DRUGS FOR UGIB

PROTON PUMP INHIBITORS

(Dexlansoprazole, Esomeprazole, Lansoprazole, Omeprazole,

Pantoprazole, Rabeprazole)

• PPIs inhibit both basal and stimulated gastric acid secretion by

more than 90%.

• Binds to Proton pump and suppress the action og hydrogen

ions into the gastric lumen

Side effects
• Nausea
• Abdominal pain
• Constipation
• Flatulence
• Diarrhea
 H2-RECEPTOR ANTAGONISTS

(Cimetidine, Famotidine, Nizatidine, Ranitidine)

Blocks the binding of histamine to H2 receptors, reducing

the secretion of gastric acid.

Therapeutic uses:
• Peptic ulcers:
• Acute stress ulcers:
• Gastroesophageal reflux disease (GERD):
Adverse effects:
Cimetidine: gynecomastia and galactorrhea
• Cimetidine interfere with the metabolism of many other
drugs, such as warfarin, phenytoin, and clopidogrel
 PROSTAGLANDINS

Misoprostol (Cytotec)

Inhibits secretion of acid and stimulates secretion of

mucus and bicarbonate (cytoprotective effect).

Adverse Effects:
Toxicities:
• Diarrhea
• Uterine bleeding
• Contractions
 ANTACIDS

(Aluminum hydroxide, Calcium carbonate, Magnesium

hyrdroxide, Sodium bicarbonate)

• Weak bases that react with gastric acid to form water

and a salt to diminish gastric acidity
• Reduces pepsin activity
• Administered after meals for maximum effectiveness.

Adverse effects:
• Aluminum hydroxide: Constipation
• Magnesium hydroxide: Diarrhea
 MUCOSAL PROTECTIVE AGENTS
Bismuth Salicylate, Sucralfate

Enhance mucosal protection mechanisms, thereby preventing mucosal

injury, reducing inflammation, and healing existing ulcers.

Sucralfate:
Forms complex gels with epithelial cells, creates a physical barrier that
protects the ulcer from pepsin and acid, allowing the ulcer to heal.

Bismuth subsalicylate:
• component of quadruple therapy to heal peptic ulcers
• Inhibits the activity of pepsin
• Increases secretion of mucus
• Interacts with glycoproteins in necrotic mucosal tissue to coat and
protect the ulcer.