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Health

Tablets from stomach ulcers

In the medicamentous treatment of gastroenterological diseases, accompanied by a violation of the integrity of the mucous membranes, tablets are used from stomach ulcers of various pharmacological actions.

Indications of the tablets from a stomach ulcer

The main indications for the use of these drugs: gastric and duodenal ulcer (peptic and bacterial); acute and chronic forms of gastritis; duodenitis and gastroduodenitis; esophagitis and gastroesophageal reflux disease; ulcerogenic gastrinoma (including Zollinger-Ellison syndrome), acid-aspiration syndrome, other benign erosive-ulcerative gastrointestinal pathologies. Many drugs in this category can be used to prevent relapse of peptic ulcer and to prevent stress ulcers and gastritis.

Names of tablets from a stomach ulcer

By appointing these or other tablets from stomach ulcers, gastroenterologists are guided not only by the presence of symptoms of the disease, but also by the results of an ultrasound examination of the patients, and also by a laboratory study of the composition of gastric juice and blood for the presence of antibodies to Helicobacter pylori that penetrates the stomach and duodenal mucosa.

We remind you that in the list of drugs their synonyms or generics (other trade names of these medicines of different manufacturers) are indicated in parentheses.

The names of tablets from stomach ulcers can be grouped according to their therapeutic effect and its biochemical mechanism:

  • drugs that block H2-histamine receptors: Acid (Nizatidine), Kvamatel (Famotidine, Anthodin, Acipep, Gastrogen, etc.), Zantak (Ranitidine, Ranigast, Ulkodin, etc.), Histodil (Cimetidine, Simethidine, Tagamet, Ulceratil and others .);
  • proton pump inhibitors: Omeprazole (Omeprol, Otsid, Omez, Omitox, Gastrozol, Losek MAPS, Promez, Pleom-20, etc.), Sunpras (Pantoprazole, Controlol, Nolpaz, etc.);
  • blockers of acetylcholine receptors or m-holinoretseptorov: Gastrotsepin (Pirenzepin, Gastril, Riabal, etc.), Bruskopan (Neoskapan, Spasmobryu), preparations with the extract of the belladonna - Bellacole, Besalol, Bécarbon and others;
  • Means that contribute to the protection of the affected mucosa: De-Nol (Bismuth subcitrat, Ventrisol, Gastro-norms, Bismofalk), Saitotec (Misoprostol, Cytotec), Liquiriton;
  • antacids (neutralizers of hydrochloric acid of gastric juice): Calcium carbonate (Vikaltsin, Upsovit calcium), Gastal (Maalox), Gelusil (Simaldrat), Compensan (Carbaldrat);
  • preparations that promote the restoration of the mucous membrane: Metiluratsil (Metatsil, Amigluratsil) and Gastrofarm.

To eradicate (destroy) Helicobacter pylori, antibiotics such as Azitral (Azithromycin, Sumamed, Azitrox, Azitrus, etc.) and Clarbact (Clarithromycin, Clacid, Fromilid, Aziklar, etc.) are used.

Anesthetic tablets with a stomach ulcer - it's No-shpa and all preparations based on alkaloids belladonna, as well as the above-mentioned blockers of m-holinoretseptorov.

And for what at a stomach ulcer can be appointed or nominated a neuroleptic Betamaks (Sulpirid), you know in the extremity or end of a material.

Tablets from stomach ulcers that reduce the secretion of hydrochloric acid

The pharmacodynamics of oral tablets Aksid, Kvamatel (Antoedin), Zantak, Histodil, included in the group of histamine H2 antagonists, is due to the fact that their active components (respectively - nizatidine, famotidine, ranitidine and cimetidine), acting on the histamine receptors of the mast cells of the mucous membrane of the gastrointestinal tract , prevent the activation of histamine of the second type (as well as gastrin, pepsin and acetylcholine). This inhibits the secretion of hydrochloric acid in the stomach.

But the pharmacokinetics of these medicines has characteristics. Nizatidin - active substance of tablets Aksid - after absorption in the gastrointestinal tract on average after 1,5-2 hours reaches the maximum level in the blood plasma and 35% binds to its proteins; is transformed in the liver and is excreted through the kidneys.

