Antiulcer meds Flashcards
a broad term for an ulcer or erosion that occurs in the esophagus, stomach, and duodenum
peptic ulcer
stomach pH of what
2 to 5
a thick viscous mucous material that provides a barrier between the mucosal lining and acidic gastric secretions
gastric mucosal barrier
occurs from reflux of acid
esophageal ulcer
occurs from breakdown of the GMB
gastric ulcer
caused by hypersecretion of acid from the stomach
duodenal ulcer
classic symptom of peptic ulcer
gnawing, aching pain
pain from gastric ulcer
30 min to 1.5 hours after eating
pain from duodenal ulcer
2 to 3 hours after eating
how long does ulcer healing take
1 to 2 months
predisposing factors for PUD
- mechanical disturbances
- genetic influences
- environmental influences
- H pylori
- drugs
usually follows a critical situation such as extensive trauma, such as burns, or major surgery
stress ulcer
gram-negative bacillus that is linked with development of peptic ulcer
H pylori
how to diagnose H pylori
endoscopy and biopsy, urea breath test, blood test
what therapy for H pylori
MOC
for quad therapy use an H2 blocker for ____ weeks
6
inflammation of the esophagus caused by a reflux of gastric acid content
smoking accelerates the disease process
GERD
treatment for GERD
H2 blockers and PPI
relieves GERD symptoms better than an H2 blocker
PPI
antiulcer drugs
tranquilizers
anticholinergics
antacids
H2 blockers
PPI
pepsin inhibitor (sucralfate)
prostaglandin E1 analogue (misoprostol)
minimal effect in preventing and treating ulcers, but they reduce vagal stimulation and decrease anxiety
adverse effects: edema, ataxia, confusion, EPS, and agranulocytosis
tranquilizers
relieve pain by decreasing GI motility and secretion, inhibit acetylcholine and block histamine and HCl; delay gastric emptying time (30min to 1hr before meals)
anticholinergic (propantheline bromide)
promote ulcer healing by neutralizing HCl and reducing pepsin activity
antacids
systemically absorbed antacid causing hypernatremia and water retention; metabolic alkalosis and acid rebound
sodium bicarb
most effective at neutralizing acid can cause acid rebound; hypercalcemia and burnett syndrome
calcium carbonate
nonsystemic antacids composed of alkaline salts
aluminum hydroxide and magnesium hydroxide
antacid that can cause diarrhea
mag
antacids that can cause constipation
aluminum and calcium
a combo of __ and __ neutralizes gastric acid without causing severe diarrhea or constipation
mag and aluminum
antigas agents is found in many antacids
simethicone
dosing interval for antacids
1 to 3 hours after meals and at bedtime with at least 2oz of water
should not be administered with other oral meds
block H2 receptors of the parietal cells in the stomach reducing gastric acid secretions
promote healing by eliminating the cause
H2 blockers
examples of H2 blockers
cimetidine, famotidine, nizatidine
(-tidine)
interactions of cimetidine
enhances effects of anticoags, theophylline, caffeine, phenytoin, diazepam, propranolol, phenobarbital, and calcium channel blockers
increase BUN, serum creatinine, serum ALP
MONITOR RENAL LABS and GASTRIC pH
cimetidine side effects
HA, dizziness, diarrhea, drowsiness, agitation, gynecomastia, and ED
suppress gastric acid secretion by inhibiting the hydrogen/potassium ATPase enzyme system located in the gastric parietal cells
block the final step of acid production
PPI
side effects of PPIs
HA, dizziness, diarrhea, constipation, abdominal pain
-prazole
which PPI through IV
pantoprazole
push slowly 2-5min and dilute
when to give PPI and what to watch
before meals and LFTs monitored
pepsin inhibitors or mucosal protective drug
sucralfate
1g, qid 30min before meals and HS
prostaglandin analogue
suppress gastric acid secretion and increase cytoprotective mucus in the GI tract
longterm NSAIDs
contraindicated in pregnant women
misoprostol
misoprostol side effects
HA, abdominal pain, nausea, vomiting, flatulence, diarrhea, and constipation
