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Pharm 2 > Exam #3 Upper and Lower GI Pt.1 > Flashcards

Exam #3 Upper and Lower GI Pt.1 Flashcards

1
Q

Stomatitis

A
  • Inflammation in the oral cavity
  • Painful, red ulcerations
  • Ex: Canker sore, cold sore, herpes

Causes:
- Recent infections
- Nutrition changes
- Oral hygiene
- Trauma
- Stress

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2
Q

Stomatitis S/S & Interventions

A
  • Dysphagia
  • Blisters
  • Drooling, pain, swelling
  • Fever
  • Red patches

Interventions:
- Oral hygiene, clotrimazole, nyastin, chlorhexidine, cool or cold liquids, high protein, vit c
Meds: Viscous lidocaine, aluminum hydroxide

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3
Q

Leukoplakia

A
  • Thickened, white, firmly attached patches on the oral mucosa that cannot be easily scraped off
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4
Q

Erythroplakia

A
  • Percutaneous, appear red, velvety mucosal lesions on the floor of mouth, tongue and palate
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5
Q

Sialadenitis

A
  • A salivary gland infection: Causes inflammation

Causes: bacteria, viruses, salivary stone/ blockage, chronic inflammation, ionizing radiation to head/ neck

Treatment: offering fluids every hour, moist heat, massage, NSAIDS, Antibiotics
- If untreated an abscess can develop

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6
Q

GERD Risk Factors

A
  • GERD is when the acid from the stomach comes all the way up to the esophagus.
    Risk:
  • Certain meds
  • Smoking
  • Alcohol
  • Pregnancy
  • Obesity
  • Hiatal hernia
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7
Q

GERD S/S

A
  • Dyspepsia
  • Morning hoarseness
  • Coughing, wheezing at night
  • Difficult, painful when swallowing
  • Worse pain when laying down
  • Abdominal fullness, nausea, flatulence
  • Pain can mimic cardiac pain ( epigastric )
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8
Q

GERD Interventions

A
  • Antacids, histamine blockers, PPI
  • Diet; small, frequent meals, limit fried and fatty foods
  • Surgery
  • Sitting upright for at least 1 hour after eating!!!
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9
Q

GERD Complications

A
  • Adult onset asthma
  • Esophagitis ( Inflammation of the esophagus )
  • Stricture ( Narrowing of the esophagus )
  • Barrett’s Esophagus ( pre-cancerous changes to the esophagus )
  • Regurgitation of acid into lungs
  • Ulcers / bleeding
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10
Q

Barrett Esophagus

A

Reversible changes of the esophageal mucosa to columnar type because of chronic exposure to gastric secretions
- Wider opening
- Metaplasia can become dysplasia
- Complication of GERD

S/S:
- Often asymptomatic
- Heartburn, regurgitation

Treatment:
- Aggressive medications and surgery treatment of GERD
- Biopsies

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11
Q

Hiatal Hernia

A

Herniation of the stomach through the esophageal hiatus of the diaphragm
- Diagnosis: By barium swallow study with fluoroscopy

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12
Q

Hiatal Hernia S/S

A
  • Some asymtomatic
  • Some GERD symptoms like heartburn
  • Epigastric distress
  • Sour / acidic taste in throat
  • Symptoms increase after a meal / laying down
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13
Q

Hiatal Hernia Treatment

A
  • PPI/ antacids
  • Less fatty, fried foods
  • Lifestyle changes
  • Laparoscopic Nissen Fundolplication ( LNF ) stomach fundus is wrapped around the distal esophagus. The wrap anchors the lower esophagus below the diaphragm
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14
Q

Esophageal Tumors

A

S/S: Dysphagia, weight loss, heartburn, dry cough
Treatment: Small, frequent meal, high cal, high protein diet, no fatty foods, monitor weight
Surgical: Esophagectomy

