This document provides an overview of gastrointestinal pharmacotherapy. It discusses peptic ulcer disease, acid reflux disease, laxatives and cathartics, and antiemetic and antidiarrheal agents. For peptic ulcer disease, it defines it, lists causes, signs/symptoms, and management approaches like eradication therapy, proton pump inhibitors, antacids, and antibiotics. For acid reflux disease it defines it, lists causes, signs/symptoms, and treatments like antacids, H2 blockers, PPIs, and prokinetic agents. It also discusses types of laxatives, cathartics, classes of antiemetics and antidiarrheal agents as well as

1. CLINICAL PHARMACOLOGY
GROUP 2 ASSIGNMENT
GASTROINTESTINAL PHARMACOTHERAPY

2. GROUP MEMBERS
Mwiti Evans Muthomi- BCM/K/0011/2021
Benedicto S Liyayi- BCM/K/0029/2021
Okoyo Judith Auma- BCM/K/0506/2019
Scolar Chepkoech- BCM/K/0501/2021
Kecha Daniel Kiplangat- BCM/K/0517/2021

3. INTRODUCTION TO GASTROINTESTINAL
PHARMACOTHERAPY
• Pharmacotherapy is the treatment of health
conditions using drugs.
• Gastrointestinal conditions that require medical
attention include:
i. Peptic ulcers disease
ii. Acid reflux disease.

4. PEPTIC ULCER DISEASE
DEFINATION
• Peptic ulcer disease is a break
in the inner lining of the stomach,
the first part of the small
intestine or sometimes the lower esophagus
• An ulcer in the stomach is
called a gastric ulcer.

5. • An ulcer in the first part
of the intestines is a duodenal ulcer.
CAUSES
• Helicobacter pylori
• Non-steroidal anti-inflammatory drugs
• Underlying health conditions.

6. SIGNS AND SYMPTOMS
o Abdominal pain
o Bloating and abdominal fullness
o Nausea and vomiting
o Loss of appetite and weight loss
o Melena- foul smelling feaces

7. MANAGEMENT OF PEPTIC ULCERS
(i) Eradication therapy
Applicable in the cases of H.Pylori
Involves first line and second line treatment.
(ii) Proton pump inhibitors
Used in management of ulcers that
are induced by NSAIDs
Omeprazole, lanzoprazole, esomeprazole are used.

8. (iii) Antacids
They ease the symptoms but for
a short time.
They affect the action of antibiotics hence
precaution should be taken.
(iv) Antibiotics
For treatment of bacterial induced ulcers.

9. ACID REFLUX DISEASE
DEFINATION
• A disease of the upper gastrointestinal
tract in which stomach content persistently
flow up into the esophagus.
• This normally has serious consequences and
complications

10. CAUSES
Poor closure of the lower esophageal sphincter.
SIGNS AND SYMPTOMS
o Dental corrosion
o Dysphagia
o Heartburn
o regurgitation

11. o Odynophagia- pain when swallowing.
o Non cardiac chest pain
DIAGNOSIS
• Monitoring of pH
• Endoscopy
• Esophageal manometry but only prior to surgery

12. TREATMENT
(i) Antacids
Used for infrequent symptoms of reflux.
(ii) Histamine blockers
They help lower acid secretion.
(iii) Proton pump inhibitors
They block the pathways of acid production.
(iv) Prokinetic agents- they act on smooth muscles.

13. LAXATIVES AND CATHARTICS
LAXATIVES
These are agents that treat and
prevent constipation
TYPES OF LAXATIVES
• Bulk forming laxatives
They increase the weight of stool
• Emollient laxatives
They soften stool by adding water and fats.

14. • Lubricant laxatives
Coat the stool with slippery lipids
• Hyperosmotic laxatives
Draw water into the bowel
• Stimulant laxatives
Alter water and electrolyte secretion.

15. CATHARTICS
They accelerate defecation
Examples:
• Vegetable oils- they are indirect acting.
• Emoclin- an irritant glycoside acting on
the large intestines.

16. ANTIEMETIC AND ANTIDIARRHEAL AGENTS
ANTIDIARRHEAL AGENTS
Non specific agents
They do no influence underlying cause.
They include:
a) Adsorbent agents
They adsorb bacterial toxins to ease
the condition

17. b) Bulk forming agents
They increase the weight of the stool
c) Antimotility and antisecretory agents
They slow the movement in the tract.
d) Anticholinergic agents
They manage abdominal pain associated with diarrhea

18. Specific antidiarrheal agents
• Used to treat underlying cause of diarrhea
• They correct malabsorption syndromes
• They include antibiotics such as ampicillin
and cotrimazole
• Agents are selected carefully for specific cases.

19. ANTIEMETIC AGENTS
Are used to control nausea and vomiting
CLASSIFICATION OF ANTIEMETICS
1. Cannabinoids- used when patients are unresponsive
to other agents. Include nabilone and dronabilone.
2. Benzodiazepine- most effective when in
combinations

20. 3. Lorazepam- active for nausea and can
be combined with selected medications.
4. Steroids- dexamethasone normally given in low
doses
5. Dopamine antagonists- they act on the
brainstem and treat vomiting associated with cancer

21. Side effects of antiemetics.
• Altered state of perception
• Indigestion and increase appetite
• Dry mouth and nasal passage
• Ringing in ears
• Fatigue
• Constipation.