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Pharm > Anti-ulcers > Flashcards

Anti-ulcers Flashcards

1
Q

Drug type for Sodium Bicarbonate

A

Systemic antacid, anti-ulcer

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2
Q

Hydrochloric acid release is influenced by what three biochemical mediators?

A

histamine
gastrin
acetylcholine

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3
Q

_____ ulcers are the result of gastric acid secretions in the esophagus as a result of a defective cardiac sphincter

A

ESOPHAGEAL

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4
Q

_____ ulcers occur TEN times more frequently than gastric or esophageal ulcers and are due to the hypersecretion of acid from the stomach.

A

DUODENAL

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5
Q

What are three causes of duodenal ulcers?

A

insufficient buffers.
defective pyloric sphincter.
hypermotile stomach.

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6
Q

With a _____ ulcer, pain will occur 2-3 hours after eating

A

duodenal

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7
Q

If pain occurs 30 min to 1.5 hours after eating, this suggests WHAT type of ulcer?

A

GASTRIC

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8
Q

____ ____ is released by the parietal cells of the stomach.

A

hydrochloric acid

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9
Q

What is the goal pH of the stomach?

A

2-5

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10
Q

Which digestive enzyme is activated at a pH of 2?

A

pepsin

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11
Q

At what pH will pepsin activity decline?

A

5

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12
Q

What are some predisposing factors in Peptic Ulcer Disease?

A

mechanical disturbances
environmental factors
drugs

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13
Q

Which GRAM-NEG bacillus is a cause of many peptic ulcers?

A

Helicobacter pylori

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14
Q

Treatment for peptic ulcers caused by H. pylori will usually include…

A

dual, triple, or quadruple drug therapy for 7-14 days.

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15
Q

WHICH medication type is usually added to peptic ulcer treatment to suppress acid secretion, continuing for up to 6 weeks following antibiotic therapy?

A

PPI

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16
Q

What is the main cause of GERD?

A

incompetent Lower Esophageal Sphincter

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17
Q

Anti-ulcer drugs to neutralize gastric contents and reduce acid secretion in GERD therapy include WHICH DRUG TYPES?

A

H2 blockers such as ranitidine.
and
Proton Pump Inhibitors such as Omeprazole, Lansoprazole, Pantoprazole.

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18
Q

Does GERD resolve completely after treatment?

A

No, it is a chronic disorder requiring continuous management.

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19
Q

What are some NONpharmacologic methods for PUD and GERD?

A 
avoid smoking and alcohol. 
Weight loss.
Avoid spicy foods. 
Avoid NSAIDs
Take glucocorticoids with food--- they can cause ulceration. 
Raise head of bed. 
Do not eat before bed. 
Loose fitting clothing.
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20
Q

THIS DRUG TYPE is no longer commonly used in PUD treatment. It has minimal effect, but it dies reduce vagal stimulation and decrease anxiety.

A

TRANQUILIZERS

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21
Q

The usage of THIS DRUG TYPE for PUD treatment has declined since the introduction of H2 blockers. It decreases GI motility and secretion, inhibits ACh, Blocks histamine and HCl, and is usually used in combination.

A

Anticholinergics

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22
Q

Since antacids slow the absorption of anticholinergics (among other drugs), when should antacids be taken?

A

At least 2 hours after taking anticholinergic.

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23
Q

THIS anti-ulcer DRUG TYPE has numerous SE including dry mouth, decreased secretions, headache, blurred vision, urinary retention, and drowsiness.

A

ANTI-CHOLINERGICS

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24
Q

THIS DRUG TYPE promotes ulcer healing by neutralizing HCl Acid, thereby reducing pepsin activity.

A

ANTACIDS

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25
Q

What are the two types of Antacids?

A

Systemic & non-systemic

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26
Q

What is one example of a SYSTEMIC antacid?

A

Sodium Bicarbonate, e.g. alka-seltzer.

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27
Q

THIS SYSTEMIC ANTACID is seldom used because it has serious SE, including HYPERnatremia, water retention, metabolic ALKALosis, and rebound acid secretion.

A

Sodium Bicarbonate

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28
Q

What is one example of a NON-SYTEMIC ANTACID?

A

Aluminum Hydroxide

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29
Q

THIS DRUG TYPE is composed of alkaline salts such as aluminum or magnesium. A very small amount of aluminum is absorbed systemically.

A

NON-SYSTEMIC ANTACIDS

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30
Q

Aluminum antacids are most likely to cause which SE?

A

CONSTIPATION

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31
Q

Magnesium antacids are most likely to cause which SE?

A

DIARRHEA

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32
Q

THIS NON-SYSTEMIC ANTACID can also help to treat hyperphosphatemia.

A

Aluminum Hydroxide

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33
Q

Adverse Reactions to THIS DRUG include Hypophosphatemia, hypercalcemia, hypomagnesemia, osteoporosis, nephrolithiasis, and long-term GI obstruction

A

Aluminum Hydroxide (a non-sytemic antacid)

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34
Q

Impaired cognition can be a side effect of this antacid.

A

Aluminum Hydroxide

35
Q

Which baseline assessments are especially important before Aluminum Hydroxide treatment for peptic ulcer?

A

renal, electrolytes - especially phosphate and calcium.

36
Q

What is important to remember about antacids if you are also taking other medications?

A

Antacids will delay absorption of other drugs, so they should be given 1-3 hours before or after other medications.

37
Q

Should antacids be taken with Vitamin D or milk?

A

NO

38
Q

Should water be consumed after taking an antacid?

A

YES

39
Q

What is a common side effect seen in stools during antacid therapy?

A

whitish color stools

40
Q

THIS DRUG TYPE blocks the Histamine-2 receptors of the parietal cells in the stomach, reducing gastric acid secretion and concentration.

