Exam 3 - 50 51 52 54 Flashcards
Acid-related diseases are caused by?
imbalance of the three cells of gastric gland their secretions
What is the most common acid relate disease?
hyperacidity
What symptoms do clients report of acid-related diseases?
Clients report symptoms of overproduction of HCl by the parietal cells as indigestion, sour stomach, heartburn, acid stomach
What are some acid-related diseases?
PUD: peptic ulcer disease
GERD: gastroesophageal reflux disease
Helicobacter pylori (H. pylori)
Bacterium found in GI tract of 90% of patients with duodenal ulcers, and 70% of those with gastric ulcers is what bacteria?
H. Pylori
What therapy is used most often to eradicate H.pylori?
Combination therapy
What is the treatment for H.Pylori?
- Eight regimens approved by the FDA
- H. pylori is not associated with acute perforating ulcers
- It is suggested that factors other than the presence of H. pylori lead to ulceration
What are the types of acids-controlling agents?
- Antacids
- H2 antagonists
- Proton pump inhibitors
What is the mechanism of action for antacids?
Promote gastric mucosal defense mechanisms
Antacids have secretions of the mucus, bicarbonate, and prostaglandins. What are the mechanism of action for those?
- Mucus: protective barrier against HCl
- Bicarbonate: helps buffer acidic properties of HCl
- Prostaglandins: prevent activation of proton pump which results in HCl production
Antacids _____ prevent the over-production of acid?
DO NOT
Antacids _____ neutralize the acid once it’s in the stomach?
DO
What are some drug effects of antacids?
- Reduction of pain associated with acid-related disorders
- Raising gastric pH from 1.3 to 1.6 neutralizes 50% of the gastric acid
- Raising gastric pH 1 point (1.3 to 2.3) neutralizes 90% of the gastric acid
- Reducing acidity reduces pain
What 2 forms of antacids of aluminum salts are there?
Carbonate and Hydroxide
Aluminum salts can cause what kind of effects?
constipating effects
The counteract constipation with aluminum salts, what should you do?
It is often used with magnesium
What are some examples of aluminum salts?
- Aluminum carbonate: Basaljel
- Hydroxide salt: AlternaGEL
- Combination products (aluminum and magnesium): Gaviscon, Maalox, Mylanta, Di-Gel
What forms of magnesium salts are there?
Forms: carbonate, hydroxide, oxide, trisilicate
Magnesium salt commonly causes what?
diarrhea; usually used with other agents to counteract this effect
what antacid is dangerous to use with a pt with renal failure?
magnesium salt; the failing kidney cannot excrete extra magnesium, resulting in hypermagnesemia
Hypermagnesemia is the result when the kidney what?
when the failing kidney cannot excrete extra magnesium
What is MOM abbreviation?
Milk of Magnesia (magnesium hydroxide)
What are some examples of magnesium salts?
Hydroxide salt: magnesium hydroxide (MOM)
Carbonate salt: Gaviscon (also a combination product)
Combination products such as Maalox, Mylanta (aluminum and magnesium)
which antacid tastes like chalk?
Hydroxide salt: magnesium hydroxide (MOM)
What are some adverse effects using MOM?
- Abdominal cramping
- Diarrhea
- dehydration
If using MOM in the A.M., what happens in the P.M.?
a bowel movement
Milk of Mag stops the burning and keeps it under control where?
the stomach
What is the forms of calcium salts?
Many forms, but carbonate is most common
Calcium salts can cause diarrhea? T or F
False, Causes constipation
Using calcium salts too long may result in ___ ___?
- kidney stones; Those with kidney stones should stay away from a calcium base
- hyperacidity rebound
What is hyperacidity rebound?
increased gastric acid secretrion
how can hyperacidity rebound occur?
using antacid calcium salt too long; the acid action may cause increased gastric acid secretion
What is an example of a calcium salts?
-Tums (Calcium carbonate)
Calcium salt is often advertised as ?
An extra source of dietary calcium
Sodium bicarbonate offers as a buffer, it is a quick onset but short duration, the problem using this may cause what?
May cause metabolic alkalosis because of the Sodium content may cause problems in patients with HF, hypertension, or renal insufficiency (fluid retention)
True of false? Where ever salt goes, water will follow?
True
Along with antacids comes with antiflatulents. Antiflatulents are used for ?
- to relieve the painful symptoms associated with gas
- Several agents are used to bind or alter intestinal gas and are often added to antacid combination products
What are some drugs of antiflatulents?
- activated charcoal
- simethicone
What does simethicone do?
antiflatulent
- Alters elasticity of mucus-coated bubbles causing them to break
- it is used often, but there are limited data to support effectiveness
- walking also relieve gas bubbles
Another name for Amphojel?
aluminum hydroxide
Amphojel does what?
lowers the phosphate and raise the pH
what must use watch for when using aluminum hydroxide?
- fecal impaction
- instestinal obstruction
- hypophosphatemia