Kwamatel and Anthidine containing famotidine bind to plasma proteins worse (no more than 20%), their bioavailability is about 45%. Oxidation in the kidneys is completed by obtaining sulfur-containing metabolites, which are excreted in the urine.

After taking Zantac tablets , ranitidine is absorbed into the digestive tract, and 15% of the substance binds to plasma proteins, providing 50% bioavailability of the drug. Excretion of metabolites is carried out by the kidneys and lungs.

With plasma proteins, up to 20% of cimetidine, the active ingredient of Gistodil tablets, is bound to be excreted from the body with urine (almost half in its original form).

Contraindications to the use of histamine H2 antagonists, in addition to hypersensitivity, include age to 12 years (Histodil - up to 14 years), as well as liver and / or kidney dysfunction. In addition, drugs that block H2-histamine receptors, it is contraindicated to use during pregnancy.

Side effects of these drugs can be expressed in the form of hypotension, cardiac arrhythmia, nausea, dry mouth, diarrhea or constipation, skin rashes and hair loss, bronchospasm, muscle pain, as well as temporary confusion. These pills from stomach ulcers can lead to a temporary loss of libido and impotence.

Method and dosage of tablets from stomach ulcers:

Aksid and Zantak - 0.15 g twice a day (morning and evening) or 0.3 g once a day;

Kvamatel - 0,02 g twice a day or a single intake of 0,04 g (in the evening); the maximum period of admission is two months.

Gistodil should be taken at 200 mg to three times a day (for the prevention of recurrence - once 200 mg).

In the instructions, an overdose of these funds is not described.

Interacting with other drugs, famotidine in Kwamatel tablets reduces the absorption of imidazole antifungal agents, and Histodil reduces the effectiveness of thyroid medications containing L-thyroxine. At the same time Histodil leads to an increase in plasma concentrations of tricyclic antidepressants; opioid preparations; muscle relaxants and tranquilizers of the benzodiazepine group; antihypertensive drugs based on nifedipine; indirect anticoagulants and anthelmintic agents.

The conditions for the storage of tablets Aksid, Kvamatel, Zantak, Gistodil presuppose a temperature not higher than + 27 ° C. And their shelf life is 3 years.

The expressed and prolonged reduction in the production of gastric acid is provided by pills from stomach ulcers, which belong to the group of proton pump inhibitors (PPI): Omeprazole (Otsid, Omitoks, Losek Maps, Pleom-20) and Sunpras.

The antisecretory effect of these tablets is due to the fact that weakly alkaline active substances (omeprazole and pantoprazole), entering the parietal cells of the stomach, bind the hydrogen cations of the hydrogen-potassium adenosine triphosphatase (H + / K + -ATPase) enzyme, which is called a proton pump. This enzyme catalyzes the hydrochloric acid synthesis reaction, and its blockade leads to a significant slowing of this reaction, and then to the relief of pain in the stomach and the cessation of heartburn.

In the pharmacokinetics of these drugs there are differences. The maximum concentration of omeprazole blood plasma is observed on average 3-4.5 hours after ingestion, and its bioavailability is not higher than 45%. The active substance of the Sunpras tablets reaches a peak plasma content 2.5 hours later, and the bioavailability of the drug exceeds 75%. Both drugs are metabolized in the liver, from the body Omeprazole and its metabolites are excreted in the urine, Sanpraz - by the kidneys and through the intestine.

Contraindications to use: age younger than 12 years and the presence of oncological pathologies. During pregnancy, the use of tablets from stomach ulcers Omeprazole and Sunpras is not practiced.

Among the side effects of pills Omeprazole and Sanpraz marked headaches and epigastric pain, nausea, diarrhea or constipation, bloating, weakness and dizziness, sleep disturbances, allergic skin reactions, rash, anxiety and depression. The use of these drugs also can cause intense myopathies associated with the destruction of muscle cells (rhabdomyolysis).

Omeprazole is taken once a day for 20 mg (in the morning, on an empty stomach, with a glass of water); treatment lasts 14-28 days. The daily dose of Sunpras is 20-40 mg (taken as omeprazole); course of treatment - three weeks.

Information about excess dosage of Sanpraz is absent, and an overdose of omeprazole causes an increase in side effects.

