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Digestive system drugs
Mucosal protective:
· Sulcralfato: not absorbed form film on the surface of the stomach, protects against erosion of the wall, prevents ulcers, and promotes healing.
· Carbenoxolone: active principle of liquorice. It stimulates the secretion of stomach wall mucus, the mucus is thicker and adheres well to the wall protecting it. It is absorbed in the digestive tract fluid retention and edema. It is contraindicated in hypertensive patients.
Secretion inhibitors:
· H2 antihistamines: HCL inhibits secretion. Used cimetidine. Ranitidine and famotidine, are indicated in gastric or duodenal ulcer, oesophagitis. They can give diarrhea or constipation, dizziness.
· Inhibitors hydrogen bomb: Omeprazole. H inhibits the pump, inhibiting the secretion of HCl. Undesirable effects: headaches, diarrhea, skin rashes.

Gastric protectors
Antiulcer drugs when used in pathology of gastric acid secretion, such as reflux esophagitis, peptic ulcer, analgesics gastropathy Nonsteroidal antiinflammatory drugs (NSAIDs) and Zollinger-Ellison syndrome.
· 1 .- Omeprazole and Lansoprazole: produce inhibition of proton pump, backbone of the secretory mechanism of acid in the stomach. The inhibition is irreversible and therefore the therapeutic effect is long lasting.

Each capsule contains: Omeprazole 20 mg.
Therapeutic Action: antiulcer. Selective blocker of the proton pump.
Dosage of omeprazole <> administration, single dose after breakfast.
Side Effects: are rare nausea, headaches, diarrhea, and flatulence estitiquez. The rash occurs rarely, these symptoms are mild and transient, often transitory.
Contraindications: Sensitivity to omeprazole. Not investigated for use in children, pregnant or nursing mothers, so it is not recommended in these patients.
Presentation: Cartons containing 7 and 14 capsules.

Composition: Each capsule contains: Lansoprazole 30 mg.
Therapeutic Action: antiulcer. Selective blocker of the proton pump.
Indications: duodenal ulcer. Gastric ulcer. Reflux esophagitis. Zollinger-Ellison.
Dosage: duodenal ulcer: 1 capsule / day for 4 weeks. Gastric ulcer: 1 capsule / day for 4 to 8 weeks. Reflux esophagitis: 1 capsule / day for 8 weeks.
Side Effects: It is rare to detect diarrhea or constipation, nausea, headache, rash, mild intensity and disappear with the removal of the drug.
Contraindications: Hypersensitivity to the drug <>. Pregnancy and lactation.
Presentation: Cartons containing 20 and 30 capsules with enteric-coated granules.

· H2 antihistamines (cimetidine, ranitidine, famotidine, nizatidine) produce inhibition of acid secretion by blocking specific receptors production < shtml> acid (H2-histamine).

CIMETIDINE: Injectable Solution
Composition: Each ampoule injection of 2 ml contains: Cimetidine 300 mg.
Therapeutic Action: receptor antagonist of histamine H 2. Antiulcer. Inhibitor of gastric acid secretion.
Dosage: Adults: 300 mg IM every 6 to 8 hours Pediatric: IM 5 to 10 mg / kg every 6 to 8 hours
Presentation: Box containing 100 blisters.

Composition: Tablets 40 mg.
Therapeutic Action: Inhibitor of H 2 histamine receptors. Antiulcer.
Dosage Peptic Ulcer: Acute Therapy: The recommended oral dose for adults is 40 mg 1 time at night. Most patients feel relief within 4 weeks of treatment.
Contraindications: Do not use in pregnant or breast feeding. The safe dose for children under 12 has not been determined.
Presentation: Tablets 20 mg: packaging containing 20 coated tablets. Tablets 40 mg: packaging containing 10 coated tablets

