Exam 4 - GERD/PUD Flashcards
What does Parietal Secrete?
Acid in stomach
3 receptors on Parietal Call? What do they do?
Histamine H2
Gastrin
Achetylcholine
Activated cAMP by secreting H+ via Proton Pump
What do Prostaglandins stimulate secretion of?
Mucous and Bicarb
What are the gastric defenses?
Muscous and bicarb
What causes mucosal damage? What contributes?
Increased acid levels which overcome protective barrier. H Pylori and NSAIDs contribute.
Results in PUD, GERD, and stress-related mucosal injury.
Define PUD and cause?
Ulcers in lining of duodenum or gastric areas.
D/T NSAIDs, H Pylori, increased HCl, steroids, iron, bisphosphonates, smkoing
Define Stress Ulcers and cause?
Acute gastric or duodenal ulcers. Often in trauma patients.
Define GERD and causes
Retrograde passage of gastric contents from stomach to esophagus.
Inflammation of mucosa from increases gastric acid. D/T relaxes LES, increased gastric pressure, decreased gastric emptying time.
Signs and symptoms of GERD? Tx?
Heart burn, belching, chronic cough, hoarseness, dental erosions, angina
Tx= Antacids, OTC H2-antagonists, or PPI
Antacid MOA, use, and onset/duration?
Neutralizes acid and increases pH using Al, Ca, Mg. Primary use for intermittent symptoms.
10min onset, 1-2 hour duration
Antacid DDI, warnings, and ADR
DDI=Floroquinolones cause chelation; Itraconazole and iron cause increased pH and decreased absorption.
Al and Ca=Constipation
Mg=Diarrhea. Renal impairment warning!
Al and Ca cause what? Mg causes what? Renal issues?
Al and Ca=Constipation
Mg=Diarrhea. Renal impairment issues with Mg.
H2-blocker MOA and use?
Competes with histamine at H2 receptors on parietal call to decrease acid secretion.
Use: GERD, PUD, stress gastritis. Best for nocturnal acid.
H2-blockers end in what?
“-tidine”
H2-blockers warn/ADR with Cimetidine? Renal? Other?
Cimetidine=Increases prolactin, gynecomastic and galactorrhea
Increases Warfarin, phenytoin, diazepam, propanolol levels.
Renal dosing! Elderly dosing!