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Pharm Exam 3 > Antiulcer > Flashcards

Antiulcer Flashcards

1
Q

describe GERD

A

aka: reflux esophagitis
- chronic inflammation of the esophageal mucosa
- caused by reflux of gastric acidic content into the esophagus
- related to:
a) an incompetent lower-esophageal sphincter (cardiac sphincter)
b) hiatal hernia
c) smoking tends to accelerate the disease process

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2
Q

describe PUD

A

Mucosal lining erosion of:

  1. Esophageal
  2. Gastric
  3. Duodenal- most common
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3
Q

antacid drugs (3)

A
  1. calcium-carbonate
  2. magnesium-hydroxide
  3. magnesium-hydroxide / aluminum-hydroxide
    - –> no constipation or diarrhea b/c Mg = diarrhea but Al = constipation
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4
Q

antacid nursing (5)

A
  1. Take up to 7 doses/day (1 & 3 hrs after meals & at HS)
  2. take other drugs at least 1 hr before or 4 hrs after antacids
  3. Monitor for diarrhea as a sign of infection (low acidity => opportunistic infections)
  4. Chewable (must chew), suspension (must shake well)
  5. take with 8 oz water, just enough to ensure the drug reaches stomach
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5
Q

antacid side effect (1)

A
  • OD of electrolytes (Mg, Ca, Al)

- –> especially with history of RF

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6
Q

histamine2 receptor blockers drugs (3)

A
  1. *famotidine IV/PO
  2. cimetidine IV/PO
  3. nizatidine PO
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7
Q

histamine2 receptor blockers MOA (2)

A
  1. reduce gastric acid by blocking H2 receptors on the stomach wall
  2. Promote healing of ulcer by reducing hydrochloric acid production
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8
Q

histamine2 receptor blockers side effects

A
  1. B12-deficiency (take supplement)
  2. Blocking androgen receptors
    • impotence, decreased libido, gynecomastia
  3. CNS effects
    • lethargy, depression, confusion (take at bedtime)
    • caution: geriatric population
  4. Low gastric acidity: may cause bacterial colonization (precautions)
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9
Q

histamine2 receptor blockers nursing (6)

A
  1. Take right before meals to decrease food-induced acid secretion
  2. Take at HS for lethargy, depression, confusion side effects
  3. Monitor I&Os
    - RF is a side effect & contraindication
    - monitor Lab: renal panel, CMP
  4. Don’t take with antacids (lower absorption) take separately 1-2 hrs
  5. May cause toxicity with warfarin, phenytoin, theophylline, lidocaine
  6. Older adults need smaller dose d/t less gastric acid
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10
Q

proton pump inhibitors (PPI) drugs

A
  1. pantoprazole IV/PO

2. omeprazole PO

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11
Q

PPI MOA (2)

A
  1. Reduce gastric acid

2. Oral peak effect after several days

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12
Q

predisposing factors for PUD that we need to know in this class

A
  1. NSAIDs, ASA, corticosteroids
    - take drugs with food
    - preferred: enteric-coated medication
  2. avoid caffeine, ETOH, nicotine, greasy foods, spices
    - educate to eat a bland diet
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13
Q

PPI side effects

A
  • diarrhea
  • insomnia
  • dizziness
  • dry mouth
  • flatulence
  • liver failure
  • C-diff
  • Long-term use = osteoporosis
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14
Q

PPI -prazole nursing (2)

A
  1. Take at least an hour before meal/drugs (to avoid poor digestion/absorption)
  2. Taper off to avoid rebound acid hypersecretion
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15
Q

pepsin inhibitor drug (1)`

A

sucralfate PO tablet or oral suspension

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16
Q

pepsin inhibitor MOA (2)

A
  1. reacts with gastric acid and forms a thick paste

2. selectively adheres to the ulcer protecting it from acid and pepsin for up to 6 hrs

17
Q

CN X is what nerve

A

vagus nerve is a cholinergic nerve (sleepy chicken) so antiulcer drugs work as anticholinergics and stop GI motility and GI secretions

18
Q

pepsin inhibitor side effects

A
  • constipation

- hyperglycemia (sugar content of the drug)

19
Q

pepsin inhibitor nursing interventions

A
  1. Given 30 minutes AC & HS (qid)
  2. Avoid taking with other drugs
    • at least 2 hrs apart from other drugs to prevent poor absorption
  3. Finish the course even if feeling better
  4. Increase activity, water, fiber to avoid constipation
20
Q

helicobacter pylori

A
  • 1-2 weeks of treatment; combination of multiple antibiotics to reduce risk of resistance, followed by 6 weeks of acid suppression therapy
  • Antibiotics (multi-agent abx therapy)
    = metronidazole, amoxicillin, tetracycline
  • Proton pump inhibitor (PPI)
    = omeprazole, pantoprazole
  • Antacid
    = magnesium-hydroxide / aluminum-hydroxide
  • H2 receptor blocker
    = famotidine

**Side effect of abx and acid suppression: opportunistic infection (C.diff)

Pharm Exam 3 (9 decks)

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