Homeopathy Peptic Ulcers

Beat Ulcers

The system is all natural and easy to use. You are just minutes away from taking your first steps to having painless days and nights. In less than 2 weeks, you can be totally free from ulcers, living without the pain and feeling free to eat without the thought of pain. All you need do is follow the plan. Beat Ulcers is a step by step guide that shows you how you can eliminate ulcers in as little as 10 days. All you need do is use the readily available natural products in the correct proportions at the correct times. Here is what you will learn in the Beat Ulcers guide: How to Eliminate an Ulcer without the use of medication. How to rid your body of the ulcer causing bacteria and keep it away. How to stop the aching. How to eliminate the burping and bloating. Focus on the root cause of ulcers rather than the symptoms. How to be totally free from pain and sleep soundly at night. How to stop using dangerous medications that are prescribed over and over. Learn the causes of ulcers and how to eliminate them forever.

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Peptic ulceration

It is no longer seriously believed that glucocorticoid treatment in adults markedly increases the risk of peptic ulceration (123,124). However, the symptoms of an existing peptic ulcer can certainly be masked. There may also be a genuine risk of ulcerative disorders in premature children. The issue has often been complicated by the simultaneous (sometimes unrecorded) use of ulcerogenic non-steroidal anti-inflammatory agents. A meta-analysis of whether glucocorticoid therapy caused peptic ulcer and other putative complications of glucocorticoid therapy was negative peptic ulcers occurred in nine of 3267 Peptic ulcer should not be considered a contraindication when glucocorticoid therapy is indicated (SEDA-19, 376) (125). However, the risk of a fatal outcome due to ulcer complications was increased about fourfold in a previous case-control study. Gastrointestinal hemorrhage occurred more often in glucocorticoid-treated patients (2.25 ) than in controls (1.6 ) (126). The frequency of...

Gastric Ulcer

Ulcer formation after ligation of the pylorus (Shay rat test) (Sofia et al. 1978). More recently, it has been shown that the cannabinoid receptor agonist WIN 55,2122 reduced, in an SR141716A-sensitive manner, stress-induced gastric ulcers in rats (Germano et al. 2001). The antiulcerative effect of WIN 55,212-2 may well be related to its antisecretory effect (Adami et al. 2002 Coruzzi et al. 1999). Indeed, the non-selective cannabinoid receptor agonists WIN 55,212-2 and HU-210 decreased (via CB1 activation) the acid secretion induced by indirectly acting secretagogues, such as 2-deoxy-D-glucose (which stimulated acid secretion by increasing the efferent activity of the vagus nerve) and pentagastrin (which acts partly through a cholinergic pathway). These observations were made in anaesthetised rats in which the secretion induced by the activation of parietal cell H2 receptors by histamine was unaffected, which is consistent with the absence of CB1 receptors on parietal cells (Adami et...

Peptic Ulcer Disease

Peptic ulcer disease (PUD) is a disease in which ulceration occurs in the lower esophagus, stomach (along its lesser curvature), the duodenum, or jejunum. These are all areas concerned with digestion, hence the name peptic. The most prominent symptom is gnawing pain that is relieved by food and alkali, but worsened by alcohol and condiments. Painless periods of remission can occur even without treatment.

H2receptor antagonists

Proton-pump inhibitors such as omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole suppress gastric acid secretion by inhibiting the H ' K -ATPase enzyme system on the surface of the parietal cell. Proton-pump inhibitors are used to treat gastroesophageal reflux and peptic ulcers. Omeprazole has been shown to be well-absorbed and to cross the placenta.

Additional ulcer therapeutics

Methantheline, an anticholinergic drug, is used for the treatment of peptic ulcer disease (see also spasmolytics). Misoprostol is a synthetic prostaglandin El analog with antisecretory and mucosal protective properties, used to treat or prevent NSAID-induced gastric ulcers. Oral use of misoprostol induces uterine contractions that can result in uterine bleeding or abortion. There is a report of fetal death in the thirty-first week of pregnancy as a result of tonic uterine contractions after the ingestion of a high dosage with the intention of committing suicide (Bond 1994). Few data are available on the inadvertent therapeutic (gastric ulcers) use of misoprostol during pregnancy. In a French collaborative study of 125 pregnancies exposed to misoprostol, 61 patients used misoprostol for prevention of NSAID-induced gastrointestinal lesions. Although the study was too small to draw conclusions, no increased risk for major malformations was noted and no consistent pattern of malformations...

