[Sucralfate: development of a new concept of anti-ulcer treatment. Review of its pharmacodynamic properties].

Sucralfate, a new drug for peptic ulcer disease, is a sulfated disaccharide, basic aluminium sucrose sulfate complex. Its development is the result of a lot studies on sulfated polysaccharides, well-known for their antipeptic activities and also, for their anticoagulant activities. Sucralfate is free from toxicity, including anticoagulant activity like all the disaccharides and is an antiulcer agent better than other drugs of its chemical family. Sucralfate is characterized by the following properties: When exposed to gastric acid, it turns into a viscous and adhesive substance which binds selectively and durably to the lesions of gastric and duodenal mucosa. The affinity of sucralfate for defective mucosa is explained by the formation of electrostatic bindings between the negatively charged sucralfate polyanions and the positively charged proteins exuding from lesions. Barrier effect to the penetration of acid, pepsin and bile salts. Interference with binding of the pepsin with the lesions. Adsorption of pepsin and bile salts. Protection of normal mucosa weakness of the reaction with acid. Possibility of stimulation of synthesis of local prostaglandins. Sucralfate is slightly absorbed by the digestive mucosa. That explains the absence of systemic effects and of toxicity. The pharmacodynamic effects corroborated by good therapeutical results make sucralfate an original antiulcer drug which leads a new way in the treatment of peptic disease.