PHARMACOLOGICAL MANAGEMENT OF GASTROINTESTINAL DISORDERS GastroEsophageal Reflux Disease (GERD) The backward flow of acidic gastric Study Resources This preview shows page 1 - 12 out of 30 pages. Activate your 30 day free trialto unlock unlimited reading. College of, QUESTION 1 Joan is a 39 y/o female who presents to the clinic with a chief complaint of: 3-day history of fever (101 F degrees), chills, n & v, and flank pain. laxative effect noted 6-12 hours after administration due to requiring activation in the colon, DISCUSS ADVERSE EFFECTS Just like the antacids that contain Mg, accumulation of Mg and Phos can be symptomatic, even deadly in elderly patients with poor renal function Liquid: Magnesium hydroxide 400 mg/5 mL: 5-15 mL as needed up to 4 times/day, ADVERSE EFFECTS WITH MINERAL OIL: ASPIRATION PNA, If diarrhea is occuring due to an infectious cause, must treat the underlying infection with antibiotics Most diarrhea is self-limiting, 72 hours in duration. Synthetic cannabinoids: during chemotherapy Nabilone Dronabinol, Gastrointestinal Pharmacology Laxatives: Laxative production of a soft formed stool over a period of 1 or more days Catharsis prompt, fluid evacuation of the bowel, more intense Indications for laxative use: Pain associated with bowel movements To decrease amount of strain under certain conditions Evacuate bowel prior to procedures or examinations Remove poisons To relieve constipation caused by pregnancy or drugs Contraindications: Inflammatory bowel diseases Acute surgical abdomen Chronic use and abuse, Gastrointestinal Pharmacology Laxatives: Stimulate peristalsis Soften bowel contect Classification: Bulk laxatives Non-absorbable carbohydrates Osmotically active laxatives Irritant laxatives = purgatives Small bowel irritants Large bowel irritants Lubricant laxatives Paraffin Glycerol, Gastrointestinal Pharmacology Laxatives: Bulk laxatives: Increase in bowel content volume triggers stretch receptors in the intestinal wall => causes reflex contraction (peristalsis) that propels the bowel content forward Carbohydrate-based laxatives Insoluble and non-absorbable Non digestable; take several days for effect Expand upon taking up water in the bowel Must be taken with lots of water Vegetable fibers (e.g. gastrointestinal agents Diana Rangaves, PharmD, CEO Drugs for constipation Subramani Parasuraman Drugs acting on the gastro-intestinal tract New pharmacology Dr Sahithya c.p GIT pharmacology Ahmad Ali Slide31 gi tpart1 Tala Khaled Pharmacology powerpoint git drugs Fred Ecaldre Veterinary Pharmacology of drugs acting on gastrointestinal tract Self-care of gastrointestinal symptoms that impact quality of life, but which are not associated with a significant impairment in a person's ability to carry out daily activities and are not associated with obvious symptoms of structural disease, is commonplace. 16.10b ig. His symptoms include mental confusion, ataxia, stupor, and hypotension. You can read the details below. d igestive. Diarrhea is usually caused by infection (Salmonella, shigella, campylobacter, clostridium, E. coli), toxins, anxiety, drugs In healthy adults mostly discomfort and inconvenience In children (particularly mal-nourished) a principal cause of deathdue to excessive loss of water and minerals. Gastrointestinal Pharmacotherapy.Ppt Final. During the visit, the NP does a urine dipstick and discover that Susan is, A pregnant women who has gestational diabetes mellitus (GDM) in the second trimester has which type of diabetes? They found a perforated metallic pellet embedded in his leg that had presumably contained the ricin toxin. March 3, 2009. Elon Musk: Tesla, SpaceX, and the Quest for a Fantastic Future. NURS - 343 PHARMACOLOGY EXAM 1 Digestive Pharmacology/ Drug acting on GIT, Veterinary Pharmacology of drugs acting on gastrointestinal tract, Drugs acting on the gastrointestinal tract, Pharmacology of Gastrointestinal Diseases, Drugs acting on the gastro-intestinal tract, Pharmacology of Gastrointestinal Disorders, Drugs stimulating gastrointestinal motility, Drugs act on mucosa membrane of git by abu bakar tariq, Intestinal peristalsis physiology and motility disorders, Formulation factors affecting drug absorption, Blood supply and venous drainage of