Pharmacology of the treatment of peptic ulcer disease

Anti-ulcer drugs may be classified according to their site and/or mechanism of action as: corticohypothalamic drugs; antisecretory drugs which may be anticholinergic agents (both classical atropine-like compounds and pirenzepine) or antagonists of the H2-receptors; antacids; agents which protect the mucosa; and gastric muscle stimulants. New groups of compounds with different pharmacokinetics and mechanisms of action are currently being investigated, and it is possible that they will represent an alternative to, or a substitute for, the present widely used anti-ulcer drugs. Among the new drugs, synthetic prostaglandins are probably the most interesting compounds, having potent antisecretory activity together with important cytoprotective properties. Another interesting group are the inhibitors of H+/K+-ATPase such as the substituted benzimidazoles, among which omeprazole is characterized by potent and long-acting antisecretory activity. Theoretically, other drugs such as calcium-entry blockers and synthetic somatostatin analogs deserve consideration although results obtained are preliminary.