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CHAPTER 15. DRUGS AFFECTING THE DIGESTIVE SYSTEM

In this Chapter:

15.1. Drugs that affect appetite

15.2. Drugs that affect salivary gland function

15.3. Drugs used for the treatment of gastric gland function disorder

15.3.1. Drugs that increase gastric secretion. Replacement therapy

15.3.2. Drugs that decrease gastric secretion

15.3.3. Antacids

15.4. Gastroprotectors

15.5. Drugs that affect gastric motility

15.6. Emetic and antiemetic drugs

15.7. Hepatoprotective drugs

15.8. Cholagogue drugs

15.9. Drugs that induce gallstone dissolution (cholelithiatic drugs)

15.10. Drugs used for the treatment of pancreatic failure

15.11. Drugs that affect intestinal motility

15.11.1. Laxatives

The disturbances of secretory and motor activity of the gastrointestinal tract are seen in many diseases and pathologic conditions. A great variety of drugs are used to normalize the function of the gastrointestinal tract. They include agents that directly affect secretory and motor functions of the stomach and intestines and excretory activity of the pancreas and the liver. Other agents that affect gastrointestinal function include drugs that regulate appetite and emetic and antiemetic drugs.

15.1. DRUGS THAT AFFECT APPETITE

Appetite is regulated by complex neurohumoral systems. These include both central and peripheral mechanisms. Taste, smell, sight sensations, signals coming from the gastrointestinal tract and peripheral tissue metabolism are conventionally referred to as peripheral mechanisms. In the

CNS appetite is controlled by «the hunger center» (lateral nuclei of the hypothalamus) and «the satiety center» (ventromedial nuclei of the hypothalamus). Appetite greatly depends on the functional condition of the limbic system and the cerebral cortex (especially the frontal lobes). Appetite is mainly regulated by noradrenergic, dopaminergic and serotoninergic systems and by corresponding receptors 1- and β2-adrenoceptors, αa1-adrenoceptors, dopamine D1-receptors, serotonin 5-HT1B- and 5-HT2C-receptors). There are substances in the organism that control appetite and energy balance. Some of these substances increase appetite (orexigenic activity), for example neuropeptide Y, A and B orexines (peptides), grelin1, a hormone that stimulates growth hormone release, GABA and others. Other endogenous substances suppress appetite (anorexigenic2 activity), for example leptine3, insulin, α-melanocyte-stimulating hormone, hormones stimulating the release of thyrotropic and corticotropic hormones, neurotensin, serotonin, glucagon-like peptides, cholecystokinin, and others.

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