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1. Pharmacology of the GIT system

3. Fig. 16.1

4. Fig. 16.10a

5. Fig. 16.10b

6. Fig. 16.11a

7. Fig. 16.11b

8. Fig. 16.12

10. Drugs affecting secretions: anti ulcer Misoprostol Prostaglandin analog Sucralfate Mucosal protectants Omeprazole Proton pump inhibitors AlOH and MgOH Antacids Cimetidine Histamine (H2) receptor antagonist/blockers Prototype Anti-ulcer drugs

12. General time of administration of the drugs affecting gastric acid secretion Misoprostol WITH MEALS Prostaglandin analog Sucralfate BEFORE MEALS Mucosal protectants Omeprazole BEFORE MEALS Proton pump inhibitors AlOH and MgOH Usually after meals Antacids Cimetidine With FOOD or ONE hour after ANTACID Histamine (H2) receptor antagonist/blockers Prototype Best time to give Anti-ulcer drugs

18. Histamine 2 receptor blockers

30. Antacids

42. proton-pump inhibitors

51. Mucosal protectants

61. Prostaglandin analogue

69. laxatives

72. Laxatives Lubricating the intestinal material to promote passage through the GIT Docusate Mineral oil Lubricants Increased fluid content of the fecal material causing stimulation of the local reflex Lactulose Mechanical (bulk) stimulants Direct stimulation of the GIT nerves Irritant laxatives Bisacodyl (Dulcolax) Chemical stimulants Action Prototype Type

89. The Anti-diarrheals Stops GIT spasm by CNS action Opium derivatives (paregoric) Central acting agent Directly inhibits the intestinal muscle activity to SLOW peristalsis Loperamide Local anti-motility Locally coats the lining of the GIT to soothe irritation Bismuth subsalicylate Local reflex inhibitor Action Prototype Type

97. Emetic and anti-emetics

108. Anti-Emetics

110. ANTIEMETICS Dronabinol, hydroxyzine Miscellaneous “ setron”- dolasetron Serotonin Receptor blockers Meclizine, buclizine Anticholinergics and Antihistaminics Metoclopramide Non-phenothiazines Prochlorperazine, Promethazine Phenothiazines Common examples Anti-emetic types

111. ANTIEMETICS Act in the CNS , either in the medulla or in the cortex Miscellaneous Centrally and locally inhibits the serotonin receptors Serotonin receptor blockers Block the transmission of the impulses to the medulla Anticholinergics Reduces the responsiveness of the nerve cell in the medulla; also blocks the dopamine receptors Non-phenothiazine Centrally block the vomiting center in the medulla Phenothiazines Pharmacodynamics Types

112. ANTIEMETICS N/V associated with chemotherapy Miscellaneous N/V associated with chemotherapy Serotonin-receptor Blockers N/V associated with motion sickness Anticholinergics N/V associated with chemical stimulation Non-phenothiazine N/V associated with anesthesia, intractable hiccups Phenothiazines Clinical Use Types

123. End