Ch36 UPPER GI TRACT DRUGS Flashcards
What is amylase
A enzyme that breaks down carbs
What are gastric secretions primarily regulated by
By the parasympathetic nervous system
Where is vomiting of the GI contents controlled
By the vomit center in the medulla of the brain, additionally the VC can be stimulated when the chemoreceptor trigger zone is stimulated
What is GERD
Allows stomach acid to back up into the esophagus
The 4 major symptoms are heartburn,regurgitation, dysphasia, and waterbrash
What is H pylori
A gram negative spiral bacterium that weakens the protective mucous lining of the stomach and duodenum
What is peptic ulcer disease
Is a general term that refers to ulcer formation in the stomach, esophagus, or duodenum
What is pancreatitis
Occurs when digestive enzymes production is reduced or no longer occurs
What is nausea and vomiting controlled by
It is caused by stimulation of the chemoreceptors in the brain and GI tract
What are proton pump inhibitors
Omerprazole ( Prilosec)
It blocks the final step of gastric acid production
It is used for the treatment of heartburn and GERD
What are adverse effects of Omerprazole ( Prilosec)
Headache
Diarrhea
What is a important culture trait to remember when administering Prilosec
Longer duration in Asians
When elderly clients are prescribed Omerprazole, what supplement should be suggested
Suggest calcium citrate supplementation for elderly patients on long term therapy
When should Omerprazole be taken
One hour before meals
What are histamine-2 receptor antagonists
They block the effect of histamine at the H2 receptors in the parietal cells of the stomach. This action inhibits gastric acid secretion in all phases and other secretions caused by histamine.
They also reduce the volume and concentration of gastric secretions.
What is the prototype H-2 receptor antagonist
Ranitidine ( Zantac)
What is ranitidine used for,
Treatment of ulcers
It inhibits both daytime and nocturnal basal gastric acid secretions
What are adverse effects of ranitidine
Headache, blood count changes, GI effects, hepatocellular, cholestatic, or mixed hepatitis
How can one minimize adverse effects of ranitidine
Monitor serum trough levels in patients with renal failure or hepatic impairment
Administer ranitidine IV slowly to prevent hypotension and cardiac arrhythmias
What are antacids
Drugs that increase the gastric pH
They are used for various upper GI disorders, including symptoms of GERD, esophagitis, hiatal hernia, gastritis, and peptic ulcer disease.
They are composed of inorganic salts
What is the prototype antacid drug
Aluminum hydroxide with magnesium hydroxide ( maaolx, mylanta)
What is aluminum Hydroxide used for
It relieves symptoms assoc with GERD
It raises the gastric pH in the stomach and duodenal bulb
Aluminum hydroxide is contraindicated in who
Caution In patients with recent massive GI bleed
What are adverse effects of aluminum hydroxide
Osteomalacia. Encephalopathy, and rebound gastric acid production
How can one minimize adverse effects of aluminum hydroxide
Administer 2 hours after other drugs to prevent drug interactions
Caution patients not to take the maximum dose for longer than 2 weeks
What is the most serious adverse effect of aluminum hydroxide
Electrolyte imbalance
What are pro kinetic agents
They increase the effects of acetylcholine on the GI system
Acetylcholine is responsible for normal GI function
Pro kinetic agents increase peristalsis and gastric emptying
What is the prototype pro kinetic drug
Metoclopramide ( reglan)
What does metoclopramide do
It relieves symptoms of diabetic gastroparesis
What are contraindications of metoclopramide
GI hemmorrhage, perforation, or mechanical obstruction
What are adverse effects of metoclopramide
Restlessness, drowsiness, depression, insomnia, headache, anxiety, dizziness, and confusion.
What are drug interactions of metoclopramide
Levodopa, anticholinergics, And narcotics
What can one do to maximize therapeutic effects of metoclopramide
Give oral doses 30 minutes before each meal
Do not administer metoclopramide with ANTICHOLINERGIC drugs
What are digestive enzymes
They are responsible for breaking down food into forms that can be easily absorbed in the GI tract
What is the prototype digestive enzyme
Pan relapse ( pancreas MT, viokase, cream, lipram,pancrecarb, panocaps)
What is the digestive enzyme pancrelipase used for
Replacement therapy for patients with deficient exocrine pancreatic secretions.
What does pancrelipase contain
Lipase, protease, and amylase which are responsible for the final phase of digestion
What are adverse effects of pancrelipase
Nausea
Abdominal cramps
Diarrhea
What are drug interactions of pancrelipase
Antacids calcium carbonate and magnesium hydroxide, iron preparations
How often should pancrelipase be administered
Every time the person eats
Pancrelipase is contraindicated in who
People allergic to pork
What are lipase inhibitors
Used specifically for long term weight reduction
What is the prototype lipase inhibitor
Orlistat ( Xenical)
What does orlistat ( Xenical) do
Manages obesity
How can one maximize the therapeutic effects of orlistat ( Xenical)
Take with all meals that contain fat
How can one minimize adverse effects of orlistat
Advise to take a multivitamin that contains fat soluble vitamins to,prevent imbalances fro drug therapy