Interactions of tablets based on pantoprazole with other drugs are not indicated; simultaneous application of omeprazole and systemic antimycotics reduces the effectiveness of the latter.

Storage conditions: t <25 ° С, shelf life - 36 months.

Tablets from stomach ulcers to protect the mucosa

Pharmacodynamics of gastroprotective action of De-Nol tablets (Ventrisol) is provided by bismuth tricalium with dicitrate (subcitrate). Having electronegative ionization, this chemical compound after ingestion inhibits the proteolytic activity of pepsin and binds the mucin glycoproteins, forming a diffusion barrier for HCl on the gastric mucosa, which contributes to the healing of the ulcer. There is also a more active production of prostaglandin E2 with the subsequent secretion of alkaline components of the gastric mucosa. Bismuth has a bactericidal effect on Helicobacteria.

Misoprostol - a synthetic derivative of prostaglandin PgE1 in the Saitotec tablets - is cleaved in the stomach, releasing active misoprostol acid, which by stimulating the PgE1 receptors of acid-producing stomach cells reduces their secretory activity.

The claimed action of the tablets Likvitorit is the ability of biologically active substances of licorice roots to relieve spasms and inflammation due to stimulation of mucus secretion.

An insignificant fraction of bismuth cleaved from the digestive tract into the blood after the De-Nol preparation is excreted by the kidneys, and the subcitrate is passed through the intestine. Saitotec is absorbed into the blood, and almost 90% of misoprostol binds to plasma proteins; excretion of metabolic products (with urine and feces) lasts about a day.

In the instructions to the drug Likvitorit pharmacokinetics is not described.

Contraindications to the use of De-Nol (Ventrisol) is functional kidney failure, age up to 14 years; Saitotec is contraindicated in serious cardiological and nephrologic diseases, hypertension, glaucoma, diabetes, bronchial asthma; is not prescribed for patients younger than 18 years.

The use of De-Nol and Saitotek tablets during pregnancy is contraindicated (Saitotec causes interruption of pregnancy).

Side effects of these drugs are manifested by nausea, vomiting of diarrhea or constipation, skin rashes. Bismuth can cause damage to the brain.

Method of application and dose De-Nol: 1-2 tablets (0.12 grams) for half an hour before breakfast, lunch and at bedtime. You should take food or drink liquid not earlier than 30 minutes after taking the tablets.

Saitotec is taken three times a day in the process of eating - on a tablet (0.2 mg). Likvitorit take before meals - three times a day for 0.1-0.2 g (1-2 tablets), the course of treatment - 30-40 days.

Overdose De-Nol can cause intoxication with bismuth compounds with damage to the liver, kidneys, nervous tissue, thyroid gland. In such cases, laxatives and hemodialysis are recommended (with severe form of poisoning).

It should be borne in mind that De-Nol is incompatible with antacids, and Saitotec - with NSAIDs.

Store these tablets at room temperature; shelf life De-Nol - 4 years, Likviriton - 3 years, Saitotec - 2 years.

Tablets from stomach ulcers, neutralizing hydrochloric acid

Among antacids - means of neutralizing hydrochloric acid of digestive juice - there are both absorbed and non-absorbed drugs. All of them reduce the level of its acidity of the stomach by a simple chemical method.

Tablets Calcium carbonate is a calcium salt of carbonic acid, which reacts with hydrochloric acid to release carbon monoxide, water and Ca 2+. Gastal contains aluminum hydroxide, carbonate and magnesium oxide; Gelusil - diamondite (simaldrate); Compensane is the sodium salt of dihydroxyaluminum carbonate. Unlike calcium carbonate, these substances are not absorbed in the stomach, but alkaline its environment and form gels that envelop the mucous membrane, adsorbing part of hydrochloric acid and pepsin. This relieves heartburn and relieves stomach pain in ulcerative diseases.

Contraindications to the use of tablets Calcium carbonate include the presence of hypercalcemia, calculus in the kidney and chronic renal failure. If problems with the kidneys can not take Gastal, Gelusil and Compensane. Also they are contraindicated to use during pregnancy.