Herbal Alert Willow Bark

Willow bark has a long history of use as an analgesic. Willows are small trees or shrubs that grow in moist places, often along riverbanks in temperate or cold climates. When used as a medicinal herb, willow bark is collected in early spring from young branches. In addition to its use as a pain reliever, various species of willow bark and leaf have been used to lower fever and as an anti-inflammatory. The salicylates were isolated from willow bark and identified as the most like source of the bark's anti-inflammatory effects. The chemical structure was replicated in the lab and mass produced as synthetic salicylic acid. Years later, a modified version (acetylsalicylic acid) was first sold as aspirin. Aspirin became the most widely used pain reliever, fever reducer, and anti-inflammatory agent, leaving willow bark to be cast aside. The synthetic anti-inflammatory drugs work quickly and have a higher potency than willow bark. Willow bark takes longer to work and may need fairly high...

General Information

Tripotassium dicitrato-bismuthate and bicitropeptide (a bismuth-peptide complex) are used in the eradication of Helicobacter pylori in combination with antibiotics (SEDA-21,233) (1-4), and ranitidine bismuth citrate is used to treat peptic ulcer (5). Bismuth salicylates are used in other intestinal diseases, such as microscopic colitis (6,7) and collagenous colitis (8). Bismuth subnitrate plus iodoform is used to pack surgical cavities. Bismuth oxide and bismuth subgallate are found in some topical formulations that are used for treating hemorrhoids. Bismuth is also used topically as a bacteriostatic.

Pharmaceutical interest

Uses In Indonesia a decoction of Alternanthera sessilis (L.) R. Br. is drunk to stop dysentery and diarrhea. In Malaysia, the plant is used to heal wounds and applied to painful areas. A decoction of 30 g of the whole plant is drunk by Malays to stop dysentery, relieve the bowels of costiveness, treat jaundice, fever, urinary tract infection, tuberculosis and peptic ulcer, resolve sore throat and intestinal inflammation, and to mitigate toothache. In Taiwan, Alternanthera sessilis (L.) R. Br. is used to treat kidney diseases and haemoptysis, and to fight depression.

Contraindications Precautions And Interactions

These drugs are contraindicated in patients with an allergy to the p blockers, in patients with sinus bradycardia, second- or third-degree heart block, heart failure, and those with asthma, emphysema, or hypotension. The drugs are used cautiously in patients with diabetes, thyrotoxicosis, and peptic ulcer.

Gerontologic Alert

EDUCATING THE PATIENT WITH A PEPTIC ULCER. The nurse gives the patient with a peptic ulcer a full explanation of the treatment regimen, which may include drugs and a special diet. The patient is instructed to take the drug exactly as prescribed by the primary health care provider (eg, 30 minutes before meals or between meals) to obtain the desired results. The nurse discusses the importance of diet in the treatment of peptic ulcer and gives a full explanation of the special diet (when ordered). 1. Mr. Anthony is prescribed a cholinergic blocking drug for the treatment of peptic ulcer. In planning patient teaching for Mr. Anthony before dismissal from the hospital, determine what information must be included to prevent complications of therapy. 3. Mr. Salinas is prescribed a cholinergic blocking drug for a gastric ulcer. You note in the admission interview that he states that he has a history of enlarged prostate. Discuss how Mr. Salinas' history of enlarged prostate relates to the...

Contraindications adverse effects precautions

- Do not administer to children under 3 months, patients with allergy to NSAID, peptic ulcer, coagulation defects, haemorrhage, surgery with risk of major blood loss, severe renal or hepatic impairment, severe heart failure, severe malnutrition, uncorrected dehydration or hypovolaemia, severe infection. - May cause allergic reactions, epigastric pain, peptic ulcer, haemorrhage, renal impairment.

Organs and Systems Gastrointestinal

Even in doses insufficient to control ulcer symptoms, enprostil has a higher incidence of adverse effects than the H2-receptor antagonists. In a randomized, doubleblind, endoscopically controlled study, 98 patients with gastric ulcers were treated with either enprostil 70 micrograms bd or ranitidine 150 mg bd (1). The healing rates at 4, 8, and 12 weeks were similar. After ulcer healing, half the patients were followed for 1 year without treatment and the others were given enprostil 70 micrograms day. Diarrhea was a common adverse effect of enprostil, and seven patients withdrew because of diarrhea or abdominal pain.

