Chapter 39: Acid Controlling Drugs Flashcards
What do parietal cells secrete?
HCL
What are the hormones that parietal cells have receptors for?
ACH, histamine, gastrin
What is the pH of the stomach?
1-4
What do chief cells do?
secrete pepsinogen
What does pepsinogen do?
becomes pepsin when exposed to acid and then pepsin digests proteins
What do mucus cells do?
secrete mucus
What are the most harmful disorders related to acid production?
PUD, esophageal cancer
What things can cause hyperacidity?
food, caffeine, alcohol, overconsumption of fatty meals, emotional stress
What is triple therapy?
clarithromycin, amoxicillin/metronidazole and proton pump therapy
What does triple therapy treat?
H. pylori
What is quadruple therapy?
proton pump inhibitor, bismuth subsalicylate, tetracycline, and metronidazole
Why would patients be put on proton pump inhibitors as prophylaxis?
to prevent ICU pts from getting ulcers. Those in ICU and traumatic states have lower blood flow to the stomach and are at risk for developing uicers
Name the drug classes of acid controlling drugs
Antacids, H2 receptor antagonists, Proton pump inhibitors
What do antacids do?
Buffers/neutralizes the HCL
How do antacids buffer the HCL?
it prevents histamine from binding to the parietal cells which means no CAMP and then the proton pump can’t be activated
What are the forms of antacids?
Aluminum, magnesium, calcium, sodium bicarb, combo format
Does Mg cause constipation or diarrhea?
natural laxative that prevents constipation
Does calcium and aluminum cause diarrhea or constipation?
constipation
What can happen if a person takes a whole bottle of antacids?
metabolic alkalosis
What is acid rebound?
when hyperacidity comes back after antacid use is discontinued
What is another risk for continued antacid use?
hypercalcemia, milk-alkali syndrome, metabolic alkalosis
What are the interactions of antacids?
Chelation, increased stomach pH, Increased urinary pH
What is chelation?
antacid makes other drugs chemically inactive, reduces the drug absorption
What happens when antacids increase the stomach pH?
Increases absorption of basic drugs and decreases absorption of acidic meds
What happens when antacids increase urinary pH?
increase excretion of acidic meds, decrease in excretion of basic meds
How should you space meds out with antacids?
1 hour before or after
What med do you not want to give with antacids?
quinolones
What do H2 receptors do?
make parietal cells less responsive to histamine
How do h2 receptors work?
competitive blocking of histamine receptors so you have less hydrogen ions
Can you use H2 receptors with antacids?
no, take them before or after
What are proton pump inhibtors?
stop the secretion of HCL
How do proton pump inhibitors work?
irreversibly bind to hydrogen, potassium, and ATPase enzyme. When bound all gastric secretion is blocked.
What is sucralfate?
a pepsin inhibitor used for pud or stress ulcers. Coats the GI tract and is a protective medication
What is a proton pump inhibitor a first line treatment for?
erosive esophagitis, GERD, active duodenal ulcers, gastric ulcers
What is long term use of proton pump inhibitors associated with?
C diff
What should you instruct people taking acid controlling drugs to do?
Drink at least 8 ounces of water to increase absorption, chew chewable tablets thoroughly and shake liquids before use. Watch for changes in BP, GI bleeds, GI irritation
What are the adverse effects of taking acid controlling drugs?
constipation, diarrhea, nausea, vomiting, abdominal pain, hypotension
