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Pharmacology and Therapeutic Terminology > GERD, Peptic Ulcer Disease - Chapter 21 > Flashcards

GERD, Peptic Ulcer Disease - Chapter 21 Flashcards

1
Q

Gastroesophageal Reflux Disease (GERD)

A
  • A motility disorder associated with impaired peristalsis

- Causes backflow of gastric contents into esophagus

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2
Q

Factors Contributing to GERD

A
  • Foods
  • Lifestyle
  • Body position
  • Hiatal Hernia
  • Pregnancy
  • Obesity
  • Immature digestive system (infants <1 year)
  • Rx and OTC medications
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3
Q

Hiatal Hernia

A
  • Prevents the diaphragm muscle from holding the LES in normal position and the sphincter shifts above the diaphragm
  • Significant risk factor for GERD in persons over 50
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4
Q

Drugs that aggravate GERD

A
  • Anticholinergics
  • Opioids
  • Calcium channel blockers
  • Nonsteroidal antiinflammatory drugs
  • Xanthines
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5
Q

What Causes LPR (Laryngopharyngeal Reflux)

A
  • Gastric contents reflux into the larynx and the pharynx and cause inflammation
  • Anatomical barriers that protect against LPR fail (upper/lower esophageal sphincters)
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6
Q

Peptic Ulcer Disease (PUD)

A
  • An ulcer is an open wound or sore

- A peptic ulcer is an ulcer that is located in the stomach (gastric) or duodenum (duodenal)

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7
Q

Risk Factors for PUD

A
  • Helicobacter pylori is the #1 cause for PUD
  • Family history of ulcers
  • Living with close relatives who have PUD
  • Age
  • Medicines (Salicylates, NSAIDS, corticosteroids)
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8
Q

Symptoms of GERD

A
  • difficulty swallowing
  • Dry cough
  • Bad breath
  • Bloating
  • Burping
  • Respiratory problems
  • Hoarseness
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9
Q

Symptoms of LPR

A
  • Hoarseness
  • Voice fatigue or breaks
  • Sore throat
  • Excessive phlegm or saliva
  • Chronic cough
  • Bad breath
  • Wheezing
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10
Q

Symptoms of PUD

A
  • Burning pain in the gut beginning 2-3 hours after a meal
  • Weight loss
  • Appetite loss
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11
Q

Common symptoms of GERD, LPR, and PUD

A
  • Heartburn
  • Stomachache
  • Hunger pains
  • Nausea/vomiting
  • Chest pain
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12
Q

Treatment Strategies for GERD, LPR, and PUD

A

1) Reduce GI irritants
2) Increase protective factors
3) Eliminate H. pylori (PUD)
4) Enhance peristalsis (GERD)

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13
Q

Drug Classifications for GERD, LPR and PUD

A

1) Acid neutralizing drugs (antacids)
2) Acid supressing drugs (histamine2 receptor antagonists, proton pump inhibitors)
3) Mucosal Protectants (prostaglandins, sucralfate)
4) Antiinfectives (eliminate H. pylori)
5) Prokinetic drugs (promote peristalsis)

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14
Q

Acid Neutralizers (Antacids)

A 
-Oldest drugs used for the treatment of 
GERD and PUD
-OTC
-Neutralize gastric acids which decreases pepsin secretion
-Effects only last 30-60 mins
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15
Q

Antacids Examples

A
  • aluminum hydroxide
  • magnesium hydroxide
  • aluminum hydroxide/magnesium hydroxide
  • aluminum hydroxide/magnesium hydroxide/simethicone
  • calcium carbonate
  • calcium carbonate/magnesium hydroxide
  • sodium bicarbonate/ASA/citric acid
  • sodium bicarbonate/citric acid
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16
Q

Generic: aluminum hydroxide

A

Amphojel

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17
Q

Generic: magnesium hydroxide

A

Milk of Magnesia

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18
Q

Generic: calcium carbonate

A

Tums

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19
Q

Generic: aluminum hydroxide/magnesium hydroxide

A

Maalox

Gelusil

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20
Q

Generic: aluminum hydroxide/magnesium hydroxide/simethicone

A

Diovol Plus

Maalox Suspension w/ Antigas

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21
Q

Generic: calcium carbonate/magnesium hydroxide

A

Diovol Plus AF

Rolaids

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22
Q

Generic: sodium bicarbonate/ASA/citric acid

A

Alka-Seltzer

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23
Q

Generic: socium bicarbonate/citric acid

A

Eno

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24
Q

Antacids ADR’s

A
  • With Magnesium: Diarrhea
  • With Aluminum: Constipation, hypophosphatemia
  • With Calcium: Constipation, hypercalcemia, kidney stones
  • Sodium Bicarbonate: Rebound hyperacidity, metabolic alkalosis, edema, hypertension
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25
Q

Unique GERD Treatment

A
  • alginic acid/aluminum carbonate

- alginic acid/magnesium carbonate

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26
Q

Generic: alginic acid/aluminum carbonate

A

Gaviscon Liquid

27
Q

Generic: alginic acid/magnesium carbonate

A

Gaviscon Tablets

28
Q

Acid Suppressing Drugs: Histamine2 Receptor Antagonists

A

-Common ending: “tidine”