Fibric Acid Derivatives

The fibric acid derivatives are contraindicated in patients with hypersensitivity to the drugs and those with significant hepatic or renal dysfunction or primary biliary cirrhosis because these drugs may increase the already elevated cholesterol. The drugs are used cautiously during pregnancy (Pregnancy Category C) and lactation and in patients with peptic ulcer disease or diabetes. Although it rarely occurs, when the fibric acid derivatives, particularly gemfibrozil, are administered with the HMG-CoA reductase inhibitors, there is an increased risk for rhabdomyolysis (see Nursing Alert). When clofibrate, fenofibrate, or gemfibrozil is administered with the anticoagulants, there is an increased risk for bleeding.

Herbal Alert Chamomile

Chamomile has several uses in traditional herbal therapy, such as a mild sedative, digestive upsets, menstrual cramps, and stomach ulcers. It has been used topically for skin irritation and inflammation. Chamomile is on the US Food and Drug Administration list of herbs generally recognized as safe (GRAS). It is one of the most popular teas in Europe. When used as a tea, it appears to produce an antispasmodic effect on the smooth muscle of the gastrointestinal (GI) tract and to protect against the development of stomach ulcers. Although the herb is generally safe and nontoxic, the tea is prepared from the pollen-filled flower heads and has resulted in mild symptoms of contact dermatitis to severe anaphylactic reactions in individuals hypersensitive to ragweed, asters, and chrysanthemums.

Promoting an Optimal Response to Therapy

Tablet form, the nurse informs the primary health care provider. A flavored antacid may be ordered if the taste is a problem. A liquid form may be ordered if the patient has a problem chewing a tablet. The primary health care provider may order that the antacid be left at the patient's bedside for self-administration. The nurse makes certain an adequate supply of water and cups for measuring the dose are available. The antacid may be administered hourly for the first 2 weeks when used to treat acute peptic ulcer. After the first 2 weeks, the drug is administered 1 to 2 hours after meals and at bedtime.

Comparative studies

In a similar study in 221 patients with peptic ulcer disease associated with H. pylori, rabeprazole has been compared with omeprazole and lansoprazole (combining them with amoxicillin plus clarithromycin for 1 week) (6). Rabeprazole was as effective as omeprazole and lanso-prazole in eradicating H. pylori (84-88 each). There were no differences in reported adverse events. Common adverse effects were soft stools, glossitis, taste disturbances, and skin rashes.

The Stomach Infections of the Stomach

Helicobacter pylori is an infection that occurs within the stomach and is interesting in terms of advanced drug delivery. H. pylori is a gram-negative, microaerophilic, spiral and flagellated bacterium, with a unipolar-sheathed flagella that provides motility. Its spiral shape and high motility allow it to penetrate mucus, resist gastric emptying and remain in the host gastric mucosa. Since its isolation in the early 1980s, it has now been firmly established that infection with this bacterium is the cause of chronic active gastritis and an aetiological factor in peptic ulcer disease, gastric mucosal-associated lymphoid tissue lymphoma and gastric carcinoma.

Vaccination as Therapy for Stomach Infections

Although effective antimicrobial delivery strategies are a major component in the treatment of H. pylori infections, there is also a need for a preventative strategy as many long-term infections are asymptomatic. The underlying chronic gastritis is a risk factor for gastric cancer and unless the host develops gastrointestinal disease (e.g. peptic ulcer), it is likely to remain untreated.

Observational studies

Rabeprazole 10 and 20 mg day in the morning were effective in erosive or ulcerative gastro-esophageal reflux disease, gastric and duodenal ulcers, and long-term maintenance of gastro-esophageal reflux disease healing (1). Healing rates were equivalent to those with omepra-zole and superior (gastro-esophageal reflux disease healing and duodenal ulcer healing) or equal (gastric ulcer healing) to ranitidine.

