Ulcer therapy

The search for specific inhibitors of gastric H,K-ATPase has a dual purpose. First, with the help of suitable inhibitors it is possible to get insight into the molecular mechanisms of H,K-ATPase, and second, a specific inhibitor might be clinically useful for inhibition of gastric acid secretion in anti-ulcer therapy. 

Approximately, 2 5 million Americans are affected by PUD, with the lifetime prevalence estimated to be 12% in men and 10% in women.2 Annual direct and indirect costs associated with PUD in the United States are estimated to be more than 9 billion. Despite the widespread use of conventional anti-ulcer therapy that effectively reduces gastric acid secretion, ulcers frequently recur, with 1-year recurrence rates (after ulcer initial healing) estimated to range from 60% to 100%.1... 

Fig. 9.6 Structural formulas of H2-receptor antagonists used for ulcer therapy. The compounds can be divided into four different chemical classes imidazole derivatives...

Herpes labialis The recommended dosage of valacyclovir for the treatment of cold sores is 2 g twice daily for 1 day taken approximately 12 hours apart. Initiate therapy at the earliest symptom of a cold sore (eg, tingling, itching, burning). There are no data on the effectiveness of treatment initiated after the development of clinical signs of a cold sore (eg, papule, vesicle, ulcer). Therapy beyond 1 day does not appear to provide additional clinical benefit. 

A third basic option available in the case of some therapeutic categories is to develop an over-the-counter version of a product subject to patent expiration. The strategy has been employed for example for anti-inflammatory pain relievers such as Motrin and Naprosyn, anti-ulcer therapies such as the H2 blockers Tagamet and Zantac, proton pump inhibitors such as Prilosec, and in several other therapeutic categories. However, a shift to OTC status requires approval by the FDA that the drug is safe for self-medication (Juhl 2000 McCarran 1991 Schweitzer 1997). A company will normally need to submit new clinical trial evidence to that effect. If approved by the FDA, the company receives a three-year exclusivity period for its OTC product in recognition for the new clinical trial work. 

The timing of medication is critical in ulcer therapy. Anticholinergic drugs should be given about 30 min before meals and antacids about 1 h after meals. A double dose of an antacid is often taken just before bedtime. 

The ability of maggots to promote healing of lacerations on skin wounds is the result of their secretion of the chemical allantoin. A less offensive source of allantoin is the synthetic form. Synthetic allantoin is available today to accelerate wound healing and is used in skin ulcer therapy when applied topically (similar uses exist in veterinary medicine). An alternative theory to explain the maggots mechanism of action is that they secrete antimicrobial waste products such as ammonium, calcium, or other bicarbonates that break down only the necrotic tissue in wounds these secretions also change the alkalinity of the wound to help it to heal. 

The cholinoceptor antagonist pirenzepine preferentially blocks cholinoceptors of the M, type its use in peptic ulcer therapy is now obsolete. 

A gastric carcinoid tumor, detected during long-term anti-ulcer therapy with a histamine receptor antagonist and proton pump inhibitors, has been reported (34). 

Proton pump inhibitors (PPIs) were introduced in 1989 with the development of omeprazole. Since then, they have become one of the most widely prescribed class of drugs on the market today. Over 43 million prescriptions were written for anti-ulcer therapy in the US in 2005 [1]. Currently, there are five PPIs available in the United States and Europe esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole. Their safety and efficacy profile is excellent, which has been the major factor leading to... 

A large variety of antagonists have proved to be useful medicines, with many showing selectivity for specific organs. For example, some act at the intestine to relieve spasm, some act selectively to decrease gastric secretions, while others are useful in ulcer therapy. This selectivity of action owes more to the distribution properties of the drug than to receptor selectivity (i.e. the compounds can reach one part of the body more easily than another). 

Sonnenberg A, Schwartz JS, Cutler AF, et al. Cost savings in duodenal ulcer therapy through Helicobacter pylori eradication compared with conventional therapies Results of a randomized, double-blind, multicenter trial. Arch Intern Med 1998 158 852-860. 

Spasmolytic in ulcer Spasmolytic for ulcer therapy preoperative medication In gastric acidity and spasm Chronic emphysema In Zollinger-EIIison syndrome Spasmolytic to treat peptic ulcer Decreases gastric hyperacidity and hypermotility Spasmolytic in peptic ulcer Antispasmodic, preoperative medication... 

Racemic form, monoclinic plates or prisms from water, rap 238°. One gram dissolves in 190 ml water, 500 ml alcohol more so] in hot water and hot alcohol. Almost insol in ether. pH of said water soln 5.5. thekaf CaT Topical vulnerary skin ulcer therapy. THERAP CAT (VET) Has been used topically to stimulate... 

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