  • Block histamine stimulated acid secretion
  • Used for treatment of GERD, LPD, and PUD
29
Q

Generic: cimetidine

A

cimetidine

Warning Labels:

  • AVOID ALCOHOL
  • AVOID GRAPEFRUIT PRODUCTS
  • AVOID ANTACIDS WITHIN 2 HOURS OF DOSE
30
Q

Generic: famotidine

A

Pepcid, Pepcid AC

31
Q

Generic: nizatidine

A

Axid

Warning Labels:
-AVOID ANTACIDS WITHIN 2 HOURS OF DOSE

32
Q

Generic: ranitidine

A

Zantac

33
Q

Generic: famotidine/calcium carbonate/ magnesium hydroxide

A

Pepcid Complete

34
Q

H2 Receptor Antagonists ADR’s

A
  • Dizziness
  • Headache
  • Constipation/diarrhea
  • Nausea
  • Abdominal pain
  • Bloating
  • Gynecomastia (cimetidine)
35
Q

Acid suppressing Drugs: PPI’s

A

-Common ending: “prazole”

  • Interfere with the final step in gastric acid production and decrease gastric acids
  • More potent than H2 antagonists
36
Q

Proton Pump Inhibitors Examples

A
  • omeprazole
  • rabeprazole
  • esomeprazole
  • pantoprazole sodium
  • pantoprazole magnesium
  • lansoprazole
  • dexlansoprazole
  • esomeprazole/naproxen
37
Q

Generic: omeprazole

A

Losec, Olex

38
Q

Generic: rebeprazole

A

Pariet

39
Q

Generic: esomeprazole

A

Nexium

40
Q

Generic: pantoprazole sodium

A

Pantoloc

41
Q

Generic: pantoprazole magnesium

A

Tecta

42
Q

Generic: lansoprazole

A

Prevacid

Prevacid FasTab

43
Q

Generic: dexlansoprazole

A

Dexilant

44
Q

Generic: esomeprazole/naproxen

A

Vimovo

45
Q

PPI Tech Note

A
  • Are delayed release formulations and must not be crushed or chewed
  • Should be taken on an empty stomach
46
Q

PPI’s ADR’s

A
  • Abdominal pain
  • Diarrhea or constipation
  • Nausea/vomiting
  • Headache
  • Vitamin B12 deficiency; calcium absorption deficiency
  • Rebound hyperacidity
  • Skin rash
  • Tiredness/fatigue
  • Agitation
47
Q

PPI Warning Labels

A
  • TAKE 1/2 HOUR BEFORE MEAL

- DO NOT CRUSH OR CHEW; SWALLOW WHOLE

48
Q

Mucosal Protectants

A

Protect cells that line the stomach and small intestine from damage by gastric acids, pepsin, and H. pylori

49
Q

Mucosal Protectants Examples

A
  • misoprostal

- sucralfate

50
Q

`Generic: misoprostal

A

misoprostal

51
Q

Misoprostal ADR’s

A
  • Abdominal cramps
  • Diarrhea
  • Menstrual irregularities
  • Miscarriage
  • Headache
  • Dizziness
52
Q

Misoprostal Warning Labels

A

-AVOID PREGANCY

53
Q

Generic: sucralfate

A

Sulcrate

54
Q

Sucralfate ADR’s

A
  • Constipation
  • Gas
  • Dry mouth
  • Headache
55
Q

Sucralfate Warning Labels

A
  • TAKE ON EMPTY STOMACH
  • NO ANTACIDS 1/2 HOUR PRIOR
  • SEPERATE DOSING OF OTHER DRUGS
  • SHAKE SUSPENSION WELL
56
Q

Antiinfectives

A
  • Antibacterials to eradicate H. pylori infection

- Prescribed in combination with drugs that decrease gastric acids and protect gastric mucosa

57
Q

Prokinetic Drugs

A

-Increase peristalsis, GI motility, gastric emptying, and improve sphincter tone

58
Q

Prokinetic Drugs Examples

A
  • domperidone
  • metoclopramide
  • prucalopride
59
Q

Generic: domperidone

A

domperidone, motilium

Warning Labels:
-AVOID GRAPEFRUIT

60
Q

Generic: metoclopramide

A

metoclopramide, Maxeran, Reglan

61
Q

Generic: prucalopride

A

Resotran

62
Q

Prokinetic Drugs ADR’s

A
  • Abdominal pain/bloating
  • Constipation/diarrhea
  • Restlessness (metoclopramide)
  • Dizziness
  • Headache
  • Drowsiness (metoclopramide)
  • Irregular heartbeat
  • Gynecomastia (domperidone)
  • Galactorrhea (domperidone)
63
Q

Prokinetic Drugs Warning Labels

A
  • MAY CAUSE DROWSINESS
  • AVOID ALCOHOL
  • TAKE 15-30 MINUTES BEFORE MEALS

Pharmacology and Therapeutic Terminology (97 decks)

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