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Pharm 201 > Chapter 40 > Flashcards

Chapter 40 Flashcards

1
Q

Gastric Mucosa components

A

Chief cells
Parietal cells
Thick mucous layer and bicarbonate ion protect stomach mucosa from acid

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2
Q

Chief cells

A

Secrete pepsinogen

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3
Q

Parietal cells

A

HCL production 1-3L/day
Activates pepsinogen to pepsin
Kills bacteria
Intrinsic factor for B12 absorption

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4
Q

Lower Digestive Tract components

A

small and large intestine

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5
Q

Small intestine

A

Location for most nutrient & drug absorption

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6
Q

Peptic Ulcer Disease causes

A

H Pylori in 90%

NSAID use

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7
Q

Helicobacter pylori

A

smoking increases reoccurance

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8
Q

Peptic Ulcer Disease Risk Factors

A 
Family history
Type O blood
Glucocorticoids & NSAIDs
Psychological stress
NOT spicy foods
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9
Q

Duodenal ulcers

A

↑er in men, peaks 35-45 years of age
PAIN-FOOD-RELIEF
ulcers come and go and may need lifelong tx

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10
Q

Duodenal ulcers symptoms

A

Bright red blood in vomit

Black, tarry stools

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11
Q

Gastric Ulcers

A

↑er in women, peaks 50-60 years of age

H. pylori present in 50-70%

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12
Q

Gastric Ulcers symptoms

A 
Burning/gaseous pressure
Pain continues after meals
Anorexia, weight loss, vomiting
Nocturnal pain, nausea
more commonly associated with CA
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13
Q

GERD can cause

A

esophageal ulcers, esophagitis, strictures

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14
Q

GERD symptoms

A

heartburn, regurgitation, early satiety, post-meal bloating, N&V, hiccoughs, “something in throat”

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15
Q

GERD risks

A

obesity

over 40

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16
Q

Meds that ↓ acid production

A

PPIs, H2 blockers, Antacids

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17
Q

Meds that ↑ mucosal protection

A

Prostaglandin analogue

Pepsin Inhibitor

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18
Q

Proton Pump Inhibitors ending

A

prazole

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19
Q

PPI long term use

A

decrease nutrient absorption

nexium decreases Mg

20
Q

H2-Receptor Blockers action

A

↓gastric acid secretion by blocking action at histamine 2 receptors in parietal cells

21
Q

H2-Receptor Blockers ending

22
Q

H2-Receptor Blockers teaching

A 
take after meals
do not take w/ antacids (decreases abs)
give at bedtime or take with food
can cause confusion in elderly
check kidney and liver function
23
Q

cimetadine (Tagamet) administration

A

Not given often due to drug-drug interactions & take 4 x /day

24
Q

cimetadine (Tagamet) adverse effects

A

agranulocytosis = ↓RBCs, WBCs, & platelets, impotence or ↓libido, gynecomastia, in men
Hepatotoxicity, psychoses, cardiac dysrhythmias, H/A, dizziness, constipation, pruritus, skin rash,

25
Q

ranitidine (Zantac) administration

A

preferred over tagamet

given 1 vs 4x daily

26
Q

Aluminum antacids

A

may cause constipation

27
Q

aluminum hydroxide (Amphojel, Alternagel) catagory

28
Q

aluminum hydroxide (Amphojel, Alternagel) adverse effects

A

minor; constipation, nausea

Prolonged use can limit phosphate absorption

29
Q

aluminum hydroxide (Amphojel, Alternagel) teaching

A

does not heal ulcer or cure H pylori

30
Q

Antacids teaching

A

do not take with H2 blockers
do not use w/ Mg in kidney disease
take 2 hours before or after other meds
stool may be white

31
Q

milk-alkali syndrome

A

Milk + Ca+ carbonate cause ↑ Ca+

32
Q

Pepsin Inhibitor function

A

Protect gastric mucosa

33
Q

Pepsin Inhibitor example

A

Sucralfate (Carafate)

34
Q

Pepsin Inhibitor teaching

A

take 1 hour before meals
take 4x daily
do not take w/ antacids (1 hour before or after)
decreases abs of other meds so take at different time
does not effect acid production

35
Q

Pepsin Inhibitor side effects

A

constipation, dry mouth, nausea

36
Q

Prostaglandin Analogue function

A

Prevents ulcers in NSAID, Prednisone use

↑ mucous ↓ acid secretion

37
Q

Misoprostol (Cytotec) category

A

Prostaglandin Analogue

38
Q

GI Stimulant (Prokinetic) use

A

given for GERD if other tx not successful

nausea/vomiting

39
Q

Metoclopramide (Reglan) catagory

A

GI Stimulant (Prokinetic)

40
Q

Metoclopramide (Reglan) adverse effects

A

drowsiness, fatigue, extrapyramidal and/or acute dystonic reactions , cholinergic-like effects, hyperprolactinemia

41
Q

Metoclopramide (Reglan) dosing

A

30 min before meals and bedtime

42
Q

Bethanechol chloride (Urecholine)

A

parasympathomimetic

Cholinergic

43
Q

Bethanechol chloride (Urecholine) use

A

Increase tone of esophagus, stomach and intestines

improves digestion

44
Q

Bethanechol chloride (Urecholine) contraindications

A

COPD, hypotension, peptic ulcer, recent GI surgery

45
Q

Bethanechol chloride (Urecholine) administration

A

Must be taken 1 h before meals & bedtime

Give on an empty stomach

46
Q

Bethanechol chloride (Urecholine) adverse effects

A

N & V, abdominal cramps, diarrhea, ↓ BP

Pharm 201 (24 decks)

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