Ulcers, peptic sucralfate

The next major class of drugs for peptic ulcer disease is the mucoprotectants and other protective agents. Sucralfate (4.158) is a carbohydrate-based drug (chapter 8) which forms an impenetrable paste that adheres to the stomach lining defect, providing a protective barrier. Misoprostol (4.159) is a semisynthetic prostaglandin derivative that promotes mucus production. Carbenoxolone (4.160) has a mineralocorticoid-type action that also promotes mucus production. 

Sucralfate is used in the management of peptic ulceration and of reflux oesophagitis, and its cytoprotective effects may be of benefit in radiation-induced mucosal damage elsewhere in the GI tract. 

Gastrointestinal. Patients taking continuous steroid, especially in combination with a nonsteroidal antiinflammatory drug (NSAID), have an excess incidence of peptic ulcer and haemorrhage of about 1-2%. It is plainly unreasonable to seek to protect all such patients by routine prophylactic antiulcer therapy, i.e. to treat 98 patients unnecessarily in order to help two. But such therapy (proton pump inhibitor, histamine H -receptor blocker, sucralfate) is appropriate when ulcer is particularly likely, e.g. a patient with rheumatoid arthritis taking an NSAID, or for patients with a history of peptic ulcer disease. There is increased incidence of pancreatitis. 

Internal use in medicine can exploit the alkaline nature and adsorptive capacities of aluminium compounds (as in antacid mixtures, antidiarrheal drugs, and vaccines). Aluminium is found in medications for antacid therapy and phosphate depletion alternatives are under investigation (7). Patients on dialysis take large amounts of oral aluminium hydroxide as a means of reducing serum phosphate. Sucralfate is used to treat peptic ulceration and gastritis. 

Sucralfate Sucralfate is aluminum sucrose sulfate, a small, poorly soluble molecule that polymerizes in the acid environment of the stomach. This polymer binds to injured tissue and forms a protective coating over ulcer beds. The drug has been shown to accelerate the healing of peptic ulcers and to reduce the recurrence rate. Unfortunately, sucralfate must be... 

A sulfated polysaccharide, sucralfate, was introduced to the market as a protective agent and has had some following for treatment of peptic ulcer disease. It is claimed to enhance the gastric barrier. However, the large number of patients needed to show efficacy indicates its weak effect. 

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