物屏障(血脑屏障、胎盘屏障)等。 影响药物分布 ?药物的理化性质； ?局部的血流量； ?体液的pH值； ?生物屏障(血脑屏障、胎盘屏障)等。 Misoprostol has both acid inhibitory and mucosal protective properties. it binds to a prostaglandin receptor on parietal cells, reducing histamine-stimulated cAMP production and causing modest acid inhibition Peptic ulcers develop in approximately 10–20% of patients who receive long-term NSAID therapy Diarrhea and cramping abdominal pain occurs in 10–20% of patients. misoprostol stimulates uterine contractions ( Sucralfate is a salt of sucrose complexed to sulfated aluminum hydroxide. the negatively charged sucrose sulfate binds to positively charged proteins in the base of ulcers or erosion, forming a physical barrier that restricts further caustic damage and stimulates mucosal prostaglandin and bicarbonate secretion. It may also bind epithelial growth factor and fibroblast growth factor, enhancing mucosalrepair a small amount of aluminum is absorbed, it should not be used for prolonged periods in patients with renal insufficiency. 1.bismuth subsalicylate, bismuth subcitrate and bismuth dinitrate are also available. 2. All bismuth formulations have an excellent safety profile. 3. Bismuth agents should be used for only short periods and should be avoided in patients with renal insufficiency. Opioid