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15
Q

Esophageal Perforation

A
  • Tear/ rupture creates hole through the esophageal layers
    Causes: Foreign body, trauma, infection, forceful vomiting
    S/S: PAIN, crepitus, systemic infection/ sepsis, hematemesis ( Mallory Weiss Tear ) … tear in the mucosal layer at the junction of the esophagus and stomach
    Treatment: NPO, stent, surgery
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16
Q

Gastritis

A

-Inflammation of the lining of the stomach
- Can be acute / chronic
Causes:
- H. Pylori, NSAIDS, Alcohol, Caffeine and Coffee, Cigarette smoking
S/S:
- N/V, abdominal pain
Diagnosis:
- EGD via endoscope
Interventions:
- Limit foods and spices that causes distress, avoid alcohol, caffeine, H2 Receptors, PPI, Antacids, Vit B12

17
Q

Peptic Ulcer Disease

A
  • Increased gastric acid secretion or a weakened mucosal barrier leads to mucosal erosion or ulceration
    Causes:
  • H.Pylori, NSAID, Smoking, Alcohol use, drug use, high stress
    S/S:
  • Epigastric tenderness/ pain, rigid board like abdomen with rebound tenderness and pain, dyspepsia, heartburn, sharp pain
    Diagnosis:
  • Testing for H.Pylori, stool antigen test
    Complications:
  • Hemorrhage
  • Perforation
  • Pyloric obstruction
  • Intractable disease
    Interventions:
  • Triple Therapy:
    PPI, Metronidiazole and tetracyline or clafithromycin and amoxicllin for 10-14 day
  • Quadruple Therapy: PPI, 2 antibiotics and bismuth therapy
  • Bland diet, stress reduction, smoking cessation
18
Q

Antibiotics:
Amoxicillian, Bismuth, Clarithromycin, Metronidazole, Tetracyline, Tinidazole

A
  • Eradification of H.Pylori
  • Combo of 2-3 antibiotics for 14 days
  • N/V/D is common
  • Take full course
19
Q

H2 Receptor Antaganists:
Ranitidine, Cimedtidine

A

MOA:Block H2 receptors, suppression of gastric acid.
Uses: GERD, Ulcers, acid indigestion
Comp: Cimetidine, Ranitidine, dont take with antacids
Cont: High risk for COPD, decrease dose in kidney disease
Education: Monitor for occult GI bleed, avoid alcohol, increase fiber

20
Q

Proton Pump Inihibitors ( PPI )
Omeprazole

A

MOA: Block the gastric proton pump
Uses: GERD- Limit treatment to 4-8 weeks
Comp: Headache, N/V/D
Inter: Digoxin, decreased effects with clopidogrel
Education: Do not crush, break, chew, take in morning on empty stomach, treats ulcers for 4-6 weeks, monitor for coffee ground emesis

21
Q

Mucosal Protectant
Sucralfate

A

MOA: Protective barrier that adheres to an ulcer.
Uses: Duodenal ulcers
Comp: Absorbed and eliminated in feces, can cause constipation
Cont: Caution in CKD. DM
Education: Take 1 hour prior to meals, dissolve in water

22
Q

Antacids
Aluminum Hydroxide, Mag, Calcium Carbonate

A

MOA: Neutralize/ reduce acidity of gastric acid
Comp: Al and Calcium = Constipation, mag = diarrhea
Education: Drink at least 8 ounces of water, NO MILK, take all meds at least one hour prior before antacid

23
Q

Gastric Cancer Risk Factors

A
  • Age
  • Diet
  • Atrophic gastris
  • H.Pylori
23
Q

Gastric Cancer S/S

A
  • May be asymptomatic if early stage
  • Abdominal discomfort
  • Anemia is present in advanced stage
    ( Macrocytic, Microcytic anemia )
24
Q

Gastric Cancer Diagnosis and Treatment

A
  • EGD w Biopsy to test
    Treat: Chemotherapy, radiation is limited because the disease often spread to other abdominal organs
    Surgical: Gastrectomy or subtotal gastrectomy

Pharm 2 (10 decks)

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