Gastritis Treatment

Gastritis Treatment

According to classification

H2-Histamine Receptor Blocked: They act selectively on H2 receptor in stomach, blood vessel. These agent inhibit gastric acid secretion induced by histamine or gastrin. It binds tightly with H2  receptor and inhibit Hcl secretion.

Example: Cimetidine, Famotidine, Ranitidine, Nizatidine.

Protone-pump inhibitor: These drug binds to H⁺/K⁺-ATPase enzyme system (Proton pump) of the parietal cell & thereby suppress secretion of hydrogen ion into the gastric lumen.

Example: Omeprazole, Pantoprazole, Esomeprazole, Rabeprazole.

Antacid: These are weak base that react with to form  H2O and salt. Thereby diminish gastric acidity. Because pepsin is inactive at a Ph greater than 4, antacid also reduce peptic activity.

Example: AlOH, CaCO3, MgOH, NaHCO3.

Antimicrobial Agent: It acts by altering the acid environment or directly inhibiting effects.

Example: Amoxicillin, Tetracyclin, Clarithromycin, Metronidazole.   


# Ulcer and its Cause 

# Sign & Symptoms of Ulcer 

# Types of Ulcer 

Cancer Drugs

Cancer Drugs

According to classification

Alkylating agent: Alter structure and function of DNA or by fragmenting of DNA strand. So, normal synthesis of DNA is prevented.

Example: Chlorambucil, Cyclophosphamide.

Anti-metabolite: Act by blocking one or more of the metabolic pathway for DNA synthesis.

Example:  Methotrexate, Fluorouracil, Mercaptopurine.

Vinca Alkaloid: It is a mitotic inhibitor. It binds to microtubular protein-tubulin, prevent its polymerization and assembly of microtubules,cause disruption of mitotic spindle and interfere with cytoskeletal function.

Example: Vincristine, Vinblastine.

Taxen: It binds reversibly to the beta tubulin subunit. They promote polymerization and stabilization of the polymer rather than disassembly. Thus, they shift the depolarization-polarization process to favor the formation of microtubules.The stable microtubules formed are non-functional and chromosome desegregation does not occur. This results in death of cell.

Example: Paclitaxel, Doxitaxel.

Glucoside: Inhibit mitosis at metaphase stage. Inhibit DNA synthesis by an action on topoisomerase II. It also inhibit mitochondrial function.

Example: Etoposide.

Antibiotics: It interact with DNA ,cause fragmentation of DNA chain.As a result disruption of DNA function occur and inhibition of DNA and RNA synthesis occur.

Example: Doxorubicin, Bleomycin.

Miscellaneous cytotoxic drugs: It is hydrolysed intracellularly to produce a highly reactive moiety which causes cross linking of DNA. As a result, cell growth is inhibited.

Example: Cisplatin, Carboplatin.

  

Camptothecin analogues: It targets the complex between DNA and topoisomerase I. This leads to DNA cleavage and cell death.

Example: Irinotecan, Topotecan.

Monoclonal Antibodies: It has been produced for numerous tumor associated antigen. It serves to active the body’s immune response to direct killer cells against the tumor.If antigen is over expressed receptor, the antibody may bind to it. So,chemical messenger cannot bind. The antibody act as a receptor antagonist.

Example: Transtuzumab, Alemtuzumab, Rituximab.

Kinase inhibitor: It acts as a signal transduction inhibitor. Inhibit tumor tyrosine kinase. Because, tyrosine kinase associated with growth factor.

Example: Imatinib.


# Chemotherapy

# Side effects of Chemotherapy Drugs

Diebetes Medications

Diabetes Medications

Mechanism of Action According to classification

Sulfonylurea
Among all diabetes medications, sulfonylurea Inhibit ATP sensitive K+ channel in pancreatic beta cell. Depolarization and influx of calcium contraction occur. As a result,  insulin release from beta cell and act on liver and peripheral tissues. Blood glucose level decrease and give antidiabetic effect.

Example: Tolbutamide, Glilazide, Glipizide.

Biguanide
Among all diabetes medications biguanide directly stimulates glycolysis (glucose breakdown) in peripheral tissue with increase glucose removal blood. It reduces blood glucose by reducing hepatic gluconeogenesis (Formation of glycogen from non-carbohydrate source). It reduces intestinal glucose absorption and enhances insulin receptor binding. 

Example: Metformine, Phenformine.

Miglitide Analogues
Among all diabetes medications miglitide act by blocking K+ channel and cause depolarization. So, calcium entry increase that result in contraction and insulin secretion.

Example: Repaglinide, Nateglinide.

Thiazolidinediones
Among all diabetes medications thiazolidinediones enhance entry of glucose into fat and muscle. It suppress the hepatic gluconeogenesis. So, gene regulating fatty acid metabolism and lipogenesis in adipose tissue , contribute to the insulin sensitizing action.

Alpha glucosidase Inhibitors: Among all diabetes medications alpha glucosidase Inhibitors is a complex oligosaccharide which reversibly inhibit alpha-glucosidase, final enzymes in the digestion of carbohydrates in the brush border of small intestine mucosa. Alpha glucosidase Inhibitors slows down and decrease digestion and absorption of polysaccharide and sucrose. It has no role on metabolism of excess glucose. Alpha glucosidase Inhibitors controls entry of glucose into blood.

Example: Acarbose, Meglitol.

