GI pharm - E3 Flashcards
go back and review
constipation & diarrhea meds
when treating gerd / PUD, what drugs increase protective factors
antacids
sucralfate
when treating gerd / PUD, what drugs decrease aggressive factors
H.pylori treatment
H2 blockers
PPIs
how to treat H.pylori
several abx + gastric acid inhibitors
-need the combo therapy to minimize resistance & bc H.py thrives in acidic environments and abc hate acidic environments
-take abx for 10 to 14 days (bad adherences bc expensive & lots of pills)
what class are cimedetidine & famotidine
H2 receptor antagonists
H2 receptor MOA
blocks H2 receptors in the stomach -> reduces gastric acid secretion by 60-70% and increases stomach pH
cimedetidine & famotidine indications
Gerd
PUD
Ulcer prophylaxis
Heartburn/dyspepsia
cimedetidine & famotidine SE
well tolerated
-CNS effects in elderly
-Slight increased risk for pneumonia in elderly
cimedetidine & famotidine nursing considerations
-give at least 1hr apart from antacids
-inhibits CYP 450 enzymes (newer does not so use famotidine when possible)
-give IV form slowly to avoid bradycardia
cimedetidine & famotidine interactions
warfarin
phenytoin
theophylline
cimedetidine & famotidine can be used to help prevent what
aspiration pneumonia
what class are omoprazole, pantoprazole, & esomeprazole
proton pump inhibits (PPIs)
PPIs MOA
Binds to proton pump and inhibits the hydrogen potassium ATPase enzyme system -> irreversibly inhibits the secretion of HCl which is the primary driver of gastric acid
more effective than H2RA
omoprazole, pantoprazole, & esomeprazole indications
Short term treatment of PUD
GERD
omoprazole, pantoprazole, & esomeprazole SE
Short term: relatively safe
Long term: increased risk for pneumonia, bone loss/ hip fx, & stomach cancer
omoprazole, pantoprazole, & esomeprazole nursing considerations
try to only use for short term use
what class is sucralfate
mucosal protectant
mucosal protectant MOA
Drug is altered when exposed to gastric acid and becomes a thick, sticky gel that creates a protective barrier
sucralfate indications
Duodenal ulcers
Gastric ulcers
sucralfate SE
May cause constipation
sucralfate nursing considerations
Always given PO
Decreased drug absorption so take 2 hrs before other meds
major forms of antacids
amphojel
tums
milk of magnesia
Maalox
Mylanta
amphojel base & SE
aluminum ; constipation
tums base & SE
calcium ; constipation