Pharmacology for Dentistry

266 Section 7/ Drugs Acting on GIT

ENPROSTIL

35-140 μg day heal duodenal and gastric
ulcer but are less effective than H 2 receptor
antagonists.

ULCER HEALING DRUGS

CARBENOXOLONE SODIUM

It is a steroid like triterpenoid synthetic
derivative of glycyrrhizic acid (obtained
from liquorice) and has been found to be
effective in healing both gastric and
duodenal ulcer without affecting volume or
acidity of gastric juice.

It acts by increasing mucus production,
slowing turnover of gastric cells and
increasing regeneration of cells around ulcer.
It also enhances pyloric tone preventing bile
reflux. It retards PG’s degradation in gastric
mucosa. Its mineralocorticoid side effects lead
to Na+ and water retention and K+ loss
preclude its use on large scale.

ULCER PROTECTIVE AGENTS

SUCRALFATE

It is a basic aluminium salt of sucrose
octasulfate. It polymerizes at pH < 4 to form a
sticky, viscid yellow white gel which adheres
to ulcer base. The gel acts as a strong
mechanical barrier because of a strong

electrostatic interaction of the drug with

proteins at ulcer site. It also binds to basic

fibroblast growth factor preventing its

degradation and thereby promotes healing.

It also protects from intracellular enzymes

released from damaged cells. It also helps in

formation of new blood vessels (angiogenesis)

and helps in cell division (mitogenic).

Sucralfate also inhibits release of cytokines

(immunomodulator). It also has antibacterial

activity.

It precipitates surface proteins at ulcer

base and act as a physical barrier, preventing

acid, pepsin and bile from coming in contact

with ulcer base. It also augments gastric

mucosal PG synthesis thereby enhancing

protective action. It has no acid neutralizing

action.

It promotes healing of both gastric and

duodenal ulcers and also prevents ulcer

recurrence.

Topical sucralfate (4-10%) is also

useful in management of decubitus ulcer,

diabetic ulcers, chemical and thermal

burns, radiation induced skin damage,

vaginal ulceration, oral and genital

ulceration.

Side effects include dry mouth,

constipation, nausea, vomiting, rash, pruritus,

dizziness. It adsorbs and interferes with

absorption of tetracycline, cimetidine, digoxin

and phenytoin.