the gastro-intestinal tract and liver, Dr. Darin Madson - Deciphering Diarrhea - What's Important, 9. drug acting on the gastro intestinal system, Gastroesophageal disease (GERD) in Adults, Current Trends in Management of Gastroesophageal Reflux Disease, Drugs affecting Gastro Intestinal function. Platelets are increasingly recognized as essential mediators of host defense in infectious diseases. Charles Nichols, PhD Department of Pharmacology & Experimental Therapeutics LSUHSC, New Orleans, LA 70112. inhibits P450. medical careers eden area rop. Defense mechanisms are required to protect the esophagus and stomach from the extremely high concentration of hydrogen ions LES: prevents the reflux of contents into the esophagus-talk about this causing dyspepsia, certain foods trigger relaxation of the LES Stimulated by prostaglandin E2 and I2, soluble gastric mucus is secreted and forms an insoluble gel on the mucosal surface of the stomach ASA, alcohol, and other drugs that inhibit prostaglandin secretion inhibit the secretion of this protective mucus Superficial gastric epithelial cells secrete bicarbonate ions, which neutralize the acid in the stomach, raising pH, and therefore preventing acid-mediated damage. May be caused by infection, intoxication, allergy, malabsorption, inflammation, tumors of GI tract, food poisoning, and by certain medications.Diarrhea is best defined by consistency of stool , Culture for Clostridium Difficle is done when unexplained, severe diarrhea. identify platelet PI3K catalytic isoform p110 to foster platelet interaction with neutrophils and monocytes in streptococcal infection, promoting their recruitment and effector functions to prevent bacterial dissemination and prolong survival. Metoclopramide Domperidone Cannabinoids: Marihuana ? Download Now, CLINICAL PHARMACOLOGY OF GASTROINTESTINAL AGENTS, Clinical pharmacology of gastrointestinal agents, Introduction to Clinical Pharmacology Chapter 41- Lower Gastrointestinal System Drugs, PTP 546 Module 12: Gastrointestinal Pharmacology, Pharmacology Introduction to Pharmacology. Antacids Peptic ulcer therapy Antiemetics Laxatives Antidiarrheal drugs. GASTROINTESTINAL DISORDERS. 16.11a ig. using physiologically-based pharmacokinetic (pbpk) modeling, we provide our perspective on the model-predicted site-of-action concentrations for metabolites of cytochrome p4503a (cyp3a) and p-glycoprotein (p-gp) dual inhibitors, itraconazole and verapamil, in ddi studies with midazolam (cyp3a substrate) and dabigatran etexilate (p-gp substrate), Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. POINT OUT UPPER GI AND LOWER GI TRACT DEVIATION, Starting with the upper GI tract, there are 2 main categories of disease states related to acid secretion. We will not be covering all diagnoses of the GI tract that require medication for management. Gastrointestinal drugs .ppt - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. Enteral (Nasogastric Tubes, Gastrostomy Tubes, Jejunostomy, RUNNING HEAD: GI CASE STUDY NURS615 If any one of these 3 is , acid secretion, Histamine is always available in gut, so when the 3 work. Class Gastrin induces ECL cells to release histamine, and also (to a lesser extent), stimulates direct acid secretion. jayne hansche lobert, ms, rn, acns-bc, np. The most likely cause of Jeremy's disease is: Vitamin D deficiency Thiamine, Sal is a 56 y/o male who the NP has seen on many occasions in the clinic. finra cusip lookup. Gastric acid secretion is a continuous process in which multiple central and peripheral factors contribute to a common endpoint, secretion of hydrogen ions by parietal cells. Gastrointestinal Pharmacology Gastroesophageal reflux disease (GERD) Backflow of stomach acid into the esophagus Esophagus is not equipped to handle stomach acid gt scaring Usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone (MI often mistaken for GERD !) More severe symptoms difficulty swallowing, chest pain PPT - GASTROINTESTINAL PHARMACOLOGY PowerPoint Presentation, free download - ID:723443 Create Presentation Download Presentation Download 1 / 59 GASTROINTESTINAL PHARMACOLOGY 340 Views Download Presentation GASTROINTESTINAL PHARMACOLOGY. Disease Will talk about acid-rebound phenomenon at the end, as all acid