LECTURE 4

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22 Terms

1
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Gastric Juice Composition

Gastric juice, produced by the stomach, contains hydrochloric acid to kill microbes and solubilize food, pepsinogen for protein digestion, gastric lipase for fat digestion, and intrinsic factor for vitamin B12 absorption.

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Regulation of Acid Secretion

Acid secretion in the stomach is regulated by acetylcholine, gastrin, and histamine binding to specific receptors, leading to increased proton pump activity and acid release into the stomach lumen.

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Mechanism of Acid Production

Acid production involves a proton pump system that pumps protons out of the cell, bicarbonate secretion to neutralize acid, and various hormonal and neural pathways to control acid secretion levels.

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Mucosal Protection

The stomach mucosa is protected by mucus layers that trap bicarbonate secretions, neutralize acid, and prevent erosion of the stomach lining, stimulated by short reflexes, the enteric nervous system, and prostaglandins.

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Vagus nerve and secretin

Stimulate mucus production in the stomach for protection against acid.

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Gastric ulcers and peptic ulcers

Result from failed protection or excessive acid production, leading to erosion of the stomach lining.

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H

Gram-negative bacteria causing inflammation of the stomach lining and associated with gastric ulcers.

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Proton pump inhibitors

Drugs that block acid production by inhibiting the proton pump, used to treat ulcers.

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Histamine receptor antagonists

Drugs that reduce stomach acid by blocking histamine receptors, such as cimetidine and Zantac.

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Potassium leak channels

Potential target for developing new anti-ulcer drugs by blocking these channels to reduce acid production.

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Prostaglandins

Protective mechanism in the stomach that can be interfered with by nonsteroidal anti-inflammatory drugs, leading to ulcers.

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Somatostatin

Hormone that reduces acid secretion in the stomach, impaired by H. Pylori infection, leading to increased acid production and ulcers.

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Proton Pump Inhibitor (PPI)

Binds irreversibly to the proton pump, leading to a long-lasting effect.

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Enteric Coated Form

Given to protect the drug in the stomach and ensure it gets absorbed in the small intestine.

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Second Generation PPIs

Improved versions of PPIs, with Nexium (S form) being one example.

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H

Involves a combination of antibiotics, proton pump inhibitors, and bismuth compounds.

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Antibiotic Resistance

Development is a concern when using antibiotics for a long period, leading to the need for combination therapies.

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Bismuth Compound

Slows acidification of the bacterial interior, enhancing antibiotic action when combined with PPIs.

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Potassium Competitive Acid Blockers

Potential new class of drugs that may outperform PPIs in reducing acid secretion and enhancing antibiotic action.

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Cyclooxygenase inhibitors that can lead to ulcers by reducing the protective layer of mucus in the stomach.

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Misoprostol

Synthetic prostaglandin that can be given alongside NSAIDs to counteract their side effects.

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Regulation of Gastric Acid Secretion

Controlled by gastrin, histamine, and acetylcholine, leading to the development of effective ulcer treatments.