Gastrointestinal Flashcards
What is is Gastro Paresis?
Gastro Paresis - is a Nerve Damage Specifically of the “Vagus Nerve”. It disrupts Stomach function (Absence/Decreased Perestalsis) causing CONSTIPATION.
Signs and Symptoms of Gastro Paresis
- Constipation
- Bloating (Indigestion)
- N&V
- Heart Burn (↑ Acid)
Causes of Gastro Paresis
- Diabetes
- Surgery
- Narcotics (Morphine, Opioids, etc.)
Give example of ANTI-EMETICS.
- Metoclopramide (Reglan, Plasil)
- Promethazine
- Scopolamine Patch
What is the effect of Long term use of Metoclopramide and Promethazine?
Long term use Causes “Dartive Dyskinesia (EPS). TD S/sx are “Tongue Twitching and Lip Smacking”
Explain what is and how to use Scopolamine Patch.
- Most/ Best anti emetic drug to manage motion sickness
- Effective for 72 hours
- Use before 4 hours
- Place @ back of ear (NO hair)
- When replacing:
1. Remove Old patch first
2. Apply New one
3. Dispose old by sticking each side together
What is Orlistat?
Orlistat (Xenical) - is a Lipase Inhibitor. Lipase is responsible for Fat breakdown and absorption.
Mgmt: Must take ADEK vitamins.
What is Hiatal Hernia?
2 types of HH?
Hiatal Hernia - problem of weak muscle (diaphragm) causing ↑ Abdominal pressure. (E.g. heavy lifting, pregnancy, tumor, obesity)
- Sliding HH - Part of stomach goes up the LES.
- Rolling HH - Part of stomach goes side the LES. ** This can lead to rupture → infection → Peritonitis.
Signs and symptoms of Hiatal Hernia?
Mgmt. of HH?
S/sx. “Same with GERD” (Heartburn, Dysphagia)
Mgmt. “Same with GERD” (↑ HOB, SFF, ↓ Fluids @ meals.
** Avoid Irritants (CATSS) Coffee, Alcohol, Tea, Spicy, Smoking.
What are Proton Pump Inhibitors?
Long term use of PPI can lead to?
How to take PPI?
PPI - ↓ the Acid (HCL/Pepsin)
Ends in Prazole (Esomeprazole, Pantoprazole, Omeprazole)
They are use for Long Term
Long term use can lead to:
1. ↓ Ca+ absorption → Brittle bones/ Osteoporosis.
Mgmt. - Monitoring (Bone Density Test) - Calcium and Vit. D
- GI Infection. (Clostridium difficile) - Because of ↓ HCL in stomach. Also causes Respiratory Infection.
** PPI must be taken 1 hour before meals or 2 hours after meals.
What are H2 Blockers?
H2B - Also ↓ Acid (HCL and Pepsin)
They are use SHORT TERM
** BEST USE FOR OVERNIGHT RELIEF
Ends in TIDINE
(Cimetidine, Ranitidine, Famotidine)
Explain Function of Liver.
“PDSM”
P- “Produce” (ABC)
A. Albumin - Maintain oncotic pressure
B. Bile - Metabolize fat (Produce Vit. ADEK)
C. Clotting/Coagulation - Fibrinogen for bleeding
D - “Detoxify”
Meds, Alcohol, Hormones (Estrogen) ↑ Estrogen in woman causes “Red Palm & Spider Angioma. In men, Gynocomastia.
S - “Store”
Glucose (Glycogen)
Half life of Meds
M - “Metabolism”
Drugs (Before use)
Fats (For abs. of ADEK)
What is Liver Cirrhosis?
Causes of Liver Cirrhosis?
Liver Cirrhosis - is the SCARRING/DEGENERATION of tissues of the liver.
Causes: (1). Alcohol, (2).Infection (Hepa B & C) (3). Obesity
Give 7 Complications of Liver Cirrhosis.
- Portal Hypertension
- Bleeding
- Hepatic Encephalopathy
- Fluid Overload
- Renal Failure
- Jaundice
- Low ADEK Vitamins
Explain Portal Hypertension and its Mgmt.
Portal Hypertension
−↑pressure at portal vein
−↑Pressure to connecting organs
* Spleen (Splenomegaly) – ↓WBC
↓PLT
* GI/Abd – Ascites
* Esophageal Varices (If HPN is not
controlled, it will rupture)
➢ Priority Mgmt.
Sengstaken Blakemore Tube
* Inflate balloon to compress bleeding
of esophageal varices
* An NG tube at opposite nares to
collect secretion
* 3 tubes
1. Inflate at esophagus to prevent
bleeding (Esophageal Balloon)
2. Inflate below esophagus above
abdomen near sphincter (Gastric
balloon) Hook to stomach/anchor
3. Tube connected to stomach w/
weight tension)
* ***SCISSORS at bedside for
emergency dyspnea to immediately
deflate
