Stomach ulcers, treatment

Traditional or Hj antihistamine drugs block many effects caused by histamine however, it turns out that they are not able to withstand events mediated by H2 receptors, in particular excess gastric juice secretion. In 1977 an H2-receptor antagonist, cimetidine, was proposed, which revolutionized stomach ulcer treatment. Later on, ranitidine was proposed, followed by drugs with minor structural and pharmacological differences such as famotidine and nizatidine. 

An important consideration in the agricultural production of plants containing medicinally active components is that they are sometimes produced by, or in consequence of, microbial agents present in or on the plant. These also constitute part of the biodiversity regulated by law, may be pathogenic to other economic crops and are not always easily cultured. Production in the natural habitat raises no problems. As an example one may notice that the maytansinoids, ansa-macrolides, which form part of the chemical make-up of Maytenus ilicifolia and M. aquifolia, Celastraceae, the two species most highly considered for stomach ulcer treatment, have been shown to be produced by bacteria associated with the plants. ... 

In severe cases, or those refractory to treatment, truncal and limb weakness may be accompanied by involvement of masticatory, bulbar, and respiratory muscles. However the most life-threatening clinical manifestations are those affecting the gastrointestinal tract, since stomach ulceration can occur and death from perforation and peritonitis are not unknown. Medication with steroidal antiinflammatory agents is necessary but weakens the childrens resistance to infection, so that systemic spread of usually self-limiting disorders, such as candidiasis, may occasionally occur. 

The main clinical use of H2 receptor antagonists is to inhibit gastric secretion in the treatment of stomach ulcers. These agents all contain features that relate to the histamine structure, in particular the heterocyclic ring. Cimetidine and ranitidine are the most widely used in this class. 

PCR amplification has led to more sophisticated and accurate diagnostic techniques regarding diseases. This allows earlier detection of the disease compared to conventional methods, making earlier treatment possible. For example HIV (human immunodeficiency virus) may be detected by searching for the DNA sequence unique to this virus. Amplifying samples and searching for DNA associated with the bacteria responsible for the condition has identified infectious bacterial diseases. Lyme disease, certain stomach ulcers, and middle ear infections have been detected in this manner. 

H2 Antagonists and the Treatment of Peptic Ulcers. Treatment of peptic ulcers is a complicated and multilevel therapy in which Hj antagonists are very successful and widely used (and abused). Peptic ulcers may affect either the stomach (gastric ulcers, less common overall but more common in people with iatrogenic [i.e., physician-induced] ulcers from the use of nonsteroidal anti-inflammatory drugs [NSAIDs]) or the duodenum (duodenal ulcers). The lining of the stomach or duodenum is attacked by the digestive juices to such an extent that the protective mucous layer on the surface has... 

Proglumide (Milid) acts as a cholecystokinin antagonist, blocking both the CCKa and CCKb subtypes. It was used mainly in the treatment of stomach ulcers but has now been largely replaced by newer drugs. 

Plate 7 Bismuth compounds administered in the treatment of stomach ulceration are seen to precipitate and form a protective patch over the ulcer. Photograph provided by Yamanouchi Pharma Ltd. 

Development of the pediatric ear infection drug, NE-1530, was terminated based on a phase II clinical trial data in which NE-1530 showed no significant benefit compared with placebo (40). Another candidate, NE-0080, was being evaluated as a treatment for stomach ulcers and other gastric complaints caused by the bacterium Helicobacterpylori,but after phase I trial indicated the safety (41), no further information became available. 

Ranitidine is one of the most commercially successful medicines ever developed it is used for the treatment of stomach ulcers and has been synthesised from furfuryl alcohol. 

Patients on long-term warfarin should have an oral anticoagulant treatment booklet. Warfarin has many interactions with commonly prescribed drugs. For example, its effects are enhanced by ibuprofen (analgesic), ketoconazole (antifungal) and cimetidine (used to treat stomach ulcers) and reduced by phenytoin (antiepileptic) and alcohol. 

The imidazole ring is a component of cimetidine, a drug used in the treatment of stomach ulcers. The structure of cimetidine is shown below ... 

The aromatic furan ring system, though not found in animal metabolism, occurs widely in secondary plant metabolites, especially in terpenoids perillene is a simple example. Vitamin C, ascorbic acid, is at the oxidation level of a trihydroxyfuran, though it assumes an unsaturated lactone tautomeric form. Though one normally associates thiols with unpleasant odours, furfuryl thiol is present in the aroma of roasted coffee. Some 5-nitrofurfural derivatives are important in medicine, Nitrofurazone, a bactericide, is a simple example. Ranitidine is one of the most commercially successful medicines ever developed it is used for the treatment of stomach ulcers. 

Products and Uses A dried root that is supplied as a tea, in capsules, tablets, tinctures, and so forth. In Chinese medicine it is a folk remedy for a variety of ailments including head colds, flu, stomach ulcers, and diabetes. Used to treat cancer patients in China who are undergoing chemotherapy and radiation treatment. It also is reported to have desirable cardiovascular effects. 

Prostanoids play a significant role in diseases of the gastrointestinal tract. Their cytoprotective and accelerated healing effects make them the remedy of choice for the treatment of stomach ulcers. The prostaglandin-Ej derivative misoprostol (Cytotec , Searle) serves, for example, as an ulcer drug. 

Interestingly, some histamine Hj-receptorantagonists, like ranitidine or nizatidine, in spite of their different pharmacological profile, showa certain structural relationship to nitenpyram (Fig. 8.48). Prior to the discovery of proton-pump inhibitors, these were the most important drugs for the treatment of stomach ulcers. 

Traditional use Baked bulbs are used to heal wounds they are also applied to fnrnncles to remove pus. According to Avicenna the herb and its seeds are the best treatment for diarrhea. If the seeds are taken with water or wine it helps to heal stomach ulcers and improve digestion. Wine infnsed with the seeds are nsed to treat kidney stones (Karimov and Shomakhmudov 1993). 

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