课件：消化系统疾病常用药物.ppt

主要经营：课件设计，文档制作，网络软件设计、图文设计制作、发布广告等 秉着以优质的服务对待每一位客户，做到让客户满意！ 致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求 * 胃粘膜壁细胞上有三种受体：胃泌素受体(G)、H2受体和M胆碱受体分 别受胃泌素、组胺和乙酰胆碱激动，但最终都通过激动质子泵 (proton pump, PP)分泌H+,奥美拉唑阻断PP，因此对各种刺激引起的胃酸分泌都 有抑制作用,作用强于其它各药。 H2受体阻断剂（雷尼替丁）和其它药物因作用环节单一，其抑酸作用均不及奥美拉唑强大。 由于乙酰胆碱和胃泌素的泌酸作用部分是通过刺激胃壁细胞附近的肠嗜铬 样细胞(enterochromaffin-like cell)释放组胺而产生的，故H2阻断剂对 乙酰胆碱和胃泌素引起的胃酸分泌也 有部分抑制作用。 * Slide 49: Chronic Hepatitis C Treatment: Characteristics of Branched PEGs Branched PEGs are nonlinear high-molecular-weight polyethylene glycol molecules of up to 60,000 kDa that have some benefits over linear PEGs. They can be strongly and stably linked to the protein, and only one PEG molecule is required per protein molecule. Each branched PEG-protein conjugate is monofunctional, and aggregatesof the conjugates do not form. * * pH6以上止血反应尚能较慢进行，pH6以下则显著受阻，CT为凝血时间。 上消化道出血初期，由于血液的缓冲作用，在血管破损的局部pH接近中性,有利止血，随着胃排空，局部酸度将逐渐升高，阻碍止血过程 。 * 治疗目标：一是胃内pH6以上，二是持续维持。因为任何泌酸反跳都可 能导致再出血发生而使治疗失败 * * Patient noncompliance is a fact of life supported by many studies. (1,2) Rabeprazole, with a rapid onset of action, potent acid inhibition on Day 1, an early maximal acid inhibitory effect, and early symptom relief would be ideal for patients who stop and start prescribed medication. In addition, rabeprazole’s properties make it ideal for “on demand” therapy. On demand therapy allows doctors to prescribe a new, highly convenient, and cost effective approach to the long-term maintenance of GERD healing. The key pharmacological property for a PPI that is suitable for on-demand treatment, is a rapid onset of acid inhibition. Rabeprazole’s onset of action within a few hours, maximal inhibition at 4 hours, potent Day 1 effect, and early symptom relief makes it suitable for on demand treatment. (3-5) 1. Levy RL, Feld AD. Increasing patient adherence to gastroenterology treatment and prevention regimens. Am J Gastroenterol. 1999;94:1733-1742. 2. Hungin AP, Rubin G, O’Flanagan H. Factors influencin