作用于消化系统的药物——山东大学药理学英文课件.pptVIP

Chapter 32drug used in digestive system This chapter describes drugs used to treat these common medical conditions involving the gastrointestinal tract: peptic ulcers, dyspepsia, vomitting, diarrhea and constipation, etc.  Part Ⅰ Drugs Used in Peptic Ulcer peptic ulcer A benign, localized defect in the mucosa of any part of the gastrointestinal tract. duodenal ulcer gastric ulcer [Symptoms and complications] The most important symptom is abdominal pain and discomfort. The atypical symptoms are abdomen distention, inappetence, belching, reflux of gastric acid. The severe complications are hemorrhage, perforation, obstruction and canceration. [Pathogenesis of peptic ulcer] although the pathogenesis of peptic ulcer disease is not fully understood, the theory that the balance between mucosal defense and injury is broken are recognized. [Pathogenesis of peptic ulcer] 1. Aggressive factors↑ Helicobacter Pylori ( H. Pylori) gastric acid and pepsin 2. Defensive factors↓ mucus-bicarbonate barrier prostaglandins Helicobacter Pylori ( H. Pylori) In 1983, H. pylori was found by two Australians, Marshall and Warren. Now, it is believed that H. pylori is the most important pathogenic factor to peptic ulcer. “No H.P., no ulcer.” And the two men won the noble prize for the important findings in 2005. H. Pylori (×48,000) H. Pylori on gastric mucosa(×16,000) Actions of H. Pylori gastric acid and pepsin Pepsin can decompose protein molecule. But its activity is depended on the pH value. When local pH value elevates to 4, pepsin can’t work well. Gastric acid is the key-factor of the formation of peptic ulcer. we can also say that “No acid, no ulcer.” mucus-bicarbonate barrier The epithelial layer of the mucosa is composed of tightly adjoined cells that are specialized for existence in an acid medium. Their tight junctions, synthesis of PGs and secret