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NURS 252 (Pharmacology 2) > Acid-Controlling Drugs > Flashcards

Acid-Controlling Drugs Flashcards

1
Q

What are the 6 substances that the stomach secretes?

A

HCL
Bicarbonate
Pepsinogen
Intrinsic factor
Mucus
Prostaglandins

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2
Q

What are the 3 glands of the stomach?

A

Cardiac
Pyloric
Gastric

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3
Q

What is the function of parietal cells?

A

Produce and secrete HCL

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4
Q

What is the function of chief cells?

A

Secrete pepsinogen which becomes pepsin when activated by exposure to acid.
Pepsin breaks down proteins

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5
Q

What is the function of mucous cells?

A

They are mucus-secreting cells that provide a protective mucus coat.
It protects against self-digestion by HCL and digestive enzymes

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6
Q

What is the function of HCL

A

Maintains stomach pH at 1 to 4

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7
Q

What is peptic ulcer disease?

A

Gastric or duodenal ulcers that involve digestion of the GI mucosa by pepsin

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8
Q

What is Helicobacter pylori (H. pylori)

A

Bacterium found in the GI tract of 90% of patients with duodenal ulcers and 70% of those with gastric ulcers

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9
Q

What is triple therapy for H. pylori?

A

7-14 day course of a PPI, clarithromycin and either amoxicillin or metronidazole.

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10
Q

What is quadruple therapy for H. pylori?

A

PPI, bismuth subsalicylate, tetracycline and metronidazole

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11
Q

What are factors for stress-related mucosal damage?

A

Decreased blood flow, mucosal ischemia, hypoperfusion, and reperfusion injury

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12
Q

What procedures predispose patients to GI bleeding?

A

Passing nasogastric tubes and placing patients on ventilators

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13
Q

What is given for prevention of stress-related mucosal damage?

A

Antihistamine or a PPI

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14
Q

What are the 3 types of acid-controlling drugs?

A

Antacids, H2 antagonists, PPIs

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15
Q

What are antacids?

A

Basic compounds used to neutralize stomach acid

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16
Q

What counteracts the constipating effects of aluminum and calcium?

A

Magnesium

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17
Q

Calcium antacids may lead to ___________________________

A

Development of kidney stones and increased gastric acid secretion

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18
Q

T/F: Patients with renal failure can use antacids that contain magnesium

A

False: They must be avoided in patients with renal failure

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19
Q

Sodium bicarbonate has a _____ onset but a ______ duration of action

A

Quick, Short

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20
Q

What is the MOA of antacids?

A

Promotion of gastric mucosal defensive mechanisms
Stimulate secretion of:
Mucus: Barrier against HCL
Bicarbonate: Buffer HCL
Prostaglandins: Inhibit proton pump.

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21
Q

What are the drug effects of antacids?

A

Reduction of pain and reflux

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22
Q

How does reducing acidity reduce pain?

A

Inhibition of protein-digesting ability of pepsin
Increases resistance of the stomach lining to irritation
Increasing the tone of the cardiac sphincter

23
Q

Raising the pH by ____ point neutralizes ____ of the gastric acid

A

1, 90%

24
Q

What are the indications of antacids?

A

Acute relief of symptoms associated with peptic ulcer, gastritis, gastric hyperacidity and heartburn

25
Q

What are the contraindications of antacids?

A

Severe renal failure
GI obstruction

26
Q

Name 5 aluminum salts and why are they recommended for patients with renal disease?

A

Antacid plus, Diovol, Gelusil, Maalox, Multiaction
It’s more easily excreted

27
Q

Name 2 magnesium salts

A

MgOH, Mineral oil

28
Q

Name 2 calcium salts and what can its long duration of action cause?

A

Calcium carbonate and simethicone
Increased gastric acid secretion (hyperacidity rebound)

29
Q

What is an example of an antiflatulent?

A

Simethicone

30
Q

What are the adverse effects of antacids?

A

Aluminum and calcium: Constipation
Magnesium: Diarrhea
Calcium: Kidney stones, rebound hyperacidity
Calcium carbonate: Gas and belching

31
Q

What are some possible interactions for antacids?

