Ch. 57 Drugs Affecting GI secretions Flashcards
what do histamine-2 antagonist do?
BLOCK the release of hydrochloric acid in response to gastrin
what do antacids do?
interact w/ acids at the chemical level to neutralize them
what do proton pump inhibitors do?
SUPPRESS the secretion of hydrochloric acid into the lumen of the stomach
what do prostaglandins do ?
inhibit the secretion of gastrin of the mucous lining of the stomach, providing a buffer
what do digestive enzymes do?
supplement the production of digestive enzymes
prototype of histamine-2 antagonist
cimetidine
prototype of antacid
sodium bicarbonate
prototype of proton pump inhibitor
omeprazole
prototype of prostaglandins
misoprostol
Cimetidine: Indications
- short term treatment of active duodenal or benign gastric ulcers
- treatment of pathological hypersecretory conditions
- prophylaxis of stress induced ulcers
- treatment of erosive gastroesophageal reflux
- relief of symptoms of heartburn and acid indigestion
Cimetidine: Actions
- inhibits the actions of histamine at H2 receptor sites of the stomach, inhibiting gastric acid secretion and reducing total pepsin output
Cimetidine: Adverse Effects
- dizziness
- confusion
- headache
- somnolence (sleepiness)
- cardiac arrhythmias
- cardiac arrest
- diarrhea
- impotence (whiskey dick)
- gynecomastia ( man boobs)
- rash
Sodium Bicarbonate: Indications
- symptomatic relief of upset stomach from hyperacidity
- prophylaxis for GI bleeding and stress ulcers
- adjunctive treatment of severe diarrhea
- treatment of metabolic acidosis
- treat certain drug intoxications to minimize uric acid crystallization
Sodium Bicarbonate: Actions
- neutralize or reduces gastric acidity , resulting in an increase in gastric pH, which inhibits the proteolytic activity of pepsin
Sodium Bicarbonate: Adverse Effects
- gastric rupture
- systemic alkalosis
- hypokalemia
- gastric rebound
Symptoms of Alkalosis
- headache
- nausea
- irritability
- weakness
- tetany
- confusion
Gastric rebound
- reflex response of the stomach to lower-than-normal acid levels
- when acid levels are lowered through the use of antacids, gastrin production and secretion are increased to return the stomach to its normal acidity
Omeprazole: Indications
- short term treatment of active duodenal or benign gastric ulcers
- treatment of heartburn or symptoms of gastroesophageal reflux
- treatment of pathological hypersecretory syndromes
- eradications of Helicobacter Pylori infection as part of combination therapy
Omeprazole: Actions
- specifically inhibits the hydrogen-potassium adenosine triphosphatase enzyme system on the secretory surface of the gastric parietal cells, blocking the final step in acid production and DECREASING gastric acid levels
Omeprazole: Adverse Effects
- headache
- dizziness
- vertigo
- insomnia
- rash
- diarrhea
- abdominal pain
- n/v
- upper respiratory infection symptoms
- cough
Misoprostol: Indications
- prevention of NSAIDS or aspirin-induced gastric ulcers in pt. at risk for complications of gastric uclers
- abortifacient w/ mifepristone
Misoprostol: Action
- inhibits gastric acid secretion and increases bicarb and mucous production, protecting the lining of the stomach
- increases stimulatory effects in the uterus
Misoprostol: Adverse Effects
- N/V
- diarrhea
- abdominal pain
- flatulence
- excessive bleeding or spotting
- hypermenorrhea ( 7+ menstrual days)
- dysmenorrheal (painful menstruation)
- miscarriage