Ongoing Assessment

The nurse assesses the patient receiving one of these drugs for relief of symptoms (such as diarrhea, pain, or constipation). The primary health care provider is notified if the drug fails to relieve symptoms. The nurse monitors vital signs daily or more frequently if the patient has a bleeding peptic ulcer, severe diarrhea, or other condition that may warrant more frequent

Miotic Direct Acting

These drugs are contraindicated in patients with hyper-sensitivity to the drug or any component of the drug and in conditions where constriction is undesirable (eg, iritis, uveitis, and acute inflammatory disease of the anterior chamber). The drugs are used cautiously in patients with corneal abrasion, pregnancy (Pregnancy Category C), lactation, cardiac failure, bronchial asthma, peptic ulcer, hyperthyroidism, gastrointestinal spasm, urinary tract infection, Parkinson's disease, recent myocardial infarction, hypotension, or hypertension. These drugs are also used cautiously in patients with angle closure glaucoma because miotics can, occasionally, precipitate angle closure glaucoma by increasing the resistance to aqueous flow from posterior to anterior chamber. See Chapter 24 for information on interactions.

Pregnancy Category B

Animal experiments show that various chemicals related to zolpidem relieve pain, reduce inflammation and body temperature, and protect against gastric ulcers. Chemically these substances differ from barbiturates and ben-zodiazepines, but have effects similar to them and operate in some ways similar to benzodiazepines. Monkeys responded in ways indicating that zolpidem shares similarities with benzodiazepines but few or none with barbiturates. Despite those resemblances to benzodiazepines, rats trained to distinguish differences in drug effects acted as if zolpidem was unlike the benzodiazepine chlordiazepoxide. Various other differences have been documented. To take one example, caffeine typically counteracts some benzodiazepine actions, but counteraction does not necessarily happen when caffeine is administered with zolpidem. In animal experimentation chemicals related to zolpidem can produce sedation at doses low enough to avoid unwanted effects that occur with benzodiazepine...

Reversible Proton Pump Inhibitors

A tetrahydroisoqunoline-based compound, YH-1885, discovered by Yuhan, is currently one of the most clinically advanced reversible proton-pump inhibitors (170). It is now being codeveloped with GlaxoSmithKline for stomach ulcers and gastroesophageal reflux disease. Clinical data on YH-1885 have demonstrated that it is safe and well tolerated when administered as a single dose (60 to 300 mg) or multiple doses (150 to 300 mg) to healthy volunteers. The compound significantly increased gastric pH and increased the fraction of time above pH 3 at doses above 150 mg. During multiple dosing, YH-1885 exhibited a reversible mode of action with no significant

Possible Effects Of Endocannabinoids On Gi Secretions

Because cannabinoid CB1 receptor agonists reduce stimulated gastric acid secretion, they are expected to possess gastric antiulcer effects. Indeed, a high oral dose of A9-THC was shown to prevent gastric ulcer formation in rats after ligation of the pylorus (Sofia et al., 1978). A more recent study shows that low intraperitoneal doses (e.g., 0.1 mg kg) of WIN55212-2, but not its inactive enantiomer (WIN55212-3), reduce gastric ulcers produced by cold or restraint stress in a SR141716A-sensitive manner (Germano et al., 2001).

Problems In The Evaluation Of Clinical Results

There are conditions for which the degree of agreement among different researchers will be very high. Psychological factors are clearly of great importance in the genesis of various psychoneuroses, such as anxiety or conversion hysteria and obsessive-compulsive neurosis. Similarly, in character disorders, alcoholism, drug addiction, and various sexual dysfunctions and deviations, the psychogenic component seems to be unquestionable. Bronchial asthma, peptic ulcers, psoriasis, and ulcerous colitis are traditionally considered to be of psychosomatic origin. The opinions of clinicians about the ratio of psychogenic and somatogenic factors in various depressions, borderline psychotic states and so-called endogenous psychoses such as schizophrenia and manic-depressive disease, vary considerably. In some other conditions only a minority of researchers consider psychological factors to be of any relevance cancer and collagenous diseases are important illustrations of these.

Family Annonaceae A L de Jussieu 1789 nom conserv the Custardapple Family

Or 5-hydroxytryptamine (5HT2) antagonist, might hold potential for the treatment of hypertension. A number of isoquinoline alkaloids, being a muscarinic blocker, 5-hydroxytryptamine (5HT0 receptor agonist or dopamine reuptake inhibitor, might hold potential for the treatment of asthma, gastric ulcer, anxiety or depression.

