Acid-Controlling Drugs Flashcards

1
Q

Peptic Ulcer Disease

A

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

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2
Q

H. Pylori

A

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

First-line therapy includes a 10 to 14 day course of a proton pump inhibitor and antibiotics

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3
Q

Stress-Related Mucosal Damage

A

GI lesions are common in ICU patients

Factors include decreased blood flow, mucosal ischemia, hypoperfusion, and reperfusion injury

NG tubes and ventilators predispose patients to GI bleeding

Histamine receptor-blocing drug or a proton pump inhibitor are given for prevention

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4
Q

Antacid Mechanism of Action

A

Do not prevent overproduction of acid but instead help to neutralize stomach acid secretions

Promote gastric mucosal defense mechanisms

Stimulate secretion of mucus, bicarbonate, and prostaglandins

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5
Q

Antacid Drug Effects

A

Reduction of pain

Increases resistance of stomach lining, increases tone of cardiac sphincter, inhibits the protein-digestion ability of pepsin

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6
Q

Aluminum Salt Antacids

A

HAVE CONSTIPATING EFFECTS

Often used with magnesium to counteract constipation

Often recommended for patients with renal disease

MAALOX, MYLANTA

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7
Q

Magnesium Salt Antacids

A

COMMONLY CAUSE DIARRHEA

DANGEROUS WHEN USED WITH RENAL FAILURE (failing kidney cannot excrete extra magnesium)

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8
Q

Calcium Salt Antacids

A

MAY CAUSE CONSTIPATION, kidney stones

Not recommended for patients with renal disease

Long duration of action

TUMS (CALCIUM CARBONATE)

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9
Q

Sodium Bicarbonate Antacids

A

Highly soluble, buffers the acidic properties of HCl

Quick onset, short duration

May cause metabolic alkalosis

May cause problems in patients with heart failure, hypertension, or renal insufficiency

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10
Q

Antiflatulents

A

Used to relieve painful symptoms associated with gas

SIMETHICONE (MYLICON)

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11
Q

Antacid Drug Interactions

A

Reduces the ability of the other drug to be absorbed in the body

Chelation (chemical binding/inactivation of other drug, produces insoluble complexes –> reduced drug absorption)

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12
Q

Histamine 2 Receptor Antagonists

A

Reduce acid secretion

Most popular drugs for treatment of acid-related disorders

CIMETIDINE (TAGAMET), FAMOTIDINE (PEPCID)

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13
Q

Histamine 2 Antagonist Mechanism of Action

A

Block the H2 receptor of acid-producing parietal cells

Increase the pH of the stomach

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14
Q

Indications for Histamine 2 Antagonists

A

GERD, peptic ulcer disease, erosive esophagitis, adjunct therapy to control upper GI bleeding, Zollinger-Ellison syndrome

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15
Q

Adverse Effects of H2 Antagonists

A

CENTRAL NERVOUS SYSTEM ADVERSE EFFECTS IN ELDERLY PATIENTS INCLUDE CONFUSION AND DISORIENTATION (ESPECIALLY CIMETIDINE)

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16
Q

Proton Pump Inhibitors

A

Parietal cells release positive hydrogen ions (protons) during HCl production

H2 BLOCKERS AND ANTIHISTAMINES DO NOT STOP THE ACTION OF THIS PUMP

OMEPRAZOLE (PREVACID) AND PANTOPRAZOLE (PROTONIX)

17
Q

Mechanism of Action of Proton Pump Inhibitors

A

Irreversibly bind to H+/K+ ATPase enzyme to prevent movement of hydrogen ions from the parietal cell into the stomach

ALL GASTRIC ACID SECRETION IS TEMPORARILY BLOCKED

18
Q

Indications for Proton Pump Inhibitors

A

GERD, erosive esophagitis, short-term treatment of GI bleeding, Zollinger-Ellison syndrome, NSAID-induced ulcers, stress ulcer prophylaxis, H. pylori ulcers

19
Q

Adverse Effects of Proton Pump Inhibitors

A

OSTEOPOROSIS AND RISK OF WRIST, HIP, AND SPINE FRACTURES IN LONG-TERM USERS

20
Q

Miscellaneous Acid-Controlling Drugs

A

SUCRALFATE (CARAFATE)
MISOPROSTOL (CYTOTEC)

Cytotec is useful in the treatment of NSAID-induced ulcers and should not be given to pregnant women, but can be used at term pregnancy to help induce labor

21
Q

Sucralfate (Carafate)

A

Cytoprotective drug used for stress ulcers and peptic ulcer disease

FORMS A PROTECTIVE BARRIER OVER BASE OF ULCERS

MAY IMPAIR ABSORPTION OF OTHER DRUGS (GIVE OTHER DRUGS AT LEAST TWO HOURS BEFORE)

22
Q

Nursing Implications for Antacids

A

LONG-TERM SELF-MEDICATION WITH ANTACIDS MAY MASK SYMPTOMS OF SERIOUS UNDERLYING DISEASES, SUCH AS MALIGNANCY OR BLEEDING ULCERS

23
Q

Nursing Implications for H2 Antagonists

A

Assess for impaired renal or liver function

Take 1-2 hours before antacids

Use with caution in those who are confused, disoriented, or elderly

24
Q

Nursing Implications for Proton Pump Inhibitors

A

MAY INCREASE SERUM LEVELS OF DIAZEPAM AND PHENYTOIN

May increase chance for bleeding with Warfarin