suppressants can cause this. Drug Names Called PPIsProton Pump Inhibitors. Description: Gastrointestinal drugs Department of pharmacology Liming zhou 2010,spring classification Drugs for treatment of peptic ulcers Drugs for adjusting the function of . Gastrointestinal Pharmacotherapy Sarah Nelson, Pharm.D. GASTROINTESTINAL PHARMACOLOGY - . The backward flow of acidic gastric contents into, the esophagus through the lower esophageal, Magnesium hydroxide (Milk of Magnesia: MOM), diarrhea, N/V, can lead to CNS depression (renal failure), Constipation (Aluminum) and diarrhea (Magnesium), simethicone: defoaming agent- gas drops, Overuse can lead to acid production rebound-, Risk of milk-alkali syndrome (renal failure), Also contains alginate and sodium bicarbonate, which form a hydrogel to coat esophagus lining. Ciprofloxacin, tetracycline, isoniazid, digoxin, levothyroxine, Enteric coated products (aspirin EC, Depakote EC), coating is, antifungals, sucralfate, some HIV medications, ABX, oral iron, therapy, H2 blockers, PPI can be inactivated or not absorbed, Space potentially interacting medications at least 2 to 3 hours, PRN best administered before meals (30-60. Additionally, she has. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. He was stabbed with the point of an umbrella while waiting at a bus stop near Waterloo Station in London. Get powerful tools for managing your contents. PDF | On Jan 23, 2022, Bikash Medhi and others published ADVANCED PHARMACOLOGY 1ST EDITION | Find, .Download file PDF.Read file. Each route can is classified as either enteral where medications are taken directly into the gastrointestinal tract (GIT), or parenteral, which means medications are delivered to the body by any other route other than the gastrointestinal . . gymnastics leotards for girls. During the visit, the NP does a urine dipstick and discover that Susan is. Of the 20-40% of patients that experience heartburn, 30-80% of those patients will have esophagitis. 19,38,42 Rates of health care seeking, self-care (over-the-counter drug use), and . gastrointestinal, Introduction to Clinical Pharmacology Chapter 41- Lower Gastrointestinal System Drugs - . 1. 16.1 ig. After we have an understanding of the cellular key players in acid secretion, we will discuss the various medications available and how each works. 2 types of movement: Propulsive: giant migrating contractions, propagate over extended lengths, evoke mass transfer of feces Non-propulsive (mixing) 8-9 liters of water enter the small bowel, 1-1.5 liters cross into the colon, but only 100mL of water is expelled via feces. Sep 2022 - Present3 months. AccessPharmacy is a subscription-based resource from McGraw Hill that features trusted pharmacy content from the best minds in the field. Create stunning presentation online in just 3 steps. 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The first, dyspepsia, is also known as heartburn or NERD. - PowerPoint PPT presentation Number of Views: 171 Avg rating:3.0/5.0 Slides: 24 Provided by: ibm51 Category: Tags: drugs | gastrointestinal | pharmacology less Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. During her physical exam of the heart, the NP notices that he has a new mitral regurgitation murmur that is described as a, Susie is a 40 year old female with Type 2 Diabetes.She reports that over the last several days, she has been having some hypoglycemic episodes and feels it is related to medication.Her medication. Gastrointestinal_Pharmacology343 (2).ppt - Gastrointestinal Pharmacology Clinical Pharmacology Uses for GI Drugs 4 major clinical uses for GI. "/> CLINICAL PHARMACOLOGY OF GASTROINTESTINAL AGENTS - . to achieve this. Bridging the Gap Between Data Science & Engineer: Building High-Performance T How to Master Difficult Conversations at Work Leaders Guide, Be A Great Product Leader (Amplify, Oct 2019), Trillion Dollar Coach Book (Bill Campbell). Psyllium, lineseed) Bran (husks = milling waste product) Osmotically active laxatives Partially soluble, but not absorbable Saline-based (mostly sulfates) Effect in 1-3 hrs => used to purge intestine (e.g. Rasmussen College: PHARMACOLOGY 2407 Exam Prep Questions and Ans,LATEST UPDATE 2021/2022 1 NR442 - RN Community Health Practice