Lonicera japonica Thunb

Botany Flower Types

Uses In China, the flowers of Lonicera japonicaThunb. are used to cool and to heal boils and carbuncles. The ashes of flowers are used to treat dysentery. The stems are used to assuage the pain of bones and to heal boils. The plant is also used to soothe intestinal inflammation and sore throat, heal stomach ulcers and painful hemorrhoids, and to expel impurities. In Malaysia, a decoction of dried flowers is drunk cool to combat fever, assuage headache and to heal boils. A distillate of flowers is used to assuage stomachaches. In Vietnam, a decoction of 10g-20g of stems or 4 g-8 g of flowers is used to heal boils,

Pregnancy Category None

Medicinal usage of European mandrake may date back as far as ancient Egypt, but in twenty-first-century Western medicine, only practitioners of homeopathy use the substance for healing. (Homeopathy uses extremely weak preparations of medicines.) Folk practitioners have given European mandrake to fight depression, asthma, hay fever, whooping cough, colic, and stomach ulcers. The plant has also been administered as a folk treatment to promote fertility, perhaps inspired by the story in Genesis 30 14-17. Such usage is referred to by the line Get with child a mandrake root from John Donne's sonnet Song Go and Catch a Falling Star. The plant is linked with romance (Song of Solomon 7 13) and is a traditional aphrodisiac, although such a characteristic has not received scientific confirmation. Sedative and pain relief actions made the plant one of the first surgical anesthetics, and an image of it appears on the coat of arms of the British Association of Anaesthetists. European mandrake...

Family Solanaceae A L de Jussieu 1789 nom Conserv the Potato Family

Are used in Western medicine to treat intestinal colic, gastric ulcer, spasmodic asthma, whooping cough, bladder and urethral spasms, on account of hyoscyamine. Hyoscyamine is a parasympatholytic tropane alkaloid, which exerts a selective blocking action on muscarinic receptors, resulting in mydriasis, tachycardia, decreased production of saliva, sweat, gastric juice, constipation and the inability to urinate.

Herbal Alert Goldenseal

There are many traditional uses of the herb, such as an antiseptic for the skin, mouthwash for canker sores, wash for inflamed or infected eyes, and the treatment of sinus infections and digestive problems, such as peptic ulcers and gastritis. Some evidence supports the use of goldenseal to treat diarrhea caused by bacteria or intestinal parasites, such as Giardia. The herb is contraindicated during pregnancy and in patients with hypertension. Adverse reactions are rare when the herb is used as directed. However, this herb should not be taken for more than a few days to a week. Because of widespread use, destruction of its natural habitats, and renewed interest in its use as an herbal remedy, goldenseal was classified as an endangered plant in 1997 by the US government.

The Borage botanical family Boraginaceae

Moreover, six pyrrolizidine alkaloids were detected in Anchusa strigosa Banks and Sol111 and Heliotrium esfandiarii europine N-oxide112. Alkaloids of both species have bioimpact. Anchusa strigosa is a plant widely distributed in the Mediterranean region. It is used in local folk medicine as a diuretic, analgesic sedative, sudorific remedies and for treatment of stomach ulcers and externally for skin diseases113114. Siciliano et al.115 have analysed the qualitative and quantitative composition of alkaloids in flowers, leaves and roots of A. strigosa. This phytochemical study led to the isolation of nine pyrrolizidine alkaloids, from which three have been unidentified. Many pyrrolizidine alkaloids have been shown to be isolated from leaves, roots and rhizomes of the lungwort species (Pulmonaria spp.). In both Pulmonaria officinalis and Pulmonaria obscura such alkaloids as intermedine, lycopsamine and symphitine have been detected. This means that P. officinalis is not an exception among...

Secondary Pharmacology of Hp

As mentioned above, Hp is used traditionally to enhance digestion, and this is acknowledged in the literature. The Hp constituent, acteoside, has been described in a short report of animal studies as a new hypertensive agent 51 and has been shown to have cardioprotective effects in vitro 52 . However, these studies were not well designed and lacked adequate control experiments. But interestingly, extracts of Hp have also been shown to have antiarythmic properties 53-56 . In light of the suggestion that Hp may be an alternative to NSAIDs, these positive effects on gastrointestinal and cardiovascular function are encouraging. However, it should be mentioned that because Hp activates the upper gastrointestinal tract, there may be cause for concern for administration to individuals prone to peptic ulcer. But such problems have never been reported despite the widespread use of Hp extracts.

