Acid Reducing + Bowel Medications

Question 1

The stomach secretes…

Answer 1

-Hcl
-bicarb
-intrinsic factor
-mucus
-prostaglandins

Question 2

The pyloric cells are the most _____ and ______ when it comes to acid control

Answer 2

numerous, important

Question 3

Cells of the gastric gland and their functions

Answer 3

-Parietal (produce/secrete HCL)
-Chief (secrete pepsinogen –> pepsin = protein breakdown)
-Mucous (secrete protective mucus coat)

Question 4

Untreated gerd can lead to

Answer 4

esophageal cancer

Question 5

1st line treatment of H pylori

Answer 5

-10-14 days of PPI, clarithromycin, amoxicillin, metronidazole OR
-PPI, bismuth, tetracycline, metronidazole

Question 6

Stress related mucosal damage is prevented with:

Answer 6

-histamine receptor blockers
-PPI

Question 7

Antacids are made up of…

Answer 7

Al, Ca, Mg, Na salts

Question 8

Antacid MOA, interactions

Answer 8

-neutralize acid
-stim mucus
-stim prostaglandins
-stim bicarb
interacts w/: quinolones, cipro, levofloxacin (certain antibiotics)
NO for kidney disesase

Question 9

H2 receptor antagonists (suffix, MOA, SFX)

Answer 9

-famotidine, cimetidine (ranitidine)
-MOA: block H2 receptors
-SFX: CNS adverse for elderly, cime = impotence, gynecomastia
-take hour before meals, 2 hours before after PPI

Question 10

PPI (suffix, use, MOA, considerations/SFX)

Answer 10

-“prazoles”
-use: GERD, esophagitis, ulcers, H pylori (w/ antibiotic)
-MOA: bind to H-K-ATPase pump, block acid secretion
-Consid: take daily, take on empty stomach before eating, -SFX: long term –> osteoporosis, increases warfarin effects

Question 11

Sucralfate MOA, use, consids

Answer 11

-ulcers
-binds to base of ulcers and forms protective barrier
-give hour before meals, not at same time as PPIs (2hrs before/after)

Question 12

Misoprostol MOA, use

Answer 12

-inhibits acid secretion, protects mucus
-prostaglandin analogue
-acid controlling drug
-NO w pregnancy

Question 13

Simethicone use

Answer 13

increase fartin n burpin, reduces gas pain

Question 14

Chronic diarrhea lasts for

Answer 14

2-4 weeks

Question 15

Adsorbants (ex, MOA, consids)

Answer 15

-bismuth, cholestyramine
-MOA: bind to toxic agent
-can affect drug absorption, darkening of tongue/stool, platelet aggregation

Question 16

Antidiarrheal anticholinergic (ex, MOA/use, SFX). For ____ diarrhea

Answer 16

-belladonna alkaloids
-MOA: slow GI motility, drying stool–reduce gastric secretions
-SFX: urinary retention, brady, hypotension, headache, dizzy
-for severe diarrhea

Question 17

Loperamide, diphenoxylate, codeine are _______ ________ opioid like drugs. How do they work?

Answer 17

-anti diarrheal
-MOA: sloowwww: decrease motility, reduce pain, increase transit time through bowel

Question 18

Probiotics like bacid (lactobacillus) are used when?

Answer 18

-ex: C diff (when there’s a need to supply missing bacteria, suppress growth of diarrhea-causing bacteria)

Question 19

Digestion usually takes ___ - ____ hours

Answer 19

24-36

Question 20

T/F: bulk laxatives can be used long term

Answer 20

T! Other laxatives cannot

Question 21

Citrucel and metamucil are _____ _______ _______. What’s their MOA, and what would you tell a pt taking these?

Answer 21

-Bulk forming laxatives.
-MOA: pull excess water from body–>stool, distend to initiate bowel activity
-take w/ lotsa water!

Question 22

Docusate and mineral oil are ______ laxatives contraindicated with ________ ________. They work by bringing water and ____ into stool

Answer 22

-emollient laxatives
-intestinal obstruction
-fat

Question 23

PEG (polyethylene glycol), sorbitol, glycerin, lactulose are ________ laxatives. What’s their MOA?

Answer 23

-hyperosmotic
-MOA: increase fecal water content –> increased peristalsis

Question 24

_______ (laxative) is gentle and often given to children.

Answer 24

Glycerin

Question 25

Mg hydroxide, Mg citrate are ______ laxatives. They draw ______ into the ______ and are contraindicated for kidney failure.

Answer 25

-saline
-draw water into intestines

Question 26

Stimulant laxatives ex, MOA

Answer 26

-senna, bisacodyl
-MOA: increase peristalsis via intestinal nerve stimulation

Question 27

Peripheral acting opioid antagonists (Ex, MOA)

Answer 27

-methylnaltrexone, alvimopan
-MOA: block opioid receptors in bowel
-strict regulations for use–opioids or bowel resections

Question 28

Lubiprostone and Alosetron treat _____. What types of _____ are they used for specifically? What are their MOAs?

Answer 28

-IBS
-lubiprostone (IBS-C): actives Cl channels
-alosetron (IBS-D): SS5HT3 antagonist

Question 29

alosetron carries a black box warning for what?

Answer 29

severe GI side effects