EFFECT OF

SALICYLATE ON GIT

Presented by
Asima bibi
13024
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PGs have protective effect on
GIT

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 1.Gastrointestinal ulcer

• salicylates suppress prostaglandin synthesis by inhibiting

the activity of the enzyme cyclooxygenase and that
prostaglandins are physiological modulators of gastric
mucosal defense.
• Inhibition of prostaglandin leads to ulcer formation.

Endoscopically ulcers can be detected in

approximately 20% of chronic NSAID users
(Graham etal1988).

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 NSAID

ffe ion
e e bit
ct
Loss of PGI2 induced inhibition of LTB4 mediated

tiv hi
ec i n
endothelial adhesion and activation of neutrophils

o t ed
pr at
to edi
d 2m
an GI

↑ Leukocyte-Endothelial
cy
P
et n d

Interactions
cr 2 a
n
se E
io
id PG
ac of
ss
Lo
of

Capillary Proteases +
Obstruction Oxygen Radicals

Ischemic Endo/Epithelial
Cell Injury Cell Injury

Mucosal Ulceration 4

http://web.calstatela.edu/faculty/mchen/454L%20lectures/NSAIDs.ppt
 Molecular mechanism of ulcer

Weiping Zhang Department of Pharmacology Zhejiang University School of Medicine

 2.Mucosal damage and GIT
irritation

• Aspirin remain non ionized at acidic pH found in the

gastric lumen and thus can be absorbed across the
gastric mucosa. Once the drug moves from the acidic
environment of the gastric lumen into the pH–neutral
mucosa, the drug ionizes and gets trapped.
• This ion trapping in mucosal cells enhace
gastric toxicity gastric irritation gastritis.

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Conti…

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 3.Stimulation of CTZ

• salicylates induce vomitting by directly irritating

the stomach.
• Vomiting centre is activated due to impulse
orignate from GIT

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 4.Hepatic effects
• Salicylates can cause hepatic injury, usually in patients
treated with high doses of salicylates that result in
plasma concentrations of >150 g/mL.
• The majority of cases occur in patients with connective
tissue disorders.
• Symptoms:
• increase in serum levels of hepatic transaminases
• upper quadrant abdominal discomfort and tenderness.

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 5.Gastric bleeding

salicylates-induced gastric bleeding sometimes is

painless and, if unrecognized, may lead to iron-
deficiency anemia.
Antiplatelet effect is responsible for gastrointestinal
bleeding.
The daily ingestion of anti-inflammatory doses of
aspirin (3-4 g) results in an average fecal blood
loss of between 3-8 mL/day.

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summary

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 Refrences

 Gastric ulceration: critical events at the neutrophil-endothelium

interface'JOHN LACE Gastrointesbr'rzaIResearch Group, Facully of
Medicine, University of Galgav, Calgary, A!bsr., Canu~fa T2N ~ I V ]
Received October 13, 1992
WALLACE, J. L. 1993. Gastric ulceration: critical events at the
neutrophil -endotheliun~interface. Can. J. Physiol. Pharmacol.
 NSAIDs (including aspirin): pathogenesis of gastrodudenal toxicity
by Mark Feldman.
 http://livertox.nih.gov/Aspirin.htm

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