Saturday, August 7, 2010


Q: Despite being an old player Sucralfate is still very well indicated in stress ulcer prophylaxis. What is the mechanism of action of sucralfate?

Answer: Sucralfate act by multiple mechanisms

1. Sucralfate acting locally that in an acidic environment , reacts with hydrochloric acid in the stomach to form a cross-linking, viscous, paste-like material capable of acting as an acid buffer for as long as 6 to 8 hours after a single dose.
2. It also attaches to proteins on the surface of ulcers, such as albumin and fibrinogen, to form stable insoluble complexes. These complexes serve as protective barriers at the ulcer surface, preventing further damage from acid, pepsin, and bile.

3. It prevents back diffusion of hydrogen ions.

4. It adsorbs both pepsin and bile acids.

5. Sucralfate also stimulates the increase of prostaglandin E2, epidermal growth factors (EGF), bFGF, and gastric mucus.

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