Drugs: sucralfate (ulcer is deposited, prevents stomach acid attack, one does not absorb)
Composition: Each 100 ml suspension contains: Sucralfate 10 g
Therapeutic Action: antiulcer.
Note: Keep gastric and duodenal ulcer, reflux esophagitis in adults and children. Dosage: Adults: for the treatment of peptic ulcer and reflux esophagitis, 1 tablespoon of the dessert (10 ml) 4 times daily , twice daily, ½ hour before meals and at bedtime. Treatment should continue for at least 4 weeks.
Presentation: Bottle containing 200 ml.
· Prostaglandins (misoprostol) <> increase the resistance of the wall of the stomach acids and high doses block acid secretion

Composition: Each tablet contains: Misoprostol 200 mcg. Excipients: Microcrystalline Cellulose: Sodium Starch Glycolate, Hydrogenated Castor Oil Directions: Misoprostol ® is indicated for the prevention of gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in performing pctes (bleeding, perforation, death) úlcerasMisoprostol such product is also useful in the treatment of active duodenal and gastric ulcers. do; cs
Dosage: Misotrol ® is administered orally. Prevention of NSAID-induced gastric ulcers: the usual dose for adults is 1 tablet of 200 mcg of misoprostol 4 times daily.
Presentation: Bottle containing 28 tablets.

· Dicitrate bismuthate Tripotassium: Produces protective cover from the mucosa may have an effect on the bacterium Helicobacter pylori.
Another patron is Acexamato zinc seems to stabilize and inhibit the secretion of histamine.
· Pirenzepine: Produces a nerve block (cholinergic) of acid secretion, thereby also produces dry mouth (3.9%) and blurred vision (1.7%).

They are usually two types:
Systemic: By reacting with hydrochloric acid part of absorbed and can produce effects on the body. They are often quick impact but rebound with sodium bicarbonate.
No systemic: A react with the hydrochloric acid form a salt that is not absorbed. Action slower and usually without prolonged rebound Such as: aluminum salts calcium salts and magnesium salts
Sodium bicarbonate and calcium carbonate can produce general effects and affect the kidney. Aluminum salts often cause loss of phosphate
The ideal antacid should cover the following:

· Neutralize immediately and lasting until the pH values of 3 to 4
· Avoid the inactivation of pepsin by the pH change

Drugs in gastroesophageal reflux and esophagitis

· Bethanechol: It is a parasympathetic-mimetic and increases lower esophageal sphincter tone and therefore improve reflux. It is administered orally and has the typical side effects of the sympathetic-mimetic (increased salivation, sweating, bronchial secretions)
· Metoclopranida: increases sphincter tone but relaxes the duodenal vulvo. Improving reflux and increases gastric emptying. Oral and parenteral administration. Side effects can be central (headache and dizziness) or extrapyramidal (rigidity and tremor).
· Domperidone: acts like the metoclopranida and has no central effects. Sometimes abdominal pain produced by intestinal spasm

Induce vomiting, treatment of acute poisoning in the digestive tract.
Ipecac stimulates the gag reflex in minutes, is used orally.
Apomorphine: morphine derivative without central action.
Antiemetic drug:
Most are neuroleptics and are used in the treatment of vomiting. Undesirable effects: sedation, drowsiness, and high-dose dyskinesia. In addition to the antiemetic action has a regulatory action of the intestinal motility and better coordinated the various segments of the digestive tract.
· Phenothiazines (diethyl-Perazine) and antihistamíicos (cyclizine): They have a central effect.
· Metoclopranida: The Joint Action.
· Cleboprida: The central action. It is administered orally and parenterally. Side effects are rigidity and tremor (extrapyramidal) and somnolence.
· Alizaprida: Central Action. Oral and parenteral. But produces less somnolence muscle spasms. Do not use more than 7 days.
· Cisapride: Action peripheral. Oral. Few side effects.
· Ondansetron, granisetron and tropisetron: They are antagonists of serotonin 5HT3 receptors which stimulates the vomiting center. They are very expensive and used only vomiting after chemotherapy and radiotherapy. The VI 8mgr ondansetron administered before chemotherapy and after 8mgr every 4-8h during the 1st day, then 4-8mgr orally every 8h for 3-4 days. Tropisetron and granisetron The advantage is that they are useful with a single administration per day. Side effects: constipation, headaches and facial color.