# Side Effects of Antidiabetic Drug

# Sign and Symptoms of Diabetes Mellitus

# Insulin and its Mechanism

# Types of Insulin

Antimicrobial Agents

Antimicrobial Agents

Mechanism of Action According to classification

Sulfonamide
Most bacteria produce its own folic acid (FA) of which Para Amino Benzoic Acid (PABA) is a constituent. Antimicrobial agents, Sulfonamide has similar structure like PABA. So, by interfering, it inhibits to produce actual folic acid and form an alternate folate which is metabolically injurious to bacteria. 

Example: Sulfadiazine, Para amino salicylic Acid (PAS).

.

Beta Lactum Antibiotics
This antimicrobial agents are bactericidal. It interferes with the last step of bacterial cell wall synthesis called transpeptidation by inhibiting the transpeptidase enzyme. So that cross linking does not take place. And resulting in exposure of less stable membrane. Cell lysis can occur then through osmotic pressure.

Example: Penicillin (Pen-G,Pen-V,Amoxicillin), Cephalospirin (Cefazolin, Cefuroxime, Cefixime, Cefepime).

Protein Synthesis inhibitor
Entry of these antimicrobial agents in organism caused by diffusion. The drugs bind to the 30s subunit of bacterial ribosome and blocking the access of amino acyl t-RNA to the m-RNA ribosome complex at the receptor site. And protein synthesis inhibited.

Example: Tetracycline, Doxicycline.

Aminoglycoside: Antimicrobial agents, Aminoglycoside transport through bacterial cell wall by diffusion and cytoplasmic membrane. Then it will bind to ribosome of bacteria, that will result, inhibition of protein synthesis.

Example: Neomycin, Streptomycin.

Macrolide: This antimicrobial agents bind irreversibly to a site on the 50s subunit of the bacterial ribosome, thus inhibiting the translocation steps of protein synthesis. They also interfere transpeptidation.

Example: Azithromycin, Erythromycin, Clarithromycin.

Chloramphenicol: This antimicrobial agents bind to the bacterial 50s ribosomal subunit and inhibits protein synthesis at the peptidyl transferase reaction.

Inhibitor of nucleic acid synthesis & function

Fluoroquinolone: It enters the cell by diffusion through water-fluid protein channel (porin) in outer membrane. Inhibit the replication of bacterial DNA by interfering with action of DNA gyrase during bacterial growth and reproduction. 

Example: Ciprofloxacin, Ofloxacin.

Quinolone: Mechanisn of action is same like  fluoroquinolone, but not fluorinated. Mainly used for gram(-) bacteria, that cause UTI.

Example: Nalidixic Acid.

# Side Effects of Antimicrobial 

Hypertension Drugs

Hypertension Drugs

Mechanism of Action According to Classification

Diuretic: Its a hypertension drugs that reduce BP by increasing Na & H2O excretion. This causes decrease in extracellular volume and resulting decrease in cardiac output and renal blood flow.

Example: Hydrochlorothiazide, Furosamide.

Beta-Blocker: Its a hypertension drugs that reduce Blood pressure (BP) by decreasing cardiac output. It also decreases sympathetic outflow from central nervous system and inhibit release of rennin from the kidney, thus decreasing formation of angiotensin II and secretion of aldosterone.

These drugs also reduce oxygen demand by reducing force and contraction of heart. So, decrease activity of heart, decrease cardiac output and fall BP.

Example: Propanolol, Atenololo.

                                          

Angiotensin Converting Enzyme (Ace) Inhibitor: Its a hypertension drugs that decrease blood pressure by reducing peripheral vascular resistance, except increasing cardiac output, rate or contractility. It blocks the angiotensin converting enzyme (ACE) that cleaves angiotensin I to form potent vasoconstrictor angiotensin II. So, vasodilatation occurs and bradykinin increase. It also decrease the secretion of aldosterone.

Example: Captopril, Ramipril.

Calcium Channel blockers: Calcium play an important role in maintaining the tone of smooth muscle and in contraction of myocardium.Calcium channel blockers are the hypertension drugs that block the inward movement of calcium (to cell) by binding to L-type calcium channel in the heart and in smooth muscle of coronary and peripheral vasculature. These cause the vascular smooth muscle to relax and dilating arterioles.

Example: Verapamil (1^st choise for Anti-arrythmic), Diltiazem (1^st choise for Anti-anginal), Nifedipine (1^st choise for Anti-hypertensive).

Alpha-Blocker: Its a hypertension drugs that decrease the peripheral vascular resistance and lower the arterial BP by causing the relaxation of arterial and venous smooth muscle. Salt & H2O retention occur.

It also blocks the post synaptic alpha adrenergic receptor. So, it inhibits the vasoconstriction produced by the norepinephrin that is released from the synaptic nerve endings. So, vasodilation occurs and lowers the blood pressure.

Example: Doxazosin, Prazosin.

Central Sympatholytics: Its a hypertension drugs that forms false neurotransmitter alpha-methyl nor-adrenaline which combines with alpha-receptor present on the surface of the neurons in the lower brain stems. So, inhibits neurons and decrease central and peripheral sympathetic activities. And finally, decrease blood pressure.

Example: Methyl dopa.

Direct vasodilator: Its a hypertension drugs that dilate resistant vessel, arteriolar dilation occur, decrease peripheral resistance and as a result decrease blood pressure.

Example: Diazoxide.

# Side Effects of Antihypertensive Drug

# Hypertension & its Cause

# Sign and Symptoms of Hypertension