GIT - Proton pum inhibitors (PUD) - Anticholinergic (Muscarinic Antagonists)

7 important questions on GIT - Proton pum inhibitors (PUD) - Anticholinergic (Muscarinic Antagonists)

Why are anticholinergic agents less effective as acid suppressing drugs in PUD?

Anticholinergic agents are less effective acid suppressing drugs due to:
  • Acetylcholine is not the final mediator of HCL secretion.
  • No effect on HCL secretion mediated by histamine or gastrin.
  • Large dose is required (leads to adverse effects).
  • Decreases mucous more than HCL (decreased buffer capacity).
  • Delay gastric emptying prolonging exposure of ulcer to HCL.

What are the pharmacological effects of anticholinergics?

  • Decreases HCL secretion (mild effect)
  • Antispasmodic
  • Decreases nocturnal GI pain

What are some examples of Atropine-like substitutes?

Examples of Atropine-like substitutes include:
  • Hyoscine
  • Dicyclomine
  • Glycopyrrolate
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Why are anticholinergics given in combination with other anti-ulcer agents?

Due to low efficacy, anticholinergics are given in combination with other anti-ulcer agents especially in patients with severe abdominal colic.

What is the function of Pirenzepine?

Pirenzepine is a selective M1 receptor antagonist mainly in gastric mucosa and decreases HCL secretion.

Why are anticholinergic drugs contraindicated in old males?

Anticholinergic drugs are contraindicated in old males to avoid glaucoma and urine retention.

What is the recommended dose for Pirenzepine?

The recommended dose for Pirenzepine is tablets 25mg; 2 tablets in the morning and 2 tablets at bedtime.

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