ANTIDIARRHEALS and laxatives.
Most give travelers diarrhea within 2-3 days, bland diet and rehydration. In very specific antidiarreicosn are used antibiotics are used only in cases of cholera (bacteria). These drugs are opiates (codeine and diphenoxylate) and anticholinergics (hyoscine bromide) decrease peristalsis.
Drugs that reduce intestinal peristalsis
Traveler Narcotics: All. Paint was used opium. 5-10 drops are given after each stool. Also non-absorbable synthetic narcotics such as diphenoxylate and loperamide.
· Lactobacilus: bacilli normal intestinal flora. It should restore the flora that has been altered when given oral antibiotics. Its effectiveness is questionable.

Laxatives and purgatives
Facilitate intestinal emptying, decreasing stool consistency. Most cases of constipation with proper diet would yield fiber, whole grain bread. Laxatives stimulate peristalsis and the muscle relaxes after placing greater degree of constipation, necessitating the laxative again. Indications: Treatment of constipation in very short periods when there hemorrhoids, digestive surgery, hospitalized patients.
According to the mechanism of action and power are:

Bulk laxatives: The cause is poor diet of waste and increase fiber, you can use the bran, agar-agar, plant mucilage oovata and methyl cellulose. All increase the volume when hydrated.
Osmotic laxatives: Sales nonabsorbable administered orally or rectally. Is to attract water from the intestine by an osmotic process. The most used is magnesium sulfate salts and fruit.
Sodium phosphate enemas: Another is that lactulose is a synthetic sugar (galactose + fructose) that is not absorbed in the intestine and draws water by osmosis. On reaching the colon is metabolizers by bacteria and produces lactic acid and acetic acid that increase peristalsis. Mostly used in hepatic encephalopathy.
Stool softeners: softening the bowel contents and promote the expulsion.
Paraffin acid, but not widely used because it blocks absorption of fat soluble vitamins.
Also glycerin suppositories and dopusato sodium (not widely used because it alters the intestinal mucosa).
Contact Laxatives: They prevent the reabsorption of water by the colonic mucosa and simultaneously stimulate the secretion of water and electrolytes from the mucosa to the colonic lumen. Physiological but are less widely used due to the dosage form that are convenient:
· Phenolphthalein.
· Castor oil.
· Extract of plant bearing sheet xenóxidos as Sen (cascara sagrada), Baldo, Cassia angustifolia
Not absorbed but not if they are eliminated in urine and pink and green stains can cause allergy.
All act within 8-12h to be taken at night.
Castor oil works in jejunum and is faster.

Antispasmodic drugs:
Used to treat colic pain (typical of an ulcer caused by an obstructed hollow increased peristalsis to overcome the obstruction). Sometimes by irritation of the wall increases peristalsis giving a similar picture.

hyoscine butylbromide and atropine:
Decreased peristalsis.

an alkaloid from the poppy. Elentece intestinal transit and reducing pain. They can make you constipated.

has spasmodic action.

Tablets: Each tablet contains: Pargeverina Hydrochloride 5 mg. Drops: Each ml solution contains: Pargeverina Hydrochloride 5 mg. Injection: Each 1 ml ampoule contains: Pargeverina Hydrochloride 5 mg.
Therapeutic Action: Antispasmodic.
Uses: Antispasmodic those for the treatment of visceral syndromes, acute or chronic, whose main component is the smooth muscle spasm. Gastrointestinal spasms of the biliary tract, urinary tract and female genital tract. Symptomatic treatment of nausea and vomiting.
Parenteral use (IV or IM):
Adults: 1-4 ampoules per day, slow inoculation. Children: ¼ - ½ ampoule according to age, 3 times a day (slow).
Drops: bottle containing 15 ml. Grageas: a pack containing 10 tablets. Injection: package containing 2 ampoules of 1 ml. Clinical packaging containing 100 vials of 1 ml.

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