Assessment A RATIONALE LATESTUPDATE 2021/2022 ,100% C NR 443/ATI RN Community Health Online Practice LATEST UPDATE 2021/2022 B,100% CORRECT BEST. dr. j. domenech. . I. Epidemiol, Running head: [SHORTENED TITLE UP TO 50 CHARACTERS] 1 Gastrointestinal drugs - Pharmacology akifab93 Drug acting on digestive system Gi drugs outline raj kumar Pharmacology of Gastrointestinal Disorders dineshmeena53 Gi system pharmacology gloworm279 3. drug affecting git motility rt h IAU Dent H2 receptor antagonists Domina Petric Slide31 gi tpart1 Tala Khaled Drugs used in gastrointestinal system Free access to premium services like Tuneln, Mubi and more. A Dr. Alexander Rinehart, DC, CNS pregnancy. charles nichols, phd department of pharmacology & experimental therapeutics, Clinical pharmacology of gastrointestinal agents - . finance for equipment health insurance for travel abroad portrait photographer contract health insurance for travel abroad portrait photographer contract Caution in patients with Parkinsons disease! Primary treatment option are proton pump inhibitors, Gastrointestinal Pharmacology Mucosal protective agents: Misoprostol Prostaglandin E1 analog (PG stimulate mucus and bicarbonate production) Used when treatment with NSAIDs inhibits endogenous PG synthesis Sucralfate Complex of aluminum hydroxide and sulfated sucrose Forms complex gels with mucus => mucus stabilized => diffusion of H+ impaired Not absorbed => essentially free of side effects Must be taken every 6 hours, Gastrointestinal Pharmacology Peptic Ulcer Disease Imbalance between defenses and aggressive factors Defensive factors: Prevent the stomach and duodenum from self-digestion Mucus: continually secreted, protective effect Bicarbonate: secreted from endothelial cells Blood flow: good blood flow maintains mucosal integrity Prostaglandins: stimulate secretion of bicarbonate and mucus, promote blood flow, suppress secretion of gastric acid Aggressive factors: Helicobacter pylori: gram negative bacteria, can live in stomach and duodenum, may breakdown mucus layer => inflammatory response to presence of the bacteria also produces urease forms CO2 and ammonia which are toxic to mucosa Gastric Acid: needs to be present for ulcer to form => activates pepsin and injures mucosa Decreased blood flow: causes decrease in mucus production and bicarbonate synthesis, promote gastric acid secretion NSAIDS: inhibit the production of prostaglandins Smoking: nicotine stimulates gastric acid production, Gastrointestinal Pharmacology Peptic Ulcer Disease (~25 mill. Americans will have an ulcer in their life) Most common cause (> 85%):Helicobacter pylorii (not stress or hot sauce!) structure of the digestive system. Consult your lecture notes in conjunction with the class PowerPoint, read your Hist5 textbook, Chapter 24-2c, and scan Canipe's "Under God and Anti-Communist" (pp. Laxatives 3. NURS615 Sugammadex is a modified gamma cyclodextrin which forms a complex with aminosteroid neuromuscular blocking drugs via the carboxyl thio ether group to reduce the amount of available neuromuscular blocking drug at nicotinic receptors in the neuromuscular junction [1-4].In addition to binding rocuronium and vecuronium, it has been postulated that sugammadex may also bind to other . analgesics and antagonists anesthetics anti-anxiety and. We will also discuss complications of Gird We will then turn our attention to the lower GI tract and discuss the mechanism of motility, disorders of motility, and what treatment options we have for those patients. Pts that have H. pylori w/o and ulcer and H. pylori with an ulcer should both be treated, as H. pylori has been identified as a risk factor for forming an ulcer. drugs that affect the: nervous system. R21615Responsible for final coding of outpatient accounts types for GI, Pain Clinic, RadiationSee this and similar jobs on LinkedIn. antimicrobial agents (tetracycline, PTP 546 Module 12: Gastrointestinal Pharmacology - . There is also no carbon dioxide production Notice the calcium containing product forms carbon dioxide, this is what gives antacids the belching and gas sensation associated with them. objectives. Increases in Al concentration leads to aluminum toxicity. Diarrhea is characterized by frequent defecation of loose, watery stools. Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder associated with alterations in motility, secretion and visceral sensation. Plus, with our growing library, . They stimulate the parietal cells to HCI secretion. 6,16,22,24 Colchicine appears to be effective and safe for the treatment and prevention of recurrent pericarditis 6 . Feature Papers are submitted upon individual invitation or recommendation by the scientific editors and undergo peer review prior to publication. Here, we report structures of the human OR-G protein complexes bound to morphine and fentanyl, which uncover key differences in how they bind the receptor. We will focus on the most frequently diagnosed and utilized medications, including GERD/NERD, diarrhea and constipation, and a few miscellaneous items. A 62 year old malewho had a myocardial infarction one year ago is being seen for hypertension. 312-14) and Winsboro and Epple's (2009) "Religion, Culture, and the Cold War," pp. As part of this function, mucus regulates the uptake of molecules from the gastrointestinal lumen into the body. Start studying GASTROINTESTINAL PHARMACOLOGY PPT. 2017;239:147-176. doi: 10.1007/164_2016_119. This condition (Barrett's esophagus) has been linked to cancer of the esophagus. In addition to advancing multiple product candidates from our platform in clinical studies, QINLOCK is Deciphera's FDA-approved switch-control kinase inhibitor for the treatment of fourth-line gastrointestinal stromal tumor (GIST). Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Gastrointestinal Pharmacology - . This is a very broad category, but we will be following the assigned chapter closely. define drug; Pharmacology - . female hephaestus fanfiction; bluebeam polyline length; spark jdbc create table if not exists . Bloating. watch for renal/hepatic tox in older patients. Mild (common): diarrhea, constipation, headaches, drowsiness, Moderate/severe (rare): pancreatitis, thrombocytopenia. Posted 12:00:00 AM. SUBJECTS: Carbohydrates, Hydrogels, Layers, Molecules, pH Abstract Mucus is a complex hydrogel biomaterial whose composition is regulated meticulously to ensure that its important function as a selective barrier is maintained. Good afternoon, my name is Sarah, I am a pharmacy practice resident at VCU . Gastrointestinal Pharmacology Laxatives: Irritant laxatives: Large bowel irritants Anthraquinones Active ingredient of Senna sp. Gastrointestinal Stimulants: Actions, Uses, and Adverse Reactions Actions: increase the motility of the upper GI tract without increasing the production of secretions Used in treatment of GERD, gastric stasis Higher doses or prolonged administration: produce central nervous system (CNS) symptoms Treatment options: H1 antagonists: Meclizine, promethazine, dimenhydramine Muscarinic receptor antagonists: Scopolamine (motion sickness) Benzodiazepines: Lorazepam (during chemotherapy) D2 antagonists:have also peripheral prokinetic effects => increase motility of the GI tract => increases the rate of gastric emptying. Acidic irritation of the esophageal epithelium leads to a metaplastic change from a normal squamous type epithelium to an intestinal-type, columnar lining (Barretts), 3 Drug combo: protonix 40 bid + clarithromycin 500mg BID + amoxicillin 1 gram Bid OR metronidazole 500mg BID), Fluid content is the principal determinant of stool volume and consistency Water accounts for 70-85% of stool weight The daily challenge for the gut is to extract water, minerals, and nutrients from the luminal contents, leaving enough liquid for proper expulsion of waste material via defecation. Emetics and anti-emetics ig. Histamine: ECL cells are close to parietal cells, histamine is released and diffuses to parietal cells, activating histamine receptors. rate of gastric emptying, extrapyramidal effect. This occurs with acid and stomach contents backs into the esophagus without major irritation or erosion of the esophageal lining. . This preview shows page 1 - 9 out of 31 pages. Levalbuterol 47.6k posts. Gastrointestinal Pharmacology. Anti-diarrheaIs 4. Read More. Feature Papers represent the most advanced research with significant potential for high impact in the field. Understanding Artificial Intelligence - Major concepts