Chapter 20 -G.I. Flashcards
Name medications associated with gastric mucosal damage and ulcer formation
NSAIDS
Steroids
NSAIDS With anticoagulants
Name two agents used to treat or prevent ulcer formation
Sucralfate (Carafate)
Misoprostal (Cytotec)
—
Sucralfate
__________ is a methyl analog of prostaglandin E1.
Analog equals what does analog mean? A compound with the molecular structure closely similar to that of another.
Misoprostol
Name two Cytoprotective agents
Sucralfate
Misoprostol
Which cytoprotective agent binds to necrotic tissue, covers the ulcer site, and acts as a barrier to acid, pepsin, and bile salts
Sucralfate
Which ulcer medication has no acid neutralizer activity?
Sulcralfate
Which ulcer medication inhibits gastric secretion through the inhibition of histamine Stimulated cyclic adenosin monophosphate production?
Misoprostol
Inhibits basil and nocturnal gastric acid secretion and acid secretion in response to meals, histamine, and coffee
Misoprostol
Has no effect on fasting or post prandial gastrin, or on intrinsic factor out put
Misoprostol
Produces a moderate decrease in pepsin concentration during basal conditions.
Misoprostol
Can be taken with food
Misoprostol
Produces uterine contractions they can in danger pregnancy
Misoprostol
Which ulcer medication is minimally absorbed and largely topical
Sucralfate
Which ulcer medication is rapidly and extensively absorbed after oral administration
Misoprostol
More than 90% of this ulcer medication is excreted in the feces
Sucralfate
Rapidly converted to its free acid, is not affected by cytochrome P4 50, half-life is 20 to 40 minutes, is excreted in the urine—which ulcer medication is this?
Misoprostol
Which ulcer medication is pregnancy category B with a few contra indications
Sucralfate
Which ulcer medication is pregnancy category X may cause abortion, premature birth, or birth defects
Misoprostol
Can cause uterine rupture when administered to induce labor
Misoprostol
Do not treat NSAID induced ulcers with this medication
Misoprostol
Metabolized into misoprostol acid And excreted in breastmilk
Misoprostol
Adverse reactions with his this ulcer medication are rare
Sucralfate
The most common adverse reaction to Sucralfate is
Constipation, dizziness, gastric discomfort
Misoprostol Most common side effect is
Diarrhea
Misoprostol may cause side effects related to
Menstrual irregularities
Sucralfate May decrease the _______ Of many drugs when given concurrently are before their administration
Absorption
Misoprostol has very few drug interactions. The risk for_—
Diarrhea
Magnesium based and acids
Many patients self medicate with antacids. Which patients should be council to not take calcium carbonate antacids without discussing it with their provider or pharmacist first?
Patients with kidney stones
Patients taking antacids should be educated regarding these drugs, including letting them know that:
They may cause constipation and diarrhea
Many are high in sodium
They should separate and acids from other medications by one hour
Answer: all of the above
Kelly has diarrhea and is wondering if she can take loperamide for the diarrhea. Loperamide:
Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
Bismuth subsalicylate is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
May lead to toxicity if taken with aspirin
Is contra indicated in children with flu like illness
Has antimicrobial affects against bacterial and viral enteropathogens
Answer: all of the above
Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop travelers diarrhea. Advice includes following normal food and water precautions as well as taking:
Bismuth subsalicylate with each meal and at bedtime
Josie is a five-year-old patient who presents to the clinic with a 48 hour history of nausea, vomiting, and some diarrhea. She is an able to keep fluids down and her weight is 4 pounds less then her last recorded wait. Besides IV fluids, Her exam warrants the use of an anti-nausea medication. Which of the following would be the appropriate drug to order for Joseph?
Ondansetron
Jim presents with complaints of heartburn that is minimally relieved with tums Calcium carbonate and is diagnosed with gastroesophageal reflux disease GERD. An appropriate first step therapy would be
Ranitidine Zantac twice a day
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for
Iron deficiency anemia, vitamin B 12 and calcium deficiency
Sadie is a 72-year-old patient it takes oMeprazole for her chronic GERD. Chronic long-term omeprazole use places her at risk for :
Megaloblastic anemia
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. And appropriate choice of medication for a 10-year-old child would be:
Bisacodyl dulcolax Suppository
Methylnaltrexone is used to treat constipation in:
Opioid associated constipation
An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include
Electrolytes, including potassium and chloride
