GI meds

Question 1

H2R blockers

Answer 1

Frequently used
Block action of histamine on H2 receptors
↓ HCl acid secretion
↓ Conversion of pepsinogen to pepsin Therapeutic effects last up to 12 hours
Oral or IV
Examples
Ranitidine (Zantac) Famotidine (pepcid)

Question 2

PPIs

Answer 2

Proton pump inhibitors (PPI)
Block ATPase enzyme—important for secretion of HCl acid
↑ Effective than H2R blockers—reducing acid and promoting healing
Esomeprazole (Nexium) omeprazole (Prilosec)

Question 3

antibiotic therapy

Answer 3

Antibiotic therapy
Eradicate H. pylori infection
Most important in treatment if H. pylori present
No single agents have been effective in eliminating H. pylori
Usual treatment 7 to 14 days
Example of therapy
Dual therapy—ranitidine bismuth citrate (Tritec) with clarithromycin (Biaxin)

Question 4

antacids

Answer 4

Antacids
Adjunct therapy for PUD
Increase gastric pH by neutralizing HCl acid
Effects on empty stomach 20 to 30 minutes
If taken after meals may last 3 to 4 hours
Magnesium hydroxide (Mag-Ox)
Watch for diarrhea
Aluminum hydroxide (Amphojel)
Watch for constipation
↑ Sodium preparations: Not be used in elderly or patients with ↑BP, heart failure, liver cirrhosis, or renal disease
Magnesium preparations: Not be used in patients with renal failure
Interact unfavorably with some drugs

Question 5

cytoprotective drug therapy

Answer 5

Cytoprotective drug therapy
Used for short-term treatment 
Protection for esophagus, stomach, and duodenum
Accelerates ulcer healing
Example
sucralfate (Carafate) 
misoprostol (Cytotec)
Health care provider must know all drugs being taken before therapy begun
Anticholinergic drugs
Occasionally used
↓ Cholinergic stimulation of HCl acid
↓ Gastric motility: Not used for gastric outlet obstruction