RT Book, Section
A1 Wallace, John L.
A1 Sharkey, Keith A.
A2 Brunton, Laurence L.
A2 Chabner, Bruce A.
A2 Knollmann, Björn C.
SR Print(0)
ID 1127869905
T1 Pharmacotherapy of Gastric Acidity, Peptic Ulcers, and Gastroesophageal Reflux Disease
T2 Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071624428
LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127869905
RD 2023/09/28
AB The  acid-peptic  diseases  are  those  disorders  in  which  gastric  acid  and  pepsin  are  necessary,  but  usually  not  sufficient,  pathogenic  factors.  Although  inherently  caustic,  acid  and  pepsin  in  the  stomach  normally  do  not  produce  damage  or  symptoms  because  of  intrinsic  defense  mechanisms.  Barriers  to  the  reflux  of  gastric  contents  into  the  esophagus  comprise  the  primary  esophageal  defense.  If  these  protective  barriers  fail  and  reflux  occurs,  dyspepsia  and/or  erosive  esophagitis  may  result.  Therapies  are  directed  at  decreasing  gastric  acidity,  enhancing  the  lower  esophageal  sphincter,  or  stimulating  esophageal  motility  (Chapter  46).  The  stomach  is  protected  by  a  number  of  factors,  collectively  referred  to  as  "mucosal  defense,"  many  of  which  are  stimulated  by  the  local  generation  of  prostaglandins  and  NO  (Wallace,  2008).  If  these  defenses  are  disrupted,  a  gastric  or  duodenal  ulcer  may  form.  The  treatment  and  prevention  of  these  acid-related  disorders  are  accomplished  by  decreasing  gastric  acidity  and  enhancing  mucosal  defense.  The  appreciation  that  an  infectious  agent,  Helicobacter  pylori,  plays  a  key  role  in  the  pathogenesis  of  acid-peptic  diseases  has  stimulated  new  approaches  to  prevention  and  therapy.