Drug affecting Gi secretions chap. 57 Flashcards
What are are acid related disease?
PUD: peptic ulcer disease
GERD: gastroesophageal reflux disease
Erosive esophagitis
Hypersecretion conditions
GI bleeds
Helicobacter pylori (H. pylori)
Bacterium found in GI tract of 90% of patients with duodenal ulcers, and
70% of those with gastric ulcers
Can be detected by serum antibody tests
Tx: combination PPIs and antibiotics
What is hydrochloric acid (HCl)
Secreted by the parietal cells when stimulated by
food
-Maintains stomach pH
-Secretion also stimulated by:
Large fatty meals
Excessive amounts of alcohol
Emotional stress (think SNS stimulation!)
What do acid controlling meds do ?
Decrease secretion activity, block action of
secretions, or form protective coating
H2 antagonists
Proton pump inhibitors (PPIs)
Antacids
GI Protectants
Prostaglandins
What is famotidine (Pepcid)?
Histamines -2 antagonists
Most popular drugs for treatment of acid-related disorders
What is the therapeutic actions of famotidine (Pepcid)?
Histamines -2 antagonists
Block release of HCl in response to gastrin
What is the pharmacokinetics of famotidine (Pepcid)?
Histamines -2 antagonists
Administer with or before meals and HS
What are the adverse effects of famotidine (Pepcid)?
Histamines -2 antagonists
Overall very few
- GI diarrhea or constipation
- CNS effects – H/A, drowsiness
-Cardiac complications – more
frequent with IV administration
What are contras of famotidine (Pepcid)?
Histamines -2 antagonists
allergy
What are cautions with famotidine (Pepcid)?
Histamines -2 antagonists
- Pregnancy/ lactation
- Thrombocytopenia
-Renal/hepatic dysfunction
-Decrease in acidity may
decrease B12 absorption
What are drug to drug interactions famotidine (Pepcid)?
Histamines -2 antagonists
May increase effects of benzos, warfarin, phenytoin, beta blockers
What is omeprazole (Prilosec)?
Proton pump inhibitors(PPIS)
What is therapeutic action omeprazole (Prilosec)?
Proton pump inhibitors(PPIS)
Suppress gastric secretion of
HCl into lumen of the stomach
What is pharmacokinetics omeprazole (Prilosec)?
Proton pump inhibitors(PPIS)
Administer before meals –
action decreased by food
What is adverse affects omeprazole (Prilosec)?
Proton pump inhibitors(PPIS)
CNS effects HA, dizziness
What is contras omeprazole (Prilosec)?
Proton pump inhibitors(PPIS
Allergy
What are cautions omeprazole (Prilosec)?
Proton pump inhibitors(PPIS
Pregnancy/lactation
What are drug interactions with omeprazole (Prilosec)?
Proton pump inhibitors(PPIS)
-Decreased absorption of Vit. B12
-May increase effect/ levels of phenytoin, warfarin, benzos
What is antacids?
Group of inorganic chemicals neutralize acid through
direct chemical reaction
Therapeutic action:
Neutralize stomach acid
Promote gastric mucosal defense mechanisms
Antacids DO NOT prevent over production of acid
Antacids DO neutralize the acid once it is in the stomach
What are drug to drug interactions with antacids?
Affect absorption of drugs in GI
tract
Most drugs formulated for
acid environment
Reduces the ability of the
drug to be absorbed into the
body
Result: reduced drug
absorption
Separate antacids by 1-2
hours
What are nursing cosniderations with antacids?
Assess for allergies and pre-existing
conditions:
Heart failure – sodium content
Renal dz
GI obstruction
F/E concerns
Be sure that chewable tablets are chewed
thoroughly, and liquid forms are shaken well
before giving
Administer with at least 8 ounces of water to
enhance absorption
Monitor for therapeutic response
Notify heath care provider if symptoms are not
relieved
What is sucralfate (Carafate)?
Gi protectants
What is therapeutic action of sucralfate (Carafate)?
Gi protectants
Coat injured area to protect
from further injury, promotes healing
What is pharmacokinetics of sucralfate (Carafate)?
Gi protectants
Admin on empty stomach
What are adverse affects sucralfate (Carafate)?
Gi protectants
GI constipation*
