A: Alimentary tract and metabolism
ATC group A covers the alimentary tract, also called the digestive or GI tract, and metabolism: from antacids and laxatives to diabetes drugs and vitamins.
Drugs acting on the gut, on metabolism and on nutrition, from mouthwashes to insulins.
Insulin was first given to a patient in January 1922, at Toronto General Hospital. The patient, Leonard Thompson, was 14 years old and seriously ill with diabetes. The first injection of pancreatic extract lowered his blood glucose only slightly, had no effect on the buildup of acidic ketones in his blood (ketoacidosis) and left a collection of pus without infection (sterile abscess). A second series of injections on 23 January brought his blood glucose down from 520 to 120 mg/dL and cleared the ketones from his urine. Part of the credit goes to the biochemist James Collip, who had developed a new extraction and concentration protocol [1].
| Description | In plain terms | Example drug | |
|---|---|---|---|
| A01 | Stomatological preparations | of the mouth and teeth | Chlorhexidine (A01AB03) / sodium fluoride (A01AA01) |
| A02 | Drugs for acid related disorders | Omeprazole (A02BC01) / pantoprazole (A02BC02) | |
| A03 | Drugs for functional gastrointestinal disorders | gut cramp and motility problems without structural disease | Metoclopramide (A03FA01) / butylscopolamine (A03BB01) |
| A04 | Antiemetics and antinauseants | stop vomiting and nausea | Ondansetron (A04AA01) / aprepitant (A04AD12) |
| A05 | Bile and liver therapy | Ursodeoxycholic acid (A05AA02) / obeticholic acid (A05AA04) | |
| A06 | Drugs for constipation | Macrogol (A06AD15) / lactulose (A06AD11) | |
| A07 | Antidiarrheals, intestinal antiinflammatory/antiinfective agents | Mesalazine (A07EC02) / loperamide (A07DA03) | |
| A08 | Antiobesity preparations, excl. diet products | Orlistat (A08AB01) / bupropion and naltrexone (A08AA62) | |
| A09 | Digestives, incl. enzymes | replace missing digestive enzymes | Pancreatin, indexed as multienzymes (A09AA02) |
| A10 | Drugs used in diabetes | Metformin (A10BA02) / dapagliflozin (A10BK01) | |
| A11 | Vitamins | Colecalciferol (A11CC05) / thiamine (A11DA01) | |
| A12 | Mineral supplements | Calcium carbonate (A12AA04) / potassium chloride (A12BA01) | |
| A13 | Tonics | old general-strengthening preparations, not evidence-based | No substance to name: A13A carries no level 5 substances, a residual historical category. |
| A14 | Anabolic agents for systemic use | tissue-building steroids acting body-wide | Nandrolone (A14AB01) / oxandrolone (A14AA08) |
| A15 | Appetite stimulants | No substance to name: A15 is subdivided no further and holds no substances or DDDs. | |
| A16 | Other alimentary tract and metabolism products | leftovers: mostly rare inherited metabolic disease drugs | Nitisinone (A16AX04) / sapropterin (A16AX07) |
References
[1]
Vecchio I, Tornali C, Bragazzi NL, Martini M. The Discovery of Insulin: An Important Milestone in the History of Medicine. Front Endocrinol 2018;9:613. https://doi.org/10.3389/fendo.2018.00613.