Acid-controlling Drugs Flashcards
What does mucus cells secrete?
Mucus
HCO3
What does parietal cells secrete?
Intrinsic factor
HCl
What do ECL cells secrete?
Histamine
What do chief cells secrete?
Pepsinogen
Gastric lipase
What do D-cells secrete? What is another name for it?
Somatostatin
GHIH
What do G-cells secrete?
Gastrin
What is the purpose of HCO3?
Buffers gastric acid
What is the purpose of intrinsic factor?
Activates pepsin
What is the purpose of pepsinogen?
Digests proteins
What is the purpose of somatostatin?
Inhibits gastric acid secretion
What is the main organ that makes HCO3?
Pancreas
What are the 3 hormones that increase acid production?
Histamine
Gastrin
ACh
What hormone decreases acid production?
Somatostatin
What is important for mucus production?
Prostaglandins
What 2 things protect the mucosal cells in the stomach?
Mucus
Rapid turnover of epithelial cells
Where do peptic ulcers commonly occur?
Stomach
Duodenal
What are 3 things that can cause peptic ulcers?
H. pylori
Hyperacidity
Decreased production
What vital sign can change w/ peptic ulcers?
Decrease in BP
What food inhibits H. pylori?
Broccoli
What medications can cause ulcers?
NSAIDs
Corticosteroids
What changes in the 2 autonomic nervous systems can cause ulcers?
Increased parasympathetic
Decreased sympathetic
What drinks, things you put in your mouth and FHx can cause ulcers?
Alcohol
Smoking
FHx of ulcers
What are the Sx of ulcers?
Heartburn N/V Loss of appetite Hemtemesis Melena
What medication has the greatest ability to decrease stomach acid?
PPIs
What is H. pylori sensitive to?
Amoxicillin
Tetracycline
Metronidazole
Clarithromycin
What medication is found in Helidac?
Tetracycline
Metronidazole
Bismuth
What medication is found in Prevpac
Lansoprazole
Clarithromycin
Amoxicillin
What are the 2 things bismuth causes to H.pylori?
Lysis of H. pylori
Decreased binding of bacteria
What are 2 combination drugs that are used to Tc H. Pylori?
Helidac
Prevpac
What does GERD stand for?
Gastroesophageal reflux disease
What Sx usually comes after meals w/ GERD?
Heart burn
What makes pt position makes GERD worse? What should you never do to a pt w/ GERD?
GERD gets worse when lying down
Never raise the foot of the bed for a pt w/ GERD
What chemicals from GERD can harm to esophagus and cause strictures?
Pepsin
HCl
If GERD doesn’t get Tx what condition can occur? What happens?
Barrett esophagus?
Squamous esophageal cells are converted into columnar cells
What are the 3 causes of GERD?
Inappropriate relaxation of LES
Increase Acid production
Large meals
What can cause relaxation of LES?
Fat Onions Coffee Caffeine CNS depressants Mints
What can a hiatal hernia cause an increase risk of?
GERD
What hat are 5 lifestyle Tx for GERD?
Small meals Decrease offending foods Weight loss Elevate head of the bed Stop eating w/in 3 hours of sleep
What is the pros and cons of antacids?
Pro=immediate relief
Con= acid rebound
What is the pro and con of H2 blockers?
Pro=long lasting
Con= takes 30min for pain relief
What H2 blockers can be taking w/ any medication?
Famotidine(Pepcid)
Why is cometidine(Tagamet)?
H2 blocker
What is famotidine(Pepcid)?
H2 blocker
What is nizatidine(Axid)?
H2 blocker
What should not be taken w/ an antacid?
H2 blockers
What are the indications for H2 blockers?
GERD Chronic use of NSAIDs Ulcers Systemic mastocytosis Zollinger-Ellison syndrome
What is systemic mastocytosis?
Mast cells in GI that are secreting histamine
What is Zollinger-Ellison syndrome?
Gastrin secreting tumor
How long must you wait between taking a H2 blocker and an antacid so they don’t mix?
1 hr
What is impotence?
Erectile dimysfunction
What conditions are reversible when taking H2 blockers?
Impotence
Gynecomastia
Why is misoprostol(cytotec)? MOA?
Prostaglandin agonist
Increases the secretion of HCO3 and mucus
What does abortifacient?
To cause an abortion
What can misoprostol(cytotec) cause in a pregnancy? How?
An abortion
Causes uterine contractions
What do PPIs end in?
-prazole
What are PPIs indicated for?
Ulcer management
GERD
Zollinger-Ellison syndrome
What drug can reduce the effectiveness of plavix?
PPIs
Long term use of PPIs can cause what? Why?
C. diff diarrhea
Because of the inhibition of HCl production causes increase pH which doesn’t kill spores in stomach
What do prokinetic drugs do?
D2 antagonist
What is metoclopramide(Reglan)? What does it target? When is it given?
Prokinetic drug(D2 antagonist)
Targets upper GI
Given before meals
What are the 2 anticholinergics for ulcers? What is their MOA?
Hyoscyamine(Levsin)
Glycopyrrolate(Robinul)
Decrease acid secretion
Decrease peristalsis
What are the indications for anticholinergics(antispasmodics)?
IBS
Diarrhea
Diverticulitis
What type of antacid cause constipation?
Al and Ca containing antacid
What type of antacid cause diarrhea?
Mg containing antacid
What are some ADR for antacids?
Acid rebound
Increase sodium
Hypercalcemia
Drug interaction
What should you not take w/ an antacid(3)?
Oral drugs
Tetracycline
H2 blockers
How many hours after a meal should you take an antacid?
1-3 hrs
What is sucralfate(Carafate)? What ulcers does it specifically Tx? MOA? Systemic action? Does it alter pH?
Barrier enhancer
Used to Tx duodenal ulcers
Binds to proteins of damages cells and provides protective layer over damaged mucosa
No systemic action
Does not alter pH
What do H2 blockers end in?
-tidine