Helicobacter Pylori H Pylori

Most patients with peptic ulcer disease are infected with H. pylori. Because ulcers recur in patients who have undergone successful H. pylori, eradication therapy, infection may not always be causative for the disease. Less than 5 of ulcer patients are H. pylori negative and in H. pylori positive patients only 10 of ulcers recur after eradicating the infection. Likely causes of ulcer recurrence are considered to be reinfection, the use of ulcerogenic drugs, and persistent gastric hypersecretion. However, true reinfection is rare and it is mcre likely that the most common cause of H. pylori recurrence is attributed to inadequate eradication. The significant reduction in H pylori density produced by a combination of antibiotic and antisecretory therapy may reduce the levels of infection to below detectable levels (22). Rapid urease tests for H. pylori have a sensitivity of only 80-90 . Therefore histological examination is also used to con-fhm an initial noninvasive test result. Whole...

Bacterial Infections

Certain bacterial infections can also lead to tumorigenesis. The best-known example is Helicobacter pylori, which colonizes in the stomach of some individuals and is associated with peptic ulcers. Infection with H. pylori has also been linked to a greater risk of developing stomach cancer and mucosa-associated lymphoid tissue, or MALT, lymphoma (a rare form of stomach cancer). The precise mechanism of tumorigenesis is unclear at present. Eradication of the infection is now routine using antibiotic therapy, which reduces the risk of developing cancer.

Ulcer Disease

Peptic ulcers arise because of an imbalance of acid-secretory mechanisms and mucosal-pro-tective factors, and the rationale for their treatment is aimed at restoring that balance. The loss of balance between acid secretion and mucosal-protective factors varies among peptic ulcer types. In type I ulcers, which occur high in the stomach, acid hypersecretion is not necessarily evident, suggesting the importance of impaired mucosal-protective factors in this clinical setting. Type II ulcers, in contrast, include gastric ulcers, distal antral (prepyloric) ulcers, and duodenal ulcers. They are associated with acid hypersecretion and the impaired negative feedback effects of acidification on gastrin release and on continued acid secretion. The causes of gastric ulcers include H. pylori infection, nonsteroidal anti-inflammatory drugs (NSAIDs), environmental factors, and malignancy. Duodenal ulcers can result from hypersecretion of gastrin, which is assessed by evaluating fasting gastrin...

Tetracyclines

Tetracyclines are used in the treatment of uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis and as adjunctive treatment in severe acne. Tetracycline in combination with metron-idazole and bismuth subsalicylate is useful in treating Helicobacter pylori (a bacteria in the stomach that can cause peptic ulcer).

Summary

The involvement of more than one endocrine hormone and neurotransmitter in the control of gastric acid secretion has resulted in a number of therapeutic approaches directed toward achieving its inhibition. Of these strategies both muscarinic and histamine H2-receptor antagonists have been used, with the latter being the method of choice for the control of acid-related disorders, particularly peptic ulcer disease, until the late 1980s. Along with the successful treatment of many patients

Naproxen

Naproxen is contraindicated in patients who are allergic to the drug or other NSAIDs and during pregnancy (Category B) and lactation. The drug is used cautiously in patients with asthma, hypertension, cardiac problems, peptic ulcer disease, and impaired liver or kidney function. Like ibuprofen, naproxen increases the risk of lithium toxicity when the drug is administered with naproxen. When naproxen is administered with the anticoagulants there is an increased risk for bleeding. When naproxen is administered with the antihyperten-sives, there is a decrease in the antihypertensive effect. Coadministration of naproxen with the diuretics decreases the diuretic effect.

Celecoxib

The drug is used cautiously in patients with a history of peptic ulcer, individuals older than 60 years, and those taking an anticoagulant or steroids. In rare instances, serious stomach problems such as bleeding can occur without warning. When celecoxib is given with the anticoagulants, there is an increased risk for bleeding.

Rofecoxib

Rofecoxib is contraindicated in patients who are allergic to the drug, any of the NSAIDs, or the sulfonamides. The drug is not used during pregnancy (Category C) or lactation. Rofecoxib is used cautiously in patients with impaired renal or hepatic function, in those with a history of gastrointestinal bleeding or peptic ulcer disease, and in patients with congestive heart failure, asthma, or hypertension. Interactions with rofecoxib are similar to those with the other NSAIDs, such as an increased risk of bleeding when taken with anticoagulants and possible risk of lithium toxicity when taken concurrently with lithium.

