Sucralfate (Carafate) achieves a therapeutic effect by:
A. Neutralizing gastric acid.
B. Enhancing gastric absorption.
C. Forming a protective barrier around gastric mucosa.
D. Inhibiting gastric acid secretion.
Correct Answer: C. Forming a protective barrier around gastric mucosa.
Sucralfate has a local effect only on the gastric mucosa. It forms a paste-like substance in the stomach, which adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.
Option A: The antacids reduce the acid reaching the duodenum by neutralizing the acid present in the stomach. The salts’ mechanism of neutralization of acid varies, and each salt has a different mechanism with the ultimate goal of acid neutralization.
Option B: Drugs that affect gastric emptying (eg, parasympatholytic drugs) affect the absorption rate of other drugs. Food may enhance the extent of absorption for poorly soluble drugs (eg, griseofulvin), reduce it for drugs degraded in the stomach (eg, penicillin G), or have little or no effect.
Option D: H2RAs decrease gastric acid secretion by reversibly binding to histamine H2 receptors located on gastric parietal cells, thereby inhibiting the binding and action of the endogenous ligand histamine. H2 blockers thus function as competitive antagonists.
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