Professional Documents
Culture Documents
Gastrointestinal Drugs
Gastrointestinal Drugs
Problem Solving
Seorang wanita berusia 55 tahun datang dengan
keluhan nyeri ulu hati setempat, setelah sarapan pagi.
Nyeri mengisap ini telah berlangsung selama 1 minggu.
Os telah minum obat antasid, namun sering kambuh.
Keluhan ini telah dirasakan selama setengah tahun. Ibu
os juga sering mengeluh nyeri di ulu hati.
Pada pemeriksaan : TD 130/80 mmHg, Temp , 36.5C, RR
20x/menit, HR 70 x/menit. Pertanyaan :
1. Pemeriksaan apa diperlukan untuk menegakkan
diagnosis ?
2. Faktor risiko apa yang menyebabkan penyakit ini ?
3. Bagaimana pengobatan penyakit ini dan komplikasi ?
4. Bagaimana mekanisme kerja (farmakodinamik) dan
farmokinetik
obat H2 histamine receptor antagonist, proton pump
inhibitor ?
GI Disorders
Peptic ulcer disease (PUD)
Gastrointestinal Reflux Disease
(GERD)
Gastroparesis (Delayed Gastric
Emptying)
Constipation
Diarrhea
Irritable Bowel Syndrome (IBS)
Inflammatory Bowel Disease
Peptic Ulcers
Occur primarily in the stomach and
duodenum at a site where the mucosal
epithelium is exposed to acid and pepsin.
A constant confrontation between acidpepsin and mucosal defense in the
stomach and upper small bowel.
Most patients with DUs have an increase
in acid secretion, patients with GUs often
have normal or low rates of acid secretion.
Peptic Ulcers
astrointestinal Reflux Disease
( GERD )
Esophagitis
Peptic Ulcers
Most peptic ulcers are associated
with either a gram-negative bacillus,
Helicobacter pylori (H pylori), or
chronic use of nonsteroidal
antiiflammatory drugs (NSAIDs).
H. Pylori
COX-1
COX-2
Nonselective
NSAID
Body Homeostasis
. Gastric integrity
. Renal Function
. Platelet Function
COX-2
selective
Inhibitor
Inflammation
Pain
Pharmacokinetics of GI drugs
Eradication of H Pylori
Side Effects
H2 Receptor Antagonist
- Headache
- Diarrhea
- Constipation
- nausea
Proton Pump Inhibitor (PPI), similar to H2 RA
- Diarrhea (more frequently)
Antacid
- constipation (aluminium-containing
antacids)
- diarrhea (magnesium containing antacids)
Side Effects
Mucosal protectant (Sucralfate)
- Constipation
Prostaglandin (misoprosol)
- Diarrhea
Promotility agents
- Metoclopramide) - parkinsonian side
effects,
sedation
- Cisapride ; torsade de pointes
(ventricular
arrhythmia)
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