Chapter 50 Flashcards
The stomach is lined with secretory cells. true or false?
true
The stomach is very acidic, there’s Hydrochloric acid (HCl) present. This aids in digestion but what else does it do for the stomach?
it’s a barrier against infection and microorganisms
List the 3 types of cells (highlighted) of the Gastric Gland
* Parietal Cells * Chief Cells * Mucous Cells
Which specific cell type ( of the Gastric Gland ) produces and secretes HCl?
(hydrochloric acid)
Parietal cells
(acidic secretions)
Which of the 3 gastric gland cells is the Primary site of action for many acid-controller drugs?
Parietal Cells
(secrete HCl)
Which proenzyme do Chief cells secrete?
Pepsinogen
When Pepsinogen becomes activated by being exposed to acid, what does it become?
Pepsin
Which of the 3 types of gastric gland cells are considered surface epithelial cells because of where you find them?
Mucous cells
What do mucous cells provide that helps protect against self-digestion by HCl?
a protective mucus coat
What do mucous cells secrete?
(don’t overthink it)
mucus
What does being a proenzyme mean?
(like pepsinogen)
it’s an enzyme precursor
What is actually happening when Pepsinogen is exposed to acid?
Pepsinogen activates and becomes Pepsin (the acid breaks it down) then it’s in it’s activated form which is Pepsin
Pepsin then assits in digestion process because it breaks down proteins
What is the commonly talked about stomach bacteria that gets in and causes infection?
H. pylori
What stimulates Parietal cells to secrete Hydrochloric Acid?
food
- large fatty meals
- excessive alcohol
- emotional stress
- Chocolate
What range is the pH of our stomach
1-4
very acidic
What do PUD and GERD stand for?
PUD= Peptic Ulcer Disease
GERD= Gastroesophageal Refux Disease
What do they find in the GI Tract of 90% of the patients that have duodenal ulcers and 70% of those with gastric ulcers?
H. pylori
(Helicobacter pylori)
How do you detect H. pylori and how is it treated?
*detected by serum antibody tests
*treated with antibiotics
What is the most common Acid-related Disease?
hyperacidity
PUD, GERD, and H. pylori all have what in common?
they are all related to excessive acid in the stomach
H. pylori caneasily be treated with antibiotics. If you don’t treat H. pylori with antibiotics, it can get out of control and eventually lead to ______.
cancer
What are the 3 types of Acid-controlling drugs
- Antacids
- H2 antagonists
- Proton pump inhibitors
Do Antacids neutralize or lessen stomac acid?
neutralize
Do Antacids STOP THE PRODUCTION/ OVERPRODUCTION of acid in the stomach?
NO!
What helps “buffer” the acidic properties of the HCl (hydrochloric acid)?
bicarbonate
(buffers, chemicals used by the body to prevent sudden, rapid changes in the pH of a fluid)
Antacids promote gastric mucosal defense mechanisms by Secretion of :
- ______
- ___________
- ______________
- mucus
- bicarbonate
- prostaglandins
Takin an Antacid leads to the production of mucuc, bicarbonate, and prostaglandins.
What is the function of the prostaglandins that are secreted in the stomach
prevent activation of proton pump
Drug effects expected from an antacid are overall symptomatic relief. Antacids don’t do anything to remedy the cause of the problem
true or false?
true
Antacids reduce the acidity (by raising pH) and this leads to relief from pain. What is causing the pain?
the acid causes the pain
Raising the Gastric pH by _ point neutralizes 90% of the gastric acid
1 point
(1.3 pH - 2.3 pH )
Raising gastric pH from ___ to ___ neutralizes 50% of the gastric acid
1.3 - 1.6
The majority of Antacids are available over- the- counter as capsules, tablets, powders, liquids and suspensions. You can buy Antacids prepared in one of two ways. What are the two options?
