Chapter 40: Drugs for Peptic Ulcer Disease and GI Problems

Question 1

proton pump inhibitor

Answer 1

reduce acid secretion in the stomach by binding irreversibly to the enzyme H+, K+ ATPase.

Question 2

Esomeprazole (Nexium)

Answer 2

PPI: adverse effects- headache, diarrhea, nausea, rash, dizziness

Question 3

Lansoprazole (Prevacid)

Answer 3

PPI: adverse effects- headache, diarrhea, nausea, rash, dizziness

Question 4

Omperazole (Prilosec) PROTOTYPE DRUG

Answer 4

PPI: adverse effects- headache, diarrhea, nausea, rash, dizziness. Concurrent use with diazepam, phenytoin and CNS depressants may cause increased blood levels of these drugs. Use with warafin may increase the likelihood of bleeding. OTC use not approved for patients under the age of 18. Should be taken on an empty stomach. Can be take w/ antacids.

Question 5

Pantoprazole (Protonix)

Answer 5

PPI: adverse effects- headache, diarrhea, nausea, rash, dizziness

Question 6

Rabeprazole (AciHex)

Answer 6

PPI: adverse effects- headache, diarrhea, nausea, rash, dizziness

Question 7

alimentary canal

Answer 7

aka: GI tract. It is a long, continuous, hollow tube that extends from the mouth to the anus.

Question 8

mucosa layer

Answer 8

the inner lining of the alimentary canal. It provides a surface area for the various acids, bases, mucus and enzymes to break down food. May contain deep grooves and pits.

Question 9

H2 Receptor Blockers

Answer 9

Form of histamine. H2 receptors are responsible for increasing acid secretion in the stomach. H2 blockers are effective at suppressing the volume and acidity of parietal cell secretions. Used to treat symptoms of PUD and GERD.

Question 10

ranitidine (Zantac)

Answer 10

Anti-ulcer drug/ H2 receptor antagonist. Administer after meals and monitor liver and renal function. Wait 1 hr to administer antacids. No OTC in children under 12.

Question 11

antacids

Answer 11

Alkaline substances that have been used to neutralize stomach acid for 100s of years. Available over the counter. Only treats symptoms.

Question 12

Amphojel (aluminum hydroxide)

Answer 12

Prototype Drug for antacids. Adverse side effects include constipation, nausea and stomach cramps. FECAL IMPACTION, HYPOPHOPHATEMIA.

Question 13

Milk of Magnesia (Mg Hydroxide)

Answer 13

diarrhea, nausea, vomiting and abdominal cramping. HYPERMAGNESEMIA, DYSRHYTMIAS (when given parenternally).

Question 14

Bulk Forming Laxatives

Answer 14

Absorb water, thus adding size to the fecal mass. These are preferred drugs for the treatment and prevention of chronic constipation, and may be taken on a regular basis w/out ill effects. B/c of their slow onset of action, they are not used when a rapid and complete bowel evacuation is necessary.

Question 15

Stool Softener/Emollients

Answer 15

Laxatives cause more water and fat to be absorbed into the stools. They are most often used to prevent constipation, especially in patients who hae undergone surgery.

Question 16

Stimulant Laxatives

Answer 16

Laxatives that promote peristalsis by irritating the bowel mucosa. They are rapid acting and more likely to cause diarrhea and cramping than the bulk forming type of laxatives. Should only be used occasionally, as they can cause dependence and depletion of fluid and electrolytes.

Question 17

Metamucil (psyllium mucilloid)

Answer 17

bulk type laxative/natural product: Adverse side effects- if not taken w enough water, can cause obstructions in the esosphagus and intestine. May increase blood serum glucose levels. Very safe.

Question 18

Lotmotil (diphenoxylate with Atropine)

Answer 18

Prototype Drug: Antidiarrheal/Opioid - slows peristalsis, allowing time for additional water reabsorption from the colon to form more solid stools. Not recommended for children. Side Effect: has no analgesic properties and has low potential for abuse. Drug is well tolerated at normal doses. Some patients may experience dizziness…do not drive or operate machinery. Could be a conflict in patients w severe liver disease, severe dehydration, narrow angle glaucoma and colitis.

Question 19

Colace (docusate)

Answer 19

Stool Softener/Surfactant -adverse side effects: no serious; abdominal cramping and diarrhea.

Question 20

Senokot

Answer 20

Laxative/Natural Agent - no serious side effect, abdominal cramping and diarrhea.

Question 21

Sulfasalazine (Azulfidine)

Answer 21

IBD/5 ASA agent: anti-inflammatory that is approved to treat mild to moderate symptoms of ulcerative colitis, Crohns and RA. Classified as a DMARD. Inhibits prostaglandins and leukotrienes.

Question 22

misoprostol

Answer 22

inhibits acid and stimulates production of mucus…considered a miscellaneous drug used to treat PUD

Question 23

dicyclomine (Bentyl)

Answer 23

?

Question 24

Dramamine (dimenhydrinate)

Answer 24

This antihistamine is effective against motion sickness and is considered an ANTIEMETIC. May cause significant drowsiness. Other common side effects include: dry mouth and blurred vision. Severe side effects: hypersensitivity rxn, tremors, seizures, hallucinations, paradoxical excitation and hypotension. DRUGS USED TO TREAT MOTION SICKNESS ARE MOST EFFECTIVE WHEN TAKE 20-60 MINUTES BEFORE TRAVEL IS EXPECTED.

Question 25

Zofran (ondansetron)

Answer 25

Antiemetics - Serotonin Receptor Anatagonist; side effects: headache, drowsiness, fatige, consitipation and diarrhea. Severe side effects: dysrhythmias.

Question 26

Pepto-Bismol

Answer 26

Antidiarrheal - Bismuth Salts; side effects: constipation, nausea, tinnitus. Severe side effects: Impaction, Reye’s syndrome.

Question 27

Sandostatin (octreotide)

Answer 27

Antidiarrheal/Miscellaneous Agent; side effects: nausea, diarrhea, abdominal pain. Severe side effects: changes in serum glucose, gallstones, cholestatic hepatitis

Question 28

Opiates

Answer 28

Antidiarrheals/Opioids: Opiates slow peristalsis, allowing time for additional water reabsorption from the colon and more solid stools

Question 29

saline cathartics: aka - osmotic laxatives

Answer 29

Laxative: function by pulling water into the fecal mass to create a more watery stool. These agents can produce a bowel movement very quickly and should not be used on a regular basis b/c of the possibility of fluid and electrolyte depletion. Side effects include: diarrhea, abdominal cramping. Severe: dysrhythmias due to altered Mg levels. Possible respiratory levels.

Question 30

kayopectate

Answer 30

antidiarrheal/abosorbant: active ingredient is bismuth subsalicylate. B/C of salicylate, severe side effect could be Reye’s syndrome. Equivalent to Pepto-Bismol. Common side effects: constipation, nausea, TINNITITUS.

Question 31

misoprostol (Cytotec)

Answer 31

PUD/Micellaneous Drug: Inhibits gastric acid secretion and stimulates the production of PROTECTIVE MUCUS. Its primary use is for the prevention of peptic ulcers in pts taking high doeses of NSAID or corticosterioids. Common sides effects: diarrhea and ab. cramps. CONTRAINDICATED for pregnant woman. Can be used to end pregnancies.