Side effects of calcium carbonate: calcium ions (Ca 2+ ) stimulate the synthesis of the hormone gastrin by the endocrine cells of the stomach, which leads to secondary production of hydrochloric acid and pain in the epigastric region. Also, there may be an excess of calcium in the body (hypercalcemia) leading to constipation, nephrolithiasis, tissue calcification and alkalosis.

Gastal, Gelusil, Compensane contain aluminum compounds, which leads to such side effects as a violation of phosphate metabolism in the body and "aluminum" intoxication, which affects the bones and brain tissue.

  • Dosage Calcium carbonate - up to three times a day for 1-2 tablets (0.25-, 05g);
  • Gastal - 4 times a day for 1-2 tablets, without chewing (60 minutes after eating);
  • Gelusil - 1 tablet 3-5 times a day (one hour after a meal, the tablets should be chewed);
  • Compensated - up to 4 times a day for 1-2 tablets (between meals and in the evening).

Exceeding the dose Calcium carbonate can cause headaches and muscle pain; general weakness; nausea and vomiting, constipation and frequent urination, as well as tachycardia and impaired renal function.

Interactions with other drugs are expressed in the reduction of antacids by absorption of any medicines used simultaneously with them.

Antacids are stored at room temperature, the shelf life of the drugs is indicated on the package.

Anesthetics for stomach ulcer

Due to the peculiarities of the biochemical effect, preparations of the group of blockers of metabotropic cholinergic receptors (m-cholinolytics) - Gastrotsepin, Bruskopan, Bellacezhol - are recommended by specialists as painkillers for stomach ulcers.

The action of these tablets is based on the fact that their pharmacologically active substances pirentzepine dihydrochloride, butylskopolamine and the alkaloids of the atropine series contained in the extract blast the peripheral muscarinic receptors (m-cholinergic receptors) of neurons, which leads to a reduction in the release of acetylcholine from postganglionic fibers of the parasympathetic nervous system. As a result, the secretory function (synthesis of gastric enzymes and acid) is deactivated and the muscle tone and motility of the stomach (and the whole gastrointestinal tract) decrease.

Pharmacokinetics of tablets Bruskopan and Bellacezhol is not described, and Gastrotsepin is poorly absorbed in the digestive tract and almost does not split; the bioavailability of pyrenecepin dihydrochloride does not exceed 30%. The drug is excreted with feces about a day after the application.

Contraindications to the use of drugs of this group: children's age, glaucoma, prostatic hyperplasia, ulcerative colitis, hypotension, chronic heart failure with tachyarrhythmia.

The use of tablets from stomach ulcers with bellies extract and hyoscyamine derivatives during pregnancy is contraindicated.

Side effects of these drugs are manifested headaches, dilated pupils, dryness in the oral cavity, constipation, increased pulse, dysuria, skin reactions.

Tablets are taken orally, at least half an hour before meals: Gastrotsepin - 0.05 g twice daily; Bruskopan - three times a day for 10-20 mg (1-2 tablets); Bellacholehol - 1 tablet 3-4 times a day.

Overdose of these tablets leads to an increase in side effects.

All cholinolytic drugs potentiate each other and enhance the action of antihistamines and neurotropic drugs.

The storage conditions of these drugs are normal, shelf life is 3 years.

About preparations Drotaverina hydrochloride and No-shpa, recommended as anesthetic tablets with stomach ulcer, read in the publication - Tablets from abdominal pain

Tablets from gastric ulcers, regenerating the mucosa

Such reagents for stomach ulcers and duodenal ulcers are promoted by such tablets from stomach ulcers as Kaleflon (with extract of calendula flowers), Alanton (with extract of elecampane high), Pantaclucin (with plantain extract), Potassium orotate, and also Metiluracil and Gastroparm.

The derivative of pyrimidine (biologically active aromatic heterocyclic compound containing nitrogen)-2,4-dihydroxy-6-methylpyrimidine, which is an active substance of Metiluracil tablets , stimulates redox processes in tissues, which improves their nutrition and accelerates the healing of ulcers.

A pharmacodynamics of the drug Gastrofarm is based on the immunostimulating effect of the lyophilizate of a lactobacillus type, such as the Bulgarian rod (Lactobacillus vulgaricus).

The main contraindications to the use of Metilitacil - oncological diseases of the blood, lymphoid tissue and bone marrow. Gastrofarm is not used for hypersensitivity to the ingredients of the drug.

