GI General Information

Question 1

Underlying Causes of GI Disorders

Answer 1

Dietary Excess
Stress
Hiatal Hernia
Esophageal Reflux
Adverse Drug Effects 
Peptic Ulcer Disease

Question 2

Effect of Drugs on GI Secretions

Answer 2

Decrease GI secretory activity
Block the action of GI secretions
Form protective coverings on the GI lining to prevent erosion from GI secretions
Replace missing GI enzymes that the GI tract or ancillary glands and organs can no longer produce

Question 3

Peptic Ulcer Disease

Answer 3

Erosions in the lining of the stomach and adjacent areas of the GI tract

Question 4

Peptic Ulcer Disease Symptoms

Answer 4

Gnawing, burning pain, often occurring after meals

Question 5

Peptic Ulcer Disease Causes

Answer 5

NSAIDs
Bacterial infection by Helicobacter pylori bacteria
Stress

Question 6

Drugs Used to Treat GERD and Ulcers

Answer 6

Histamine-2 (H2) Antagonists
Antacids
Proton Pump Inhibitors
GI Protectants
Prostaglandins

Question 7

Histamine-2 (H2) Antagonists

Answer 7

Antagonists: Block the release of hydrochloric acid in response to gastrin

Question 8

Antacids

Answer 8

Interact with acids at the chemical level to neutralize them

Question 9

Proton Pump Inhibitors

Answer 9

Suppress the secretion of hydrochloric acid into the lumen of the stomach

Question 10

GI Protectants

Answer 10

coat any injured area in the stomach to prevent further injury from acid

Question 11

Prostaglandins

Answer 11

inhibit the secretion of gastrin and increase the secretion of the mucous lining of the stomach, providing a buffer

Question 12

Across the Lifespan: CHILDREN

Answer 12

Dosing should be based on age, weight, and formulation
Concerns: Electrolyte disturbances
Interference with nutrition

Antacids:
      For upset stomach or if kids are on drugs known to increase stomach acid
H2 antagonists:
         Famotidine
         Ranitidine 

Proton Pump Inhibitors:
Not specifically for kids, but successful in decreasing ulcer formation related to stress or drug therapy
Lansoprazole has pediatric dosing

Question 13

Across the Lifespan: ADULTS

Answer 13

Concerns:
      Overuse
      GI discomfort continuing
     Electrolyte disturbance
     Interference with absorption or action of other drugs

Prolonged use:
Many issues

Pregnancy and lactation:
    Safety has not been established
    May enter breast milk 
    Misoprostol
    Abortifacient

Question 14

Across the Lifespan: OLDER ADULTS

Answer 14

Frequently prescribed these drugs
More likely to develop adverse effects
Sedation
Confusion
Dizziness
Urinary retention
CV effects

Concerns:
Poor absorption of nutrients, especially B12
Renal and hepatic impairment

Toxic effects:
Use of multiple OTC drugs or combination of OTC/Rx drugs

Best choice: Proton pump inhibitors (PPI)