Classification of gastrocytoprotectors
Pharmacological agents of this group are divided into two main categories according to their predominant mechanism of action:
- Agents that increase mucus secretion:
- Synthetic prostaglandin analogues (misoprostol, enprostil).
- Licorice preparations (carbenoxolone).
- Agents that form a protective mechanical film:
- Sucralfate.
- Bismuth preparations (bismuth subnitrate, bismuth tripotassium dicitrate).
Synthetic prostaglandin analogues
These agents mimic the action of natural prostaglandins, providing comprehensive mucosal protection.
- Misoprostol is a synthetic analogue of prostaglandin $E_1$. It stimulates the production of protective mucus and bicarbonates, the synthesis of surfactant-like phospholipids, and improves local microcirculation. The main indication is the prevention of ulcerogenic lesions during the use of nonsteroidal anti-inflammatory drugs and glucocorticoids.
- Enprostil is an analogue of prostaglandin $E_2$. Pharmacologically, it is similar to misoprostol, but differs in better tolerability and a lower incidence of adverse reactions.
Glycyrrhizic acid preparations and film-forming agents
Carbenoxolone, derived from licorice root extract, stimulates mucus production, alters its chemical composition via sialic acids, and prevents the back-diffusion of hydrogen ions. Due to its mineralocorticoid action, it can cause water retention and hypokalemia.
Sucralfate upon contact with damaged mucosa forms an insoluble protective complex lasting up to six hours. The drug reduces pepsin activity, adsorbs bile acids, and provides a local antacid effect without affecting the overall gastric pH. Bismuth preparations, such as bismuth tripotassium dicitrate and bismuth subnitrate, coagulate proteins to form a film, possess an astringent effect, and tripotassium dicitrate additionally inhibits the development of Helicobacter pylori.
Class and exam questions
Which drugs are included in the group of agents that increase mucus secretion?
This group includes synthetic prostaglandin analogues (misoprostol, enprostil) and licorice preparations (carbenoxolone).
What is the specific feature of bismuth tripotassium dicitrate action compared to other gastroprotectants?
Bismuth tripotassium dicitrate not only forms a protective film and stimulates prostaglandin E₂ production, but also exhibits pronounced anti-Helicobacter activity, inhibiting the development of Helicobacter pylori.
What side effects are characteristic of licorice preparations (carbenoxolone)?
The drugs can cause systemic side effects of a mineralocorticoid nature: sodium and water retention, edema, arterial hypertension, and hypokalemia.
What else to study on this topic
- Pharmacodynamics and defense mechanisms of synthetic prostaglandin analogues
- Pharmacokinetic features and encapsulated forms of carbenoxolone
- Comparative characteristics of sucralfate and its effect on pepsin
- Anti-Helicobacter properties and clinical use of bismuth preparations
- Composition and differences of the combination drugs Vikalin and Vikair
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