When using Metiluracil, there may be a side effect in the form of a headache and rash on the skin.

According to the instructions, Gastrofarm should take 1-2 tablets three times a day (half an hour before meals), and Methyluracil - in the same dosage 4-5 times a day. It should be borne in mind that with the simultaneous administration of antibacterial drugs, methyluracil enhances their effect.

Storage conditions for these preparations: away from moisture and sunlight, at t <20 ° C; the expiry date is indicated on the package.

Tablets from stomach ulcers that kill Helicobacter pylori

In the treatment of gastric ulcers, a complex of drugs is often used, in which antibiotics are used to eliminate Helicobacter pylori, which is introduced into the mucosa of the pyloric part of the stomach and duodenal bulb.

Pharmacodynamics of antibiotic-azalide Azitram (Azithromycin, Asitrus, Azicidum, Sumamed, etc.) and antibiotic group of macrolides Clarbath (Clarithromycin, Clacid, Aziklar, Fromilide, etc.) consists in interaction with RNA molecules of microorganisms, which leads to inhibition of biosynthesis of amino acids and proteins in their cells and the cessation of growth and reproduction.

Pharmacokinetics of these medicines has both similarities and differences: after taking the pill inside, the drugs are quickly absorbed in the stomach (the drug is acidic) and enter the blood and tissues; After about 2-3 hours, the maximum level of azithromycin or clarithromycin in plasma is noted.

Due to the ability to accumulate in leukocytes, Asitrus (Azicid) acts gradually, so it can take only three days. Biotransformation occurs in the liver, metabolites are excreted by the intestine and kidneys.

Clarithromycin (Formylid) binds more to plasma proteins (almost 90%), and the process of maximum plasma concentration passes in two stages (capturing the gallbladder intestine). Therefore, it is considered the most effective antibiotic against H. Pylori. The drug and its metabolites are excreted in urine and feces.

Contraindications to use Azitral: age to 16 years, serious pathology of kidney and liver, heart failure.

Contraindications to the use of Clarbact: age to 12 years, hypersensitivity to Clarithromycin.

The use of antibiotic-azalides during pregnancy can be prescribed by a doctor only taking into account the ratio of expected benefits to the mother and the risks to the fetus. Clarbactom (Clarithromycin) is not allowed to use during the first trimester.

Possible side effects of these medicines: nausea, abdominal pain, vomiting, stool disorder, increased heart rate, headache, sleeping problems and some changes in the psyche.

Dosing and Administration (with eradication of H. Pylori): Azitral - 1 g once a day; duration of application - three days; Clarbact - 0.5 g twice a day (for 10-14 days). Overdosing of drugs leads to an increase in side effects, primarily from the digestive tract.

Antibiotics must be taken separately from antacids (two hours before or after taking an anti-acid drug). There is incompatibility between Azitral and Clarbact with heparin preparations and α-adrenoblockers containing ergot alkaloids and their derivatives, as well as with the increase in the effect of indirect anticoagulants (when used together).

Storage conditions are normal; Shelf life Azitral - 3 years, Clarbakt - 2 years.

And now it was the turn to answer the question, for what purpose in the treatment of stomach ulcers gastroenterologists use tablets Betamax (Sulpiride). This drug refers to atypical antipsychotic drugs (neuroleptics) based on substituted benzamides. These substances specifically "disconnect" the receptors of dopamine, serotonin and acetylcholine in a specific way (about blockers of m-holinoretseptorov discussed above).

By inhibiting the signaling of serotonin receptors (5-HT2B, 5-HT2C, 5-HT3, 5-HT4) located in the gastrointestinal tract, which control the motor and muscle tone of the digestive system, the active substance of the Betamax drug helps to reduce the intensity of pain and alleviate the condition of patients with a stomach ulcer.

The drug has contraindications: hypertension, epilepsy, pregnancy and age under 14 years. And the list of side effects includes skin allergies, dizziness, sleep disorders, as well as increased blood pressure, a feeling of dry mouth, heartburn, constipation, hyperhidrosis, etc.

Like tablets from stomach ulcers, this neuroleptic remedy - along with other pharmaceutical preparations - should be prescribed by the attending physician.

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