CH 41: PUD Drugs Flashcards
an erosion of the mucosal layer of the GI tract, usually associated with acute inflammation.
ulcer
refers to a lesion located in either the stomach (gastric) or small intestine (duodenal).
peptic ulcer
risk factors of PUD
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.
primary cause of PUD
H. pylori
Non-infected patients most common cause of PUD
NSAIDs
Symptoms of duodenal ulcer
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
Symptoms of gastic ulcer
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
Ulceration in the distal small intestine
Crohn’s Disease
Ulceration in the distal large intestine
Ulcerative Colitis
acidic contents of the stomach move upward into the esophagus.
GERD GASTROESOPHAGEAL REFLUX DISEASE
The goals of PUD pharmacotherapy are to provide:
provide immediate relief from symptoms, promote
healing of the ulcer, and prevent future recurrence of the disease
PUD drug examples
Proton pump inhibitors
H2-receptor antagonists
Antacids
Antibiotics – IF POSITIVE FOR H. PYLORI
Miscellaneous drugs.
PPIs: Omeprazole therapeutic effects
Block enzyme that secretes HCL in the stomach
PUD and GERD
h.pylori
Reduce stomach acid
adverse effects of Omeprazole
Headache
diarrhea
nausea
rash
dizziness
Increased risk for
osteoporosis-related fractures of the hip, wrist, or spine,
interstitial nephritis
Omeprazole safety monitoring
the PPI should be taken 20 to 30 minutes
before the first major meal of the day.
Do not crush
H2 Antagonists: famotidine therapeutic effects
Blocks H2
suppressing the volume and acidity of parietal cell secretions.
Reduce stomach acid
adverse effects of H2 antagonists: famotidine
Headache
nausea
dry mouth
Rare:
Musculoskeletal pain
tachycardia
blood dyscrasia
blurred vision
safety monitoring for H2 antagonists: famotidine
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
antacids: aluminum hydroxide therapeutic effects
Alkaline – neutralize stomach acid
Neutralize stomach acid
Aluminum hydroxide raises the pH
adverse effects of antacids
Constipation (w mag = diarrhea)
nausea
stomach cramps
Fecal impaction
hypophosphatemia
safety monitoring for antacids
Milk alkali syndrome*
Contraindicated for pt with Na restrictions or CKD
Take 2 hours before or after other drugs
preferred regimen for H. pylori drugs
Omeprazole (or other PPI), clarithromycin (Biaxin), and
amoxicillin (Amoxil)
Activation of H1 receptors produces
the classic symptoms of inflammation and allergy
H2 receptors are responsible for:
increasing acid secretion in the stomach
