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343 Pharm Exam 4 > Chapter 46: Antiulcer Drugs > Flashcards

Chapter 46: Antiulcer Drugs Flashcards

1
Q

What is gastric ulcers? Like where?

A

Ulcers in the stomach

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2
Q

Where is esophageal ulcers?

A

In the esophagus

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3
Q

Where is duodenal ulcers?

A

In the early part of the small intestine

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4
Q

What are reason why we get peptic ulceration? (3)

A

Mucosal lining erosion
Hyper secretions
( hycrocholirc acid or pepsin )
Gastric ph too low

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5
Q

What are some factors that cause or predisposed a patient to peptic ulcers?

Main bacteria?

A

H.pylori
Mechanism disturbances
( how food flows their your gut, genetic influence )
Genetic influence
Environmental influence

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6
Q

What 2 medication increases ulcers?

A

NSAIDs and steroids

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7
Q

What are the 2 main symptoms of peptic ulcers?

A

Gnawing and aching pain

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8
Q

What is the definition of peptic ulcer disease?

A

Gastric or duodenal ulcers that involve digestion of the GI mucosa by the enzyme pepsin

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9
Q

H. Pylori is the found in almost all ulcers, so what’s the first line therapy for these patients?

A

10-14 day course of PPI and antibiotics

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10
Q

Why does esophageal ulcers occur?

A

Due to reflux of acid gastric secretions into the esophagus from an incompetence cardiac spichter

( GERD )

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11
Q

Why does gastric ulcer occur?

A

Due to breakdown of gastric mucosal barrier

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12
Q

Why does duodenal ulcers occur?

A

Due to hypersecretion of acid

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13
Q

What is stress ulcers usually caused by?

A

It’s in the name itself
However mainly from trauma, burns and major surgery

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14
Q

Usually what is the first finding of a stress ulcers after a patient in the ICU comes back from surgery 24 hours after?

A

GI lesions

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15
Q

What are some symptoms we can see with stress ulcers ? (3)

A

Decreased blood flow
Mucosal ischemia
Hypo perfusion and repefusion of inury

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16
Q

Does an NG tube and ventilator cause GI bleeding?

A

Yess it can

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17
Q

Usually what do we want to do for these patients, for stress ulcers, like how do we prevent?

A

Usually using PPI
And or histamine receptor

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18
Q

What is GERD?

A

Inflammation or erosion of the esophageal mucosa caused by reflux or gastric acid content into the esophagus

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19
Q

What causes GERD?

A

Incompetent lower esophageal spincter

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20
Q

Does GERD have ulcers?

A

No
They can lead to ulcers tho!

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21
Q

What can aggravate GERD?

A

Smoking
Spicy foods
Citrus stuff

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22
Q

What is the 3 treatment we use to help GERD?

A

Antiulcer drugs
H2 blockers
PPIs

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23
Q

What are some Nonpharmacologic measure for ulcers?

A

Avoid tobacco and alcohol
Weight loss
Avoid hot spicy greasy foods
Take nsaids and steroids with food
Don’t eat before bedtime
Wear loose fitting clothing
Elevate HOB

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24
Q

What are the 7 anti ulcer drug options we are going to talk about?

A

Tranquilizers
Anticholinergic
Antacids
H2 blockers
Proton pump inhibitors
Pepsin inhibitors
Prostaglandin analogue

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25
Q

What are tranquilizers mix with?

A

Anxiety medication and anticholinergic

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26
Q

What is the action of tranquilizers and how it places a role in helping with ulcers?

A

So it reduces the Vegas nerve which runs right by our stomach by reducing the amount of acid producing & the anti cholinergic helps dry up gastric secretions

27
Q

What are the side effects of tranquilizers? (3)

A

Edema
Ataxia ( unsteady movement )
Confusion

28
Q

What does anticholinergic drugs do?

A

Pretty much help reduce the amount of acid in the body and helps dry it out

29
Q

What are anticholinergic drug side effects?

A

Same dry mouth
Headache
Dizziness
Blurred vision
Urinary rention and constipation
( no glaucoma !

30
Q

What is the first line of treatment for ulcers ? Usually OTC?

A

Antacids

31
Q

What are the 4 antacids?

