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Anti-ulcer / Anti-acids - Coggle Diagram

- - - - Ligand: Histamine
      - Receptor Type: Gs
    - - Ligand : ACh
    - - Ligand: Gastrin
      - Receptor type
  - - - Gastrin
      - Ach
      - Histamine
    - - Somatostatin
      - Prostaglandins E2 and I2
- - - - Decreased prostaglandins
      - Prostaglandins decrease cAMP and reduce GA secretion
    - - Increased neutrophil adherence
      - Mucosal damage due to neutrophil derived free radicals and proteases
- - - - PPI and 2 antibiotics (amoxicillin and clarithromycin) 1-2 2ks
    - - PPI, tetracycline, metronidazole, bismuth
    - - PPI and single antibiotic (amoxicillin or clarithromycin)
- - - - Cimetide
    - - Omeprazole
        
        Covalent disulfide bond with ATPase
        
        Pro-drug
    - - Pirenzepine (M1)
  - - - Bind and neutralise pepsin
  - - - Polymerisation in Acid
        Adheres to necrotic ulcer tissue via +ve glycoproteins
        Protective barrier
    - - Selectively binds to ulcer crater to protect it from acid & pepsin.
        Inhibit pepsin & stimulate mucus production
        Toxic to H. Pylori
    - - Activates E1 Prostaglandin receptor (Gi) to prevent cAMP accumulation, inhibiting parietal cell activation and activating epithelial mucosal production