Antisecretory drugs

Antisecretory drugs

In the gastrointestinal system, anti-secretory drugs are used to decrease acid secretion in the stomach.

Drug families include:

Histamine H2 receptor antagonists are used to treat functional dyspepsia and to promote healing of NSAID-associated ulcers e.g. cimetidine and famotidine.

Proton pump inhibitors (PPIs) are used to treat gastric and duodenal ulcers, dyspepsia, gastro-oesophageal reflux disease (GERD) and NSAID-associated ulcers. Combined with antibacterials, PPIs are used to eradicate Helicobacter pylori infection. Can also be used to reduce the degradation of pancreatic enzyme supplements in cystic fibrosis patients, and to control excessive gastric acid production in Zollinger–Ellison syndrome. Examples are omeprazole and its single active enantiomer esomeprazole, lansoprazolerabeprazole and pantoprazole. Infrequently, patients taking PPIs have been reported to be suffering from drug-induced subacute cutaneous lupus erythematosus (SCLE), so prescribers should be aware of this rare side-effect and consider discontinuing PPI treatment if feasible.

The Prostaglandin analogue misoprostol is approved for treatment of gastric and duodenal ulceration and NSAID-associated ulceration and prophylaxis of NSAID-induced gastric and duodenal ulcers.

Antimuscarinic drugs such as the muscarinic M1 receptor antagonist pirenzepine were used to treat peptic ulcer, but are no longer widely used.

Mucosal protectants such as sucralfate may be used to manage benign gastric and duodenal ulceration and chronic gastritis, and as a prophylactic for stress-induced ulcers. Sucralfate aids healing by forming a viscous, protective layer on the ulcer's surface, but does not prevent new ulcer formation.