A

Sodium bicarbonate
Calcium carbonate
Magnesium hydroxide
Aluminum hydroxide

32
Q

What is our biggest concern of sodium bicarbonate? ( baking soda )

A

Hypernatremia !!( too much sodium )
Water rentetion
Metabolic alkalosis

33
Q

What is the effect or action of sodium bicarbonate we tell patients about?

A

It’s quick onset but it doesn’t last long
And you can have that rebound again

34
Q

In which patients should be careful with the administer of sodium bicarbonate?

A

Caution in patients with heart failure
Hypertension
Renal insufficiency

35
Q

Calcium carbonate ( tongs )
Help reduce the acid in the stomach
What are the 4 side effects?

A

Acid rebound
Constipation
Hyper calcium
Hypo phosphorus

36
Q

What’s important to remember is that whenever we see high calcium what do we think?

A

Low phosphors

Or vise versa

37
Q

What is a complication of calcium carbonate ? (3)

A

Burnett syndrome alkalosis
Hypercalcemia
Crystalluria& renal failure

38
Q

What is the side effect of magnesium hydroxide?

A

Diarrhea - often mixed with alminium hydroxide

39
Q

Magnesium hydroxide is very dangerous against which type of patients?

A

Renal failure
( failing kidney cannot excrete extra magnesium )

40
Q

Aluminum hydroxide side effects? (4)

A

Constipation
Anoriexa
Weakness
Impaired cognition

41
Q

What are your aluminum hydroxide complication?

A

Hypo phoso
Hyper calcium
Osteroposories
Neprhotlithaid
GI constipation

42
Q

Usually again that magnesium causing diarrhea and aluminum causing constipation what do we do?

A

Mix them together so it levels out

43
Q

What is the function behind antacids?

A

Neutralize HCI and reduced pepsin activity

Increasing PH in the stomach and bladder

44
Q

If the ph is not where it needs to be in the stomach, usually because antacids increase it, what happens with other drugs?

A

Usually will not be absorbed

45
Q

What drug binds with calcium and should be avoided with antacids?

A

Tetracyclines

46
Q

Most medication should be administered _ to _ hours after an antacids?

A

1-2

47
Q

Educate patients that long term use of antacids can what?

A

Hide underlying causes or bleeding

48
Q

Now onto histamine blockers 2

A
49
Q

What is the action of histamine blockers 2?

A

These block h2 receptors that is released

50
Q

What are the 3 histamine blockers 2?

A

Cimetidine ( Tagamet )
Nizatidine ( axid )
Famotidine ( Pepcid (

51
Q

What are some side effects of h2 blockers? (3)

A

Erectile dysfunction
Vitamin b12 deficiency
Theombocytopenia

52
Q

Remmeber H1 is for allergies
H2 is for ulcers

A
53
Q

Proton pump inhibitors!!

A
54
Q

What is the action of PPI?

A

So in our body, we have this enzyme hydrogen/potassium ATPase enzyme in the parietal cells that release this protons causing that heavy secretions of acid

But the PPI literally shuts that down! And restarts it to a better level of acid

55
Q

What is PPI side effects? (3)

A

Vitamin B12 deficiency
Hypomagenseima
Blood dyscrasias

56
Q

PPI are highly protein bound
So if you give this to another protein bound medication, like digoxin, it’ll have a more effect on which one?

A

Digoxin!

57
Q

Pepsin inhibitors!!

A
58
Q

What is pepsin inhibitors action?

A

Combined with protein to form thick paste covering ulcer protecting ulcer from acid and pepsin

Covers stomach lining and protecting its from the acid

59
Q

What is the pepsin side effect?

A

Constipation !

60
Q

Pepsin
Given 1 hour before meals and bedtime
Do not give other medication at the same time

Drug interactions
Decrease the absorption of tetracycline, phenytoin, fat double vitamins, cipro, norfloxacin

Hour of antacids separation

A
61
Q

Prostaglandins analogue

A
62
Q

What are the two medication of prostaglandin analogue?

A

Cytotec
Misoprostol

63
Q

What is the action of prostaglandin analogue?

A

Decrease acid secretions
Protects gastric mucosa
Usually given for NSAIDS

64
Q

Prostaglandin analogue contraindication??????

A

Abortion pill !!!!!!!!!

( either for abortion or cervix dilation )

343 Pharm Exam 4 (6 decks)

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