H2- ??????????? ???????????

1
????? ????? ??????? ??????

• ???? ???? ???? ??????
• ???? ???????????
• ??????? ????? ????
• 1389

2
??????? ??????

• H2- ??????? ???? ???????????
• ???? ????? ??? ??? ?????? ???? ??????
• ???? ??????????? ???? ??
• ??????? ????????? ???????

3
Histamine H2-AntagonistsH2- Blockers
4
???? ?? ??? ??????? ??? ????? ????? ??? ?? ??
????????? ?????????? (??? ????) ???? ???? ????
?? ????? (????? ?? ????????? ???????)? ????
???????? ????????
5
Unlike cimetidine, ranitidine does not seem to
affect cytochrome P450 to any great extent, and
therefore is considered to have little effect on
the metabolism of other drugs
6
Ranitidine
Adverse Effects (mainly by parentral forms)
Effects on the cardiovascular system.
Bradycardia, AV block and cardiac arrest has
been reported . Also a ve inotropic effect.
Effects on the endocrine system gynaecomastia,
loss of libido, and impotence less than
cimetidine
7
.. Ranitidine
Effects on the nervous system confusion, loss of
color vision, aggressiveness, lethargy,
somnolence, disorientation, depression,
hallucinations and severe headache,
Effects on the liver hepatotoxicity
8
Famotidine
Adverse Effects
Effects on the cardiovascular system 40 mg daily
by mouth reduced cardiac output and stroke
volume. Also bradycardia and AV block has been
reported
Effects on the endocrine system transient
hyperprolactinaemia and glactorrhoea
Effects on the nervous system convulsions and
mental deterioration in elderly patients with
renal failure,
9
Nizatidine
Unlike cimetidine, nizatidine does not seem to
affect cytochrome P450 to any great extent, and
therefore is considered to have little effect on
the metabolism of other drugs
10
Nizatidine
Adverse Effects
Effects on the cardiovascular system has been
reported to reduce heart rate, also tachycardia,
bradycardia, orthostatic hypotension and syncope
have been reported rarely with rapid intravenous
injection
Some patients taking nizatidine may experience
excessive sweating and urticaria anaemia may
also occur
11
.. Nizatidine
Nizatidine is considered to have little or no
anti-androgenic activity although there are
isolated reports of gynaecomastia and impotence
12
Proton Pomp Inhibitors(PPIs)
Omeprazole Lansoprazole Rabeprazole
Pantoprazole
13
Omeprazole
Side effects
Some of the most frequent side effects of
omeprazole are headache, diarrhea, abdominal
pain, nausea, dizziness, trouble awakening and
sleep deprivation
Proton pump inhibitors may be associated with a
greater risk of hip fractures, and clostridium
difficile-associated diarrhea
14
Pantoprazole
This medication may affect the results of certain
lab tests (pantoprazole can cause a false
positive for THC)
15
Lansoprazole
Side effects
Infrequent dry mouth, insomnia, drowsiness,
blurred vision, rash, pruritus
Rarely and very rarely taste disturbance, liver
dysfunction, peripheral oedema, hypersensitivity
reactions
Severe Gastro-intestinal disturbances (such as
nausea 1.3, abdominal pain 2.1, diarrhea 3.8)
16
Rabeprazole
Side effects
The most common is headache in 2.4 of patients
Diarrhea, vomiting, nausea, abdominal
pains, Constipation, meteorism, dry mouth,
increased or decreased appetite, asthenia,
anxiety, vertigo, Sleeplessness,
thrombocytopenia, skin eruption Granulocytopenia,
leukocytopenia, Erythema, myalgia, arthralgia,
muscle or bone pain
17
Prokinetic drugs
18
????????????
?????????? ??????? ??? ???? ?????
??????????????? ?????? ????? ???? ?????? ??????
????? ??? ?? ?? ???? ??????????? ?????????? ??
??? ?????? ?????? ????? ???? ???
19
Cisapride
?????? ????????????? ???? ????? ????? ?????
?????? ??? 5-HT4 ? ?????? cAMP
????? ????? ?????? ??? ? ???? ????? ????
????? ????????? ???? ? ??????????? ????
20
Domperidone
Adverse Effects
galactorrhoea or gynaecomastia plasma prolactin
increased
Effects on the cardiovascular system Sudden
death , ventricular arrhythmias with parenteral
products
Extrapyramidal effects such as acute dystonic
reactions
21
Colpermin
Active ingredient Peppermint oil
Indications And Clinical Uses For the
symptomatic relief of abdominal pain, distension,
flatulence and gas associated with the irritable
bowel syndrome (IBS).
22
Colpermin
Adverse Reactions Reactions may include
heartburn and hypersensitivity to peppermint oil
or menthol, which is rare and includes
erythematous skin rash, headache, bradycardia,
muscle tremor and ataxia
Not to be used in Children under 15 years of age
23
Misoprostol
Adverse Effects The commonest adverse effect of
misoprostol is diarrhoea. Other
gastrointestinal effects include abdominal pain,
dyspepsia, flatulence, and nausea and vomiting
24
. Misoprostol
Increased uterine contractility and abnormal
vaginal bleeding (including menorrhagia and
intermenstrual bleeding) have been reported.
Other adverse effects include skin rashes,
headache, and dizziness. Hypotension is rarely
seen at doses recommended for peptic ulcer
disease.
25
???? ???????????
???? ??? ?????? ?? ???? ????? ???? ???? ? ????
????? ?????????? ???? ?? ????? ???
?????? ??-????? ??????? ?? ???????? ??????????
?????????- C ??????? ??-??
26
????? ????? ???? ???????????
??????? ????? ?????? ???? ??????????? ??????? ??
???? ???? ?????? ?????? ???????? ???? ????? ?????
? ?????????
????? ??????? ???? ?? ??????? ??????? ??
????? ???? ???? ?? ?????????? ???? ?????
???? ???? ???? ?? ???? ???? ????
???? ???? ?? ??????? ?? ?????
???????????? ???? ?? ????? ?????? ???
27
Antacids
Side effects from antacids vary depending on
individual and other medications they may be
taking at the time. Those who experience side
effects most commonly suffer from changes in
bowel functions, such as diarrhea, constipation,
or flatulence.
28
. Antacids
Milk-alkali syndrome, which is serious toxicity
and can be fatal
Aluminum hydroxide may lead to the formation of
insoluble aluminium-phosphate-complexes, with a
risk for hypophosphatemia and osteomalacia
Al(OH)3 3HCl ? AlCl3 3H2O
29
. Antacids
Magnesium hydroxide has laxative properties.
Magnesium may accumulate in patients with renal
failure leading to hypermagnesemia, with
cardiovascular and neurological complications
Mg(OH)2 2HCl ? MgCl2 2H2O
30
Laxatives(also known as purgatives or aperients)

• Laxative Abuse
• occurs when a person attempts to get rid of
  unwanted calories, lose weight.

laxative abuse is serious and dangerous, often
resulting in a variety of health complications
and sometimes causing life-threatening risks.
31
Health consequences of laxative abuse
Upset of electrolyte and mineral balances.
Sodium, potassium, magnesium, and phosphorus
Severe dehydration may cause tremors, weakness,
blurry vision, fainting, kidney damage, and, in
extreme cases, death
Internal organ damage may result, including
stretched or lazy colon, colon infection,
Irritable Bowel Syndrome, and, rarely, liver
damage. Chronic laxative abuse may contribute to
risk of colon cancer.
32
??? ? ????? ?????
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)