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Antiulcer medications: Mechanism of action, pharmacology, and side effects

Author
Nimish B Vakil, MD, AGAF, FACP, FACG, FASGE
Section Editor
Mark Feldman, MD, MACP, AGAF, FACG
Deputy Editor
Shilpa Grover, MD, MPH, AGAF

INTRODUCTION

Eradication of Helicobacter pylori, withdrawal of nonsteroidal anti-inflammatory drugs, and antisecretory drugs are the mainstays of treatment for peptic ulcer disease.

The pharmacology of antiulcer drugs, excluding the antibiotics used to treat H. pylori, will be reviewed here. For detailed prescribing information, readers should refer to the individual drug information topics within UpToDate. Comprehensive information on drug-drug interactions can be determined using the drug interactions tool (Lexi-Interact online). This tool can be accessed from the UpToDate online search page or through the individual drug information topics in the section on drug interactions. Complete information on United States Food and Drug Administration (FDA) labeling for each drug can be accessed using the FDA searchable database.

Treatment regimens for H. pylori and management of peptic ulcer disease are discussed elsewhere. (See "Treatment regimens for Helicobacter pylori" and "Peptic ulcer disease: Management".)

ANTISECRETORY AGENTS

Histamine-2 receptor antagonists

Mechanism of action — Histamine-2 receptor antagonists (H2RAs) (eg, cimetidine, ranitidine, famotidine, and nizatidine) inhibit acid secretion by blocking H2 receptors on the parietal cell (figure 1).

H2RAs are well absorbed after oral dosing; peak serum concentrations occur within one to three hours. Absorption is reduced 10 to 20 percent by concomitant antacid administration, but not by food.

                          

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Literature review current through: Aug 2017. | This topic last updated: Apr 08, 2016.
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