A

H2 Blockers/ H2 Receptor Antagonists

41
Q

In patients with renal insufficiency, the dosage of H2 Blockers may need to be…

A

REDUCED

42
Q

What is one example of an H2 Blocker?

A

Famotidine

43
Q

What are the pharmacodynamics of Famotidine?

A

Inhibits gastric acid secretion by blocking the H2 receptors of parietal cells in the stomach.

44
Q

THIS H2 BLOCKER is used to prevent and treat peptic ulcers, pyrosis, dyspepsia, esophagitis, GERD, and Zollinger-Ellison Syndrome

A

Famotidine

45
Q

Famotidine can cause decreased absorption of what essential mineral? And for this reason, it should be used with caution in Vitamin B12 deficiency, as anemia may result.

A

Iron

46
Q

Although drugs that reduce stomach acid usually decrease effects of many drugs, mainly by slowing their absorption, FAMOTIDINE increases the action of THIS antidiabetic biguanide.

A

METFORMIN

47
Q

Famotidine is likely to increase WHICH lab result?

A

Serum alkaline phosphatase

48
Q

Palpitations and gynecomastia are adverse reactions of THIS H2 blocker

A

famotidine

49
Q

Blood dyscrasias, HEPATOTOXICITY, and cardiac dysrhythmias are serious adverse reactions to which anti-ulcer drug?

A

Famotidine

50
Q

Confusion, agitation, and depression may be side effects of THIS anti-ulcer

A

Famotidine

51
Q

Before administering Famotidine, the nurse should assess WHICH baseline labs?

A

Liver function, GI status

52
Q

When should H2 Blockers be administered?

A

Just before meals and at bedtime.

53
Q

THIS DRUG TYPE suppresses gastric acid by inhibiting the hydrogen/potassium ATPase pump located in parietal cells.

A

Proton Pump Inhibitors

54
Q

THIS DRUG TYPE inhbits gastric acid secretion 90% more than H2 blockers.

A

Proton Pump Inhibitors

55
Q

THIS DRUG TYPE blocks the final step of gastric acid production

A

Proton Pump Inhibitors

56
Q

Long term usage of PPIs can lead to…

A

osteoporosis and hypomagnesemia

57
Q

What is one example of Proton Pump Inhibitors>

A

PANTOPRAZOLE

58
Q

What is the mechanism of action of Pantoprazole?

A

Inhibits gastric acid secretion by inhibiting the hydrogen/potassium ATPase pump in parietal cells.

59
Q

One use of THIS DRUG is to prevent NSAID-induced ulcers

A

PANTOPRAZOLE

60
Q

Adverse reactions of PANTOPRAZOLE include hypertriglyceridemia and hyperbilirubinemia, so it should be used with extreme caution in …

A

hepatic impairment

61
Q

This PPI may cause dry mouth, blurred vision, and itchy rash.

A

PANTOPRAZOLE

62
Q

Older adults may need to ________ dosing of Pantoprazole due to their lower production of gastric acid.

A

REDUCE

63
Q

One serious adverse reaction Pantoprazole is…

A

GI Bleeding

64
Q

Because GI bleeding is one serious adverse reaction of Pantoprazole, it is important for the patient to report WHICH conditions?

A

Coughing or vomiting blood, blood in sputum or stools, GI pain

65
Q

Smoking has WHAT effect on Pantoprazole?

A

Decreases efectiveness

66
Q

True/False It is important to take Pantoprazole EXACTLY as prescribed?

A

TRUE

67
Q

THIS DRUG TYPE forms a protective coating on the ulcer surface

A

PEPSIN INHIBITORS

68
Q

What is one example of Pepsin Inhibitors?

A

Sucralfate

69
Q

This drug is most likely to be used to prevent gastric mucosal injury from drug-induced ulcers, but it can be used to manage existing ulcers.

A

SUCRALFATE

70
Q

HYPERGLYCEMIA is an adverse reaction in SUCRALFATE use, so it should be used with caution in patients with ____ _____.

A

Diabetes Mellitus

71
Q

______ (a pepsin inhibitor) should be used with caution in Renal Impairment.

A

SUCRALFATE

72
Q

HYPOphosphatemia is an adverse reaction of THIS pepsin inhibitor.

A

SUCRALFATE

73
Q

WHICH baseline labs would be important to assess before SUCRALFATE therapy?

A

Renal Function, Electrolytes

74
Q

If a patient is using SUCRALFATE with other medications, how does this affect their drug schedule?

A

Allow 1-2 hours between sucralfate and other drugs

75
Q

Approximately how long does Sucralfate take to achieve optimal ulcer healing?

A

4-8 weeks

76
Q

This pepsin inhibitor is likely to cause _____, which can be mitigated by increased fluids, fiber, and exercise.

A

Constipation

77
Q

THIS DRUG is a Prostaglandin Analogue Antiulcer Drug

A

MISOPROSTOL

78
Q

This drug suppresses gastric acid and increases production of protective mucus, but it can also cause menstrual spotting AND may induce labor and harm a fetus.

A

MISOPROSTOL

79
Q

This anti-ulcer must be avoided in pregnancy and in women of child-bearing capacity.

A

MISOPROSTOL

80
Q

Aluminum Hydroxide drug type

A

non-systemic antacid, antiulcer

81
Q

Famotidine drug type

A

H2 blocker, antiulcer

82
Q

pantoprazole drug type

A

proton pump inhibitor, antiulcer

83
Q

sucralfate drug type

A

pepsin inhibitor/mucosal protective agent, antiulcer

84
Q

misoprostol drug type

A

prostaglandin analogue antiulcer

Pharm (5 decks)

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