A

Adsorption of other drugs to antacids which reduces the ability to be absorbed into the body
Chelation(chemical binding or inactivation of another drug which produces insoluble complexes resulting in reduced absorption)
Increased stomach and urinary pH

32
Q

When should other drugs be taken to prevent interactions with antacids?

A

1-2 hours before or after antacids

33
Q

What are H2 receptor antagonists and name 2 types

A

They reduce acid secretion
Ranitidine HCL
Famotidine

34
Q

What is the MOA of H2 antagonists?

A

Block the H2 receptor of parietal cells reducing hydrogen secretion and increasing the pH of the stomach

35
Q

What are the indications of H2 antagonists?

A

GERD
Peptic ulcer
Erosive esophagitis
Adjunctly to control upper GI bleeding
Zollinger-Ellison syndrome

36
Q

What are the adverse effects of H2 antagonists?

A

Confusion
Disorientation
ED
Gyne
Thrombocytopenia

37
Q

What are possible interactions with H2 antagonists?

A

They may inhibit the absorption of drugs that require an acidic GI environment for absorption
Smoking can decrease effectiveness

38
Q

T/F: Antacids should be taken before H2 receptor antagonists

A

F: H2 receptor agonists should be taken 1 hour before antacids

39
Q

What is the proton pump?

A

Parietal cells releasing positive Hydrogen ions (protons) during HCL production

40
Q

Name 3 types of PPIs

A

Lansoprazole
Omeprazole
Pantoprazole

41
Q

What is the MOA of PPIs?

A

They bind to H-K-ATPase enzyme which prevents the movement of hydrogen ions from the parietal cell into the stomach and it results in achlorhydria

42
Q

What is achlorhydria and how is it reversed?

A

All gastric secretion is temporarily blocked
The parietal cell must synthesize new H-K-ATPase

43
Q

What are the indications of PPIs

A

GERD
Erosive esophagitis
Short-term for duodenal and benign gastric ulcers
Zollinger-Ellison syndrome
NSAID-induced ulcers
Stress ulcer prophylaxis
Treatment of H. pylori-induced infections

44
Q

What are the adverse effects of PPIs?

A

Possible predisposition to GI infections: C. diff
Osteoporosis and risk of wrist, hip, and spine fracture if used long-term
Pneumonia
Depletion of Mg

45
Q

What are possible drug interactions with PPIs

A

Increase serum levels of diazepam and phenytoin
Warfarin (bleeding)
Interference with absorption of ketoconazole, ampicillin, iron salts and digoxin
Copidogrel: MI and death
Sucralfate and food may decrease absorption of the PPIs

46
Q

When should PPIs be administered?

A

On an empty stomach

47
Q

Name 3 miscellaneous acid-controlling drugs

A

Sucralfate
Misoprostol
Simethicone

48
Q

What is sucralfate?

A

A cytoprotective drug used for stress ulcers and PUD
Binds to the base of ulcers and forms a protective barrier, protecting them from pepsin which breaks down proteins
May cause nausea, constipation and dry mouth
Do not administer with other medication; give other drugs at least 2 hours before
Binds with phosphate so can be used in renal failure to reduce phosphate levels

49
Q

What is misoprostol?

A

Its a prostaglandin E analogue
Prostaglandins cytoprotective activity include: protecting gastric mucosa from injury, promoting local cell regeneration and maintaining mucosal blood flow
Used for prevention of NSAID-induced gastric ulcers
Increased doses my produce abdominal cramps and diarrhea

50
Q

What is the MOA of simethicone?

A

Alters elasticity of mucus-coated gas bubbles, breaking them down into smaller ones

51
Q

What is a consideration regarding antacids and enteric-coated medications?

A

May cause premature dissolving resulting in stomach upset

52
Q

Antacids must be administered with __________ of water

A

240 mL

53
Q

What PPI capsules can be given via NG tubes?

A

Pantoprazole

NURS 252 (Pharmacology 2) (23 decks)

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