Chlordiazepoxide

This classic benzodiazepine is used mainly for calming anxiety and for treating symptoms of alcohol withdrawal, including delirium tremens. Studies have found, however, that alcoholics receiving this drug to help them through withdrawal are about three times more likely to resume drinking than alcoholics who receive a placebo. The substance is also used to overcome convulsions and to treat insomnia, migraine headache, gastric ulcers, and irritable bowel syndrome (persistent cramps and diarrhea). Actions from a dose of this drug take longer to appear than actions from a dose of lorazepam or diazepam, so those latter substances are sometimes preferred when faster results are needed.

Gastrointestinal

Gastrointestinal adverse effects are particularly frequent, and affect some 14-25 of patients the incidence of the most serious, peptic ulcer and bleeding were 0.16-0.34 and 0.16-0.17 , respectively (1). A prospective 12-week endoscopic study documented better gastrointestinal tol-erability with diclofenac than naproxen (SEDA-20, 92). Upper gastrointestinal hemorrhage has been associated with transdermal application of diclofenac, with massive bleeding in two of four patients (SEDA-21, 104).

Histamine

Histamine receptors were first divided into two subclasses H1 and H2 by Ash and Schild (1966) on the basis that the then known antihistamines did not inhibit histamine-induced gastric acid secretion. The justification for this subdivision was established some years later when Black (see Black et al. 1972) developed drugs, like cimetidine, that affected only the histamine stimulation of gastric acid secretion and had such a dramatic impact on the treatment of peptic ulcers. A recently developed H2 antagonist zolantidine is the first, however, to show significant brain penetration. A further H3 receptor has now been established. It is predominantly an autoreceptor on histamine nerves but is also found on the terminals of aminergic, cholinergic and peptide neurons. All three receptors are G-protein-coupled but little is known of the intracellular pathway linked to the H3 receptor and unlike H1 and H2 receptors it still remains to be cloned. Activation of H1 receptors stimulates IP3...

Caffeine

Precautions It should not be taken by anyone who is allergic to stimulants, has heart disease or irregular heartbeats, who suffers from insomnia, anxiety, or panic disorders, or has a peptic ulcer of the stomach or duodenum. A physician should be consulted first if any of the following conditions are present hypoglycemia, epilepsy, or high blood pressure. To discontinue use, gradually decrease the amount over a month or more, or headaches, irritability, and drowsiness may result. Though it is readily absorbed into the bloodstream, researchers still do not understand its full effects upon the human body. Caffeine can lead to a condition in coffee drinkers called coffee intoxication, in which more than four or five cups a day results in irritability, muscle twitches, rambling speech and thought, and trouble sleeping. It can also worsen existing health problems, and may contribute to birth defects, bladder and colon cancer, kidney disease, osteoporosis, hypertension, abnormal heart...

Drug formulations

In a study of the efficacy and tolerability of a modified-release formulation in 269 adults and 230 additional adults for whom short-term safety data were available, 13 of 269 patients (4.8 ) withdrew because of flushing (41). During the first 4 weeks about half had flushing. The mean intensity was about 4.0 on a visual analogue scale (representing none'' to intolerable''). Patients were encouraged to use aspirin prophylactically to minimize flushing. Other nicotinic acid-related adverse effects leading to withdrawal included nausea (3.3 ) sometimes with vomiting, other gastrointestinal symptoms (1.5 ), and pruritus (2.6 ). Once case each of gout, acanthosis nigricans, headache, palpitation, raised glucose concentrations, and shoulder pain led to patient withdrawal. Certain adverse events thought to be associated with nicotinic acid were uncommon in the study group. There was one case of peptic ulcer, amblyopia occurred in three patients, and leg aches and myalgias in one patient...

Rabeprazole

The use of rabeprazole in acid-related disorders has been reviewed (40R). Rabeprazole has proven efficacy in healing, symptom relief, and prevention of relapse of peptic ulcer and gastro-esophageal reflux disease and can form part of effective Helicobacter pylori eradication regimens. It was generally well tolerated in both short-term and long-term studies of up to 2 years. Headache was the most important reported adverse effect. Other commonly reported adverse effects were diarrhea, rhinitis, nausea, pharyngitis, abdominal pain, and flatulence. The changes in serum gastrin concentrations were consistent with proton pump inhibitor pharmacology, and no study has reported mean values at end-point that were outside the reference range. In controlled trials, the frequency of abnormalities of hepatic amino-transferases was similar to that of placebo. Scoring of enterochromaffin-like cells in gastric biopsies taken prospectively from patients in studies of up to 2 years have shown some...

