acid controlling drugs (SG 2) Flashcards
stomach secretions
hydrochloric acid
bicarbonate
pepsinogen
intrinsic factor
mucus
prostaglandings
stomach secretion functions
HCI ➺ released by parietal cells to aid digestion and prevent infection (pH 1-4)
BICARB ➺ enzyme precursor to pepsin that helps digest protein
INF ➺ facilitates absorption of vitamin b12
MUCUS ➺ protective lining of HCI + digestive enzymes
PROSTAGLANDIN ➺ anti-inflammatory / digestive enzymes that stimulate mucus secretion
stomach glands and their cells
GLANDS: cardiac, pyloric, gastric
GASTRIC GLAND CELLS: parietal (HCI), chief (secretes pepsin for protein breakdown, mucous (mucus secretion)
what stimulates HCI production?
chocolate
alcohol
stress
food
caffeine
large, fatty meals
*important to regulate because it can cause hyperacidity / breakdown in the stomach
antiacids
neutralize stomach acid and promote gastric mucosal defense mechanisms
contains SALTS ➺ Al (better for patients with renal failure), Mg, Ca, Na
contains SIMETHICONE (antiflatulent)
stimulates production of mucus, bicarb (buffer), prostaglandins (prevents activation of PP)
indications for AA
peptic ulcers
gastritis
gastric hyperacidity
heartburn
contraindications / adverse effects of AA
allergies
Ca ➺ renal failure, stone formation, hyperacidity, constipation, gas, belching (simethicone)
Mg ➺ renal failure, diarrhea
Al ➺ constipation
Na ➺ HF, HT, renal failure
AA interactions
reduces absorption of other drugs
CHELATION ➺ inactivation of other drugs due to insoluble complexes
increased stomach and urinary pH
types of AA
Mg ➺ gariscon, maalox + mylania (Al + Mg), hydroxide salt, milk of mag
Ca ➺ carbonate salt (tums)
Na Bicarb ➺ alka-seltzer, segerid
Al ➺ aluminum carbonate, hydroxide salt
h2 antagonists
reduce acid secretions; blocks the h2 receptors in the parietal cells (red. H+ ion secretion, inc. pH in stomach)
popular for acid-related disorders
indication for H2
GERD
PUD
erosive esophagitis
upper GI bleeding
Z-E syndrome
h2 medications
end in -DINE
cimentidine
nizadine
famotidine
rantidine (no longer used)
adverse effects + interactions of h2
ADVERSE EFFECTS:
CNS ➺ confusion, disorientation
CIMENTIDINE ➺ impotence, gynecomastia
FAMOTIDINE ➺ thrombocytopenia
INTERACTIONS:
smoking decreases efficacy
gap time of 1-2 hours before taking AA due to absorption issues
proton pump inhibitor
inhibits proton pump in parietal cells (important for releasing H ions for HCI production) by binding to the H+ / K+ enzyme to prevent the movement of hydrogen ions from reaching the parietal cells
*TAKE ON EMPTY STOMACH
indications for PPI
used a lot for ulcerations (duodenal, gastric, PUD)
erosive esophagitis
GERD (if not responding to H2)
Z-E syndrome
NSAID / H. pylori ulcers
stress ulcer prophylaxis
PPI medications
end in -ZOLE
lansoprazole
omperazole
radeprazole
pantoprazole
adverse effects of PPI
wrist / hip / spine fractures
c. diff infections
pneumonia
decreased levels of Mg
systemic lupus erythematous
drug interactions for PPI
increased effect of diazepam / phenotypin / warfarin (bleeding)
decreased effect of clopidrogel
reduced absorption of ampicillin, iron salts, digoxin, ketocon
sucralfate
used as a mucosal protectant by binding to the bases of ulcers and creating a protective barrier
it decreases the secretion of pepsin, which can cause exacerbations of ulcers due to breakdown of protein
INDICATION:
active stress ulcers / PUD, chronic renal failure due to phosphate binding ability
SE:
dry mouth, constipation, NV
* DO NOT GIVE WITH OTHER MEDS
misoprostol
prostaglanding E analogue that helps increase gastric acid and mucus secretion; it lowers the incidence of gastric ulcers with patients taking NSAIDs
simethicone
antiflatulent drug decreasing gas discomfort / pain; it alters the elasticity of mucus coated gas bubbles
AA reminders
give with 8 ounces of water to increase absorption
give 1-2 hours before any other meds
assess for electrolyte imbalance, RF, HF, GI obstruction, pregnancy