Antacids alone
or
Antacids in combination with
- aluminum salts
- magnesium salts
- calcium salts
- sodium bicarbonate
What effects do Aluminum salts have?
constipation
Doctors recommend Aluminum salts (antacids) to patients that have _____ disease, as long as _________ is not included, because they are easiest to excrete.
renal disease
magnesium not included
Why might they include magnesium in an aluminum salt antacid?
to counteract constipation
Aluminum and _______ cause patients to be constipated
aluminum and calcium
________ salts are “safer” than calcium or magnesium would be for renal disease patients
aluminum salts
(safer, but still not completely safe)
What is the common side effect of Magnesium salts?
commonly cause diarrhea
(they are normally used with other drugs to counteract the effect)
Which of the antacid “salts” is the most dangerous for patients with renal disease because of the failing kidney not being able to excrete it which leads to accumulation?
Magnesium Salts
Which form of antacid (salt) is the oldest and most common
Calcium salts
Name the most common form of Calcium salt (antacid)
Carbonate
Give two common side effects of Calcium Salts (antacids)
- constipation
- kidney stones
Calcium salts are not recommended for patients with Renal failure because just like magnesium, it is difficult for the kidneys to excrete it so then the calcium accumulates in the system.. It accumulates to extremely toxic levels and having too much Calcium accumulate in your system can cause major issues with which two main areas of the body?
Cardiac issues
Muscular issues
Give a few descriptive factors about Sodium bicarbonate (a common antacid)
highly soluble, quick onset short duration, buffers the acidic properties of HCl, may cause metabolic alkalosis
What would be the cause of metabolic alkalosis?
too much bicarbonate in the blood
What part of sodium bicarbonate might cause problems with patients that have HF (heart failure), hypertension, or renal insufficiency?
(people with these conditiond should not take sodium bicarbonate)
the Sodium content
Lots of H+ means a ____ pH
Lots of -OH means a ____ pH
low (very acidic)
high (very alkaline)
What are Antiflatulants used for?
used to relieve the painful symptoms associated with gas
often times, antiacid combination products are combined with what?
antiflatulants
What does Mylicon (Simethicone) do for infants ?
relieves gas by altering the elasticity of the gas pockets causing them to break so that the gas does not build up
What are the drug interactions that we need to worry about when taking antacids?
taking antacids will….
*reduce the ability of other drugs to be absorbed into the body
* Chelation (can render a drug you’re taking completely inactive because it’s been chelated)
*increased stomach pH (increase absorption of basic drugs, decrease absorption of acidic drugs)
*increase urinary pH (increase excretion of acidic drugs, decrease excretion of basic drugs)
H2 Antagonists are used for people who have what diseases and issues?
- GERD
- PUD
- erosive esophagitis
- Adjunct therapy to control upper GI Bleeding
- Pathologic gastric hypersecretory conditions
When you need to administer another medication as well as an antacid, make sure to give the other medication _ hour before or _ hours after the antacid
1 hour before
2 hours after
Antacids may cause premature dissolving of what type of medication that will ultimately result in stomach upset?
Enteric-coated medications
With Antacids, chewable tablets must be chewed thoroughly and liquid forms must be shaken well.
true or false?
true
How many ounces of water should you drink along with your antacid to enhance absorption?
(except for “rapid-dissolve forms”)
at least 8 ounces
Longterm self-medicating with antacids could be masking symptoms of serious underlying diseases such as ______ or ________ _____
cancer
bleeding ulcers
What specific type of Antagonist is Pepcid (famotidine) or Zantac (ranitidine)?
H2 Antagonist
(Histamine type 2)
(used to be Rx only but now most available over-the-counter in lower dosage forms)
How do H2 Antagonists work?
these drugs work by blocking histamine at the histamine type 2 (H2) receptors in acid producing parietal cells
Name a drug effect of an H2 Antagonist
suppressed acid-secretion in the stomach
When H2 Antagonists block the H2 receptors in the acid-producing parietal cells, the production of ________ ions is reduced, resulting in decreased production of HCl in the stomach
Hydrogen Ions reduced
There are very few adverse effects to taking an H2 Antagonist
true or false?
true
H2 Antagonist Cimetidine, may cause _________ and gynecomastia.
in elderly patients it may also cause headaches, lethargy, confusion, diarrhea, urticaria, sweating, and flushing
impotence