Thrombolytics

Activation of plasminogen to plasmin produces several events. The primary event is the dissolution breakup of any fibrin-containing clots encountered, including those found obstructing blood vessels. However, clots formed to prevent bleeding caused by injuries, such as cuts (surgical), puncture wounds, or pathological sites such as bleeding ulcers, would also be degraded. This constitutes an undesirable interference with the integrity of the vascular system. Excessive circulating plasmin is continuously destroyed by the plasmin inhibitors to control or to minimize such effects. As mentioned, circulating plasmin continuously breaks down fibrinogen and other clotting factors. Another factor to be considered is that the plasmin-produced FDPs prevent the production of more fibrin by inhibiting the conversion of fibrinogen to fibrin by thrombin (Fig. 11-1). This will reduce available circulating fibrinogen, thereby producing an anticoagulant effect that FDPs will continue to have even...

Therapeutic Market

The therapy for gastric acid-related gastrointestinal disorders has evolved from nonspecific gastro-protective agents to treatments directed at specific sites regulating the secretion of gastric acid. H2-receptor antagonists and PPIs are currently the major therapies used to inhibit the production of gastric acid. The discovery that H. pylori infection was highly correlated with the presence of duodenal ulcer and hypersecretion of gastric acid has introduced an additional therapy that targets the eradication of H. pylori. This combination therapy of an antisecretory agent and an antibiotic has been shown to dramatically reduce the number of patients in which ulcer formation recurs (1).The incidence of upper gastrointestinal disorders such as ulcer and GERD shows an element of global variation. For example, in Western countries duodenal ulcers are more common, whereas in Eastern countries gastric ulcers predominate (2).These dif- * ferences may be attributable to any of a number of...

Physical description

Anti-inflammatory properties Fixed oil of Ocimum basilicum L. inhibits carrageenan-induced arachidonic acid and leukotriene-induced paw edema the castor oil-induced diarrhea in rats is made possible by blockade of the enzymatic activity of both cyclo-oxygenase and lipo-oxygenase (Singh S, 1999). An aqueous extract protects rats against gastric ulcers caused by aspirin in rats (Akhtar MS etal., 1989). Note that caffeic acid displays significant analgesic, anti-inflammatory and antiarthritic properties in rats (Ficarra R et al, 1995).

Methamphetamine

Methamphetamine's smokable format is considered twice as strong as dex-troamphetamine, can produce pulmonary edema, and has been identified as causing skin affliction. Smoking methamphetamine can narrow blood vessels, which will increase blood pressure. Another suspected consequence of the narrowing is acidosis found among methamphetamine users, a condition in which levels of acid in blood rise high enough to make a person sick. Studies of patients suffering from harm to bones and to skeletal muscles have found possible association with methamphetamine. Ischemic colitis, a bowel problem normally associated with old age, has been seen among young methamphet-amine users. The substance is also associated with duodenal ulcers and malignant giant gastric ulcers. Inhaling the drug (as opposed to smoking, injecting, or swallowing) promotes excessive wear on teeth.

Caapi Pinima

Larger doses of caffeine, especially when given to non-users, can produce headache, jit-teriness, abnormally rapid heartbeat (tachycardia), convulsions, and even delirium. Near-fatal doses cause a crisis resembling the state of a diabetic without insulin, including high levels of blood sugar and the appearance of acetone-like substances in urine. The lowest known dose fatal to an adult has been 3,200 mg - administered intravenously by accident. The fatal oral dose is in excess of 5,000 mg - the equivalent of 40 strong cups of coffee taken in a very short space of time. Tolerance refers to the body's getting used to a drug with its repeated taking. It is difficult to study the tolerance of human subjects to the various effects of caffeine because nearly everyone in our society uses caffeine regularly in one form or another. Careful research has suggested that tolerance develops to most of caffeine's effects - meaning that, with experience of the drug, the same dose produces a reduced...

Prostaglandins

Evidence that endogenous PGs are crucial to maintaining gastroduodenal integrity has led to the suggestion that PUD might be a prostaglandin deficiency disease. Along these lines, this also partially explains the ulcerogenic character of all presently available NSAIDS. The fact that the stomachs of gastric ulcer patients contained significantly lower levels of PGEs than did those of normal subjects is an important piece of supportive evidence for the central role of PGs in PUD. Finally, with the recognition of a new receptor in the cell membrane of parietal cells from canine, porcine, and rabbit sources,6 an explanation for the antisecretory effects of E-type PGs is now at hand (Fig. 13-2).