CH 41: PUD Drugs

Question 1

an erosion of the mucosal layer of the GI tract, usually associated with acute inflammation.

Answer 1

ulcer

Question 2

refers to a lesion located in either the stomach (gastric) or small intestine (duodenal).

Answer 2

peptic ulcer

Question 3

risk factors of PUD

Answer 3

 Close family history of PUD
 Blood group O
 Smoking tobacco (increases gastric acid secretion)
 Consumption of beverages and food that contain caffeine
 Drugs, particularly corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and
platelet inhibitors, such as aspirin and clopidogrel
 Excessive psychologic stress
 Infection with Helicobacter pylori.

Question 4

primary cause of PUD

Answer 4

H. pylori

Question 5

Non-infected patients most common cause of PUD

Answer 5

NSAIDs

Question 6

Symptoms of duodenal ulcer

Answer 6

 gnawing or burning upper abdominal pain that occurs 1 to 3 hours after a meal. The pain is worse when the stomach is empty and often disappears on ingestion of food.
 Nighttime pain, nausea, and vomiting may occur.
 erosion progresses deeper into the mucosa, and bleeding occurs, which may be evident as
either bright red blood in vomit or black, tarry stools.
 Most heal spontaneously

Question 7

Symptoms of gastic ulcer

Answer 7

relieved by food, pain may continue even after a meal.
Loss of appetite, known as
anorexia, as well as weight loss and vomiting are more common.
Most common cause NSAID use

Question 8

Ulceration in the distal small intestine

Answer 8

Crohn’s Disease

Question 9

Ulceration in the distal large intestine

Answer 9

Ulcerative Colitis

Question 10

acidic contents of the stomach move upward into the esophagus.

Answer 10

GERD GASTROESOPHAGEAL REFLUX DISEASE

Question 11

The goals of PUD pharmacotherapy are to provide:

Answer 11

provide immediate relief from symptoms, promote
healing of the ulcer, and prevent future recurrence of the disease

Question 12

PUD drug examples

Answer 12

 Proton pump inhibitors
 H2-receptor antagonists
 Antacids
 Antibiotics – IF POSITIVE FOR H. PYLORI
 Miscellaneous drugs.

Question 13

PPIs: Omeprazole therapeutic effects

Answer 13

Block enzyme that secretes HCL in the stomach
PUD and GERD
h.pylori
Reduce stomach acid

Question 14

adverse effects of Omeprazole

Answer 14

Headache
diarrhea
nausea
rash
dizziness
Increased risk for
osteoporosis-related fractures of the hip, wrist, or spine,
interstitial nephritis

Question 15

Omeprazole safety monitoring

Answer 15

the PPI should be taken 20 to 30 minutes
before the first major meal of the day.
Do not crush

Question 16

H2 Antagonists: famotidine therapeutic effects

Answer 16

Blocks H2
suppressing the volume and acidity of parietal cell secretions.
Reduce stomach acid

Question 17

adverse effects of H2 antagonists: famotidine

Answer 17

Headache
nausea
dry mouth

Rare:
Musculoskeletal pain
tachycardia
blood dyscrasia
blurred vision

Question 18

safety monitoring for H2 antagonists: famotidine

Answer 18

Take with meals
CBC
Assess for GI bleed
Smoking interferes with action
may experience confusion,
restlessness, hallucinations, or depression
Take at same time every day

Question 19

antacids: aluminum hydroxide therapeutic effects

Answer 19

Alkaline – neutralize stomach acid
Neutralize stomach acid
Aluminum hydroxide raises the pH

Question 20

adverse effects of antacids

Answer 20

Constipation (w mag = diarrhea)
nausea
stomach cramps
Fecal impaction
hypophosphatemia

Question 21

safety monitoring for antacids

Answer 21

Milk alkali syndrome*
Contraindicated for pt with Na restrictions or CKD
Take 2 hours before or after other drugs

Question 22

preferred regimen for H. pylori drugs

Answer 22

Omeprazole (or other PPI), clarithromycin (Biaxin), and
amoxicillin (Amoxil)

Question 23

Activation of H1 receptors produces

Answer 23

the classic symptoms of inflammation and allergy

Question 24

H2 receptors are responsible for:

Answer 24

increasing acid secretion in the stomach

Question 25

condition in which there is a high level of calcium in the body (hypercalcemia).

Answer 25

Milk-alkali syndrome

Question 26

results of milk-alkali syndrome

Answer 26

there can be a loss of kidney function.
headache
urinary frequency
anorexia
nausea
fatigue

Question 27

labs for PUD drugs

Answer 27

liver
kidney
CBC
platelets
electrolytes