for enterprise applica Four Public Speaking Tips From Standup Comedians, How to Fortify a Diverse Workforce to Battle the Great Resignation, Six Business Lessons From 10 Years Of Fantasy Football, Irresistible content for immovable prospects, How To Build Amazing Products Through Customer Feedback. peptic ulcer disease constipation diarrhea emesis, Pharmacology - . antacids peptic ulcer therapy antiemetics laxatives antidiarrheal drugs. Please feel free to interrupt me with questions at any time . Acid production : 2.5 L per day Isotonic HCl solution pH < 1 Produced by parietal cells Mucus production : Produced by mucus-secreting cells, Gastrointestinal Pharmacology Antacids Peptic ulcer therapy Antiemetics Laxatives Antidiarrheal drugs, Gastrointestinal Pharmacology Acid production: 2.5 L per day Isotonic HCl solution pH < 1 Produced by parietal cells Mucus production: Produced by mucus-secreting cells Also produce bicarbonate, which becomes trapped in the mucus layer => pH gradient across the mucus layer (can become destroyed by alcohol), Gastrointestinal Pharmacology Antacids: Weak bases: Aluminum hydroxide Cause constipation Magnesium hydroxide Cause diarrhea => often combined Usally taken 5-7 times per day, Gastrointestinal Pharmacology Antacids: Histamine stimulates acid production by parietal cells Mast cells produce a steady basal level of histamine,which increases in response to gastrin or acetylcholine Parietal cells express histamine H2 receptors => H2 receptor blockers: Cimetidine (Tagamet) First H2-blocker available Inhibits P450 => Drug interaction Ranitidine (Zantac) Does not inhibit P450 => fewer side effects Nizatidine (Axid) Famotidine (Pepcid), Gastrointestinal Pharmacology Antacids: Proton pump inhibitors: Irreversibly inhibit the H+/K+ - ATPase in gastric parietal cells Drugs are inactive at neutral pH, but since they are weak bases,are activated in the acidic stomach milieu => restricted activity Acid production abliterated for 24-48 hours Omeprazole (Prilosec) Lansoprazole (Prevacid) Esomeprazole (Nexium) Rabeprazole, Gastrointestinal Pharmacology Gastroesophageal reflux disease (GERD): Backflowof stomach acid into the esophagus Esophagus is not equipped to handle stomach acid => scaring Usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone (MI often mistaken for GERD !) Pharm II Exam 3 (NURSING) Pharmacology of the GITPharmacology of the GIT systemsystem 2. Click here to review the details. Authors Miguel Saps 1 , Adrian Miranda 2 Affiliations 1 . With thematic analysis, 18 cases are systematically coded, and several findings are discovered. Sal is a 56 y/o male who the NP has seen on many occasions in the clinic. Study materials This presentation On-line book (e-book): The Gastrointestinal System at a Glance by S. Keshav Access via Voyager, make sure you are logged into Athens Chapters 26-34, 47 about mechanism and treatment of the most common GI disorders You can print the relevant pages (20) Other text books and reviews Nausea and vomiting : It also increases the release of histamine from the enterochromaffin-like (ECL) cells in the fundus of the stomach, and of gastrin in the gastric antrum. Cerca nel pi grande indice di testi integrali mai esistito. QINLOCK is also approved for fourth-line GIST in Australia, Canada, China, and Hong Kong. Simethicone is an anti-foaming agent that decreases the surface tension of gas bubbles , causing them to combine into larger bubbles in the stomach that can be passed more easily by burping, Notice that the aluminum containing antacid can neutralize 3 hydrochloric acid molecules at a time. LECTURE OutlineLECTURE Outline REVIEW the Anatomy of the GIT REVIEW the physiology of the GIT Review common GI drugs in the following categories: 1. Chapter 19 Gastrointestinal Pharmacology Dawn Merton Boothe Chapter Outline DRUGS THAT TARGET APPETITE OR CALORIC BALANCE APPETITE STIMULANTS Cachexia APPETITE SUPPRESSANTS AND ANTI-OBESITY DRUGS EMETICS AND ANTIEMETICS The Vomiting Reflex Emetics Antiemetics ANTIULCER DRUGS Pathophysiology of Gastrointestinal Ulceration Cytoprotective Drugs The first, dyspepsia, is also approved for fourth-line GIST in Australia, Canada, China and... 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