药理学教学（广西医科大学）第三十二章 作用消化系统药.pptxVIP

Chapter 32 作用于消化系统药物 Drugs affecting gastrointestinal system Section 1 助消化药 酶类：胃蛋白酶 胰酶 乳酶生：乳酸杆菌制剂黄仁彬（Department of Pharmacology 5339805 huangrenbin518@163.com）Key concepts: 1.Peptic ulcer disease is one of the most common diseases in the clinic. Relief from pain, promotion of healing, and prevention of recurrence may be considered the main therapeutic strategies in the drug treatment of this disease. 2. Drugs used in the treatment of peptic ulcers comprise antacids, inhibitors of gastric acid secretion, mucosal protective agents, and agents used to treat infection by helicobacter pylori. 3. Antacids, such as magnesium hydroxide, aluminum hydroxide, and sodium bicarbonate, are weak bases that directly counteract the excessive gastric acid in the stomach and duodenum. 3. Since gastric acid secretion is mainly regulated by histamine, acetylcholine, and gastrin, inhibitors of gastric acid secretion function in peptic ulcer disease by blocking H2 or M1 receptors. 4. Suppressors of proton pumps have demonstrated notable effects and are widely used in the clinic currently. Proton pump inhibitors must be activated in the acid environment of the secretory canaliculus of the parietal cell. Therefore, these agents are actually considered to be pro-drugs. Section 2 抗消化性溃疡药【药物分类】一．抗酸药二．H2受体阻断药三．M受体阻断药四．胃壁细胞H＋泵抑制药五．胃泌素受体阻断药六．粘膜保护药七．抗幽门螺旋菌药胃泌素前列腺素组胺乙酰胆碱 AC：腺苷酶环化E cAMP：环-磷酸腺苷米索前列醇西米替丁哌仑西平激活AC抑制Ca2+Ca2+cAMPATP蛋白激酶奥美拉唑↓H+K+质子泵壁细胞H+胃腔胃酸K+H+胃酸作用机制及抑制剂的主要作用位点AC抗消化性溃疡药The mechanisms of the secretion of gastric acid and the major targets of actions of inhibitors 抗酸药 antiacid 常用抗酸药物作用比较作用 氢氧 三硅 氧化 氢氧 碳酸 碳酸 化镁 酸镁 镁 化铝 钙 氢钠抗酸强度 强 弱 强 中 较强 强起效时间 快 慢 慢 慢 较快 快维持时间 较长 较长 较长 较长 较长 短粘膜保护 无 有 有 有 无 无 作用收敛作用 无 无 无 有 有 无碱血症 无 无无无 无 有产生CO2 无 无无 无 有 有排便影响 轻泻 轻泻 轻泻 便秘 便秘 无 一、H2受体阻断药（1）常用药物：西米替丁，雷尼替丁，法莫替丁，尼扎替丁（2）拮抗组胺、五肽胃泌素和M受体激动剂引起的胃酸分泌（3）用于：十二指肠溃疡，胃溃疡，法莫替丁强于西米替丁20～50倍，尼扎替丁，