Drug affecting Gi secretions chap. 57

Question 1

What are are acid related disease?

Answer 1

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

Question 2

What is hydrochloric acid (HCl)

Answer 2

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!)

Question 3

What do acid controlling meds do ?

Answer 3

Decrease secretion activity, block action of
secretions, or form protective coating
H2 antagonists
Proton pump inhibitors (PPIs)
Antacids
GI Protectants
Prostaglandins

Question 4

What is famotidine (Pepcid)?

Answer 4

Histamines -2 antagonists
Most popular drugs for treatment of acid-related disorders

Question 5

What is the therapeutic actions of famotidine (Pepcid)?

Answer 5

Histamines -2 antagonists
Block release of HCl in response to gastrin

Question 6

What is the pharmacokinetics of famotidine (Pepcid)?

Answer 6

Histamines -2 antagonists

Administer with or before meals and HS

Question 7

What are the adverse effects of famotidine (Pepcid)?

Answer 7

Histamines -2 antagonists

Overall very few
- GI  diarrhea or constipation
- CNS effects – H/A, drowsiness
-Cardiac complications – more
frequent with IV administration

Question 8

What are contras of famotidine (Pepcid)?

Answer 8

Histamines -2 antagonists

allergy

Question 9

What are cautions with famotidine (Pepcid)?

Answer 9

Histamines -2 antagonists

• Pregnancy/ lactation
• Thrombocytopenia
  -Renal/hepatic dysfunction
  -Decrease in acidity may
  decrease B12 absorption

Question 10

What are drug to drug interactions famotidine (Pepcid)?

Answer 10

Histamines -2 antagonists

May increase effects of benzos, warfarin, phenytoin, beta blockers

Question 11

What is omeprazole (Prilosec)?

Answer 11

Proton pump inhibitors(PPIS)

Question 12

What is therapeutic action omeprazole (Prilosec)?

Answer 12

Proton pump inhibitors(PPIS)
Suppress gastric secretion of
HCl into lumen of the stomach

Question 13

What is pharmacokinetics omeprazole (Prilosec)?

Answer 13

Proton pump inhibitors(PPIS)
Administer before meals –
action decreased by food

Question 14

What is adverse affects omeprazole (Prilosec)?

Answer 14

Proton pump inhibitors(PPIS)
CNS effects  HA, dizziness

Question 15

What is contras omeprazole (Prilosec)?

Answer 15

Proton pump inhibitors(PPIS
Allergy

Question 16

What are cautions omeprazole (Prilosec)?

Answer 16

Proton pump inhibitors(PPIS
Pregnancy/lactation

Question 17

What are drug interactions with omeprazole (Prilosec)?

Answer 17

Proton pump inhibitors(PPIS)
-Decreased absorption of Vit. B12
-May increase effect/ levels of phenytoin, warfarin, benzos

Question 18

What is antacids?

Answer 18

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

Question 19

What are drug to drug interactions with antacids?

Answer 19

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

Question 20

What are nursing cosniderations with antacids?

Answer 20

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

Question 21

What is sucralfate (Carafate)?

Answer 21

Gi protectants

Question 22

What is therapeutic action of sucralfate (Carafate)?

Answer 22

Gi protectants
Coat injured area to protect
from further injury, promotes healing

Question 23

What is pharmacokinetics of sucralfate (Carafate)?

Answer 23

Gi protectants
Admin on empty stomach

Question 24

What are adverse affects sucralfate (Carafate)?

Answer 24

Gi protectants
GI  constipation*

Question 25

What are contras sucralfate (Carafate)?

Answer 25

Gi protectants
Allergy
 Renal failure/ dialysis

Question 26

What are cautions sucralfate (Carafate)?

Answer 26

Gi protectants
Pregnancy/lactation

Question 27

What are drug to drug sucralfate (Carafate)?

Answer 27

Gi protectants
Decreased effectiveness of
phenytoin, fluoroquinolones–>
separate by 2 hrs

Question 28

What is misoprostol (Cytotec)?

Answer 28

Prostaglandins

Question 29

What is therapeutic actions of misoprostol (Cytotec)?

Answer 29

Prostaglandins
Protect stomach lining by inhibiting acid and increasing mucus for protection

Question 30

What are adverse effects of misoprostol (Cytotec)?

Answer 30

Prostaglandins
GI distress – nausea, vomiting

Question 31

What are contras of misoprostol (Cytotec)?

Answer 31

Prostaglandins
Pregnancy – category X!!

Question 32

What are cautions of misoprostol (Cytotec)?

Answer 32

Prostaglandins
Hepatic/renal disease

Question 33

What is pancrelipase (Pancrease)?

Answer 33

Digestive enzyme

Question 34

What is therapeutic actions of pancrelipase (Pancrease)?

Answer 34

Provide digestive enzymes needed to break down food into nutrients

Question 35

What is pharmacokinetics of pancrelipase (Pancrease)?

Answer 35

Capsules swallowed whole with meals

Question 36

What is adverse effects of pancrelipase (Pancrease)?

Answer 36

GI irritation – n/v/d, cramps

Question 37

What are contras of pancrelipase (Pancrease)?

Answer 37

Allergy to pork products