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Pharmacology > GI Tract > Flashcards

GI Tract Flashcards

1
Q

Alimentary canal

A

Long continuous hollow tube

Extends from mouth to anus

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2
Q

Accessory Digestive organs

A

salivary glands
liver
gallbladder
pancreas

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3
Q

Function of GI tract

A

transport food
provide enzymes
provide surface area for chemical digestion
provide surface area for absorption

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4
Q

Control of GI system

A 
nerve plexus
a.  maintains basic electrical rhythm
b.  responds to local stimuli to increase or decrease activity
influenced by the ANS
a.   sympathetic reduces
parasympathetic increases
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5
Q

digestive enzymes of St

A

gastrin in anticipation of food
chief cells secrete pepsinogen
parietal cells secrete HCl and intrinsic factors

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6
Q

Gastrin function

A

causes St muscle to contract
causes release of HCl and Pepsinogen
Fibber decreases the concentration of acid in St.

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7
Q

Pepsinogen function

A

breaks down protein

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8
Q

Instrinsic factor function

A

essential for Vit B 12 absorption

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9
Q

Parietal Cell function

A

protect body from ingested microbes
aid in chemical digestion
secrete HCl and intrinsic factor
HCO3 and thick mucous layer protect the stomach lining from acid

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10
Q

Liver/Pancreas enzymes

A

Trypsin - protein
Amylase - sugar
Lipase - fat

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11
Q

Bile

A

breaks down fat

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12
Q

Endocrine hormones involved

A

insulin
glucagon
somatostatin

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13
Q

Where is portal system?

A

Liver

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14
Q

what is basic movement

A

peristalsis

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15
Q

how many muscle layers does St have

A

3 - produces churning action

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16
Q

Motility process of Si

A

segmentation

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17
Q

Motility process of Li

A

mass movement

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18
Q

Gastroenteric reflex

A

stimulates St by stretching causing an increase in Si activity

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19
Q

Gastrocolic reflex

A

stimulates the St causing increase colon activity

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20
Q

Duodenal - colic reflex

A

stimulates colon activity and mass movement by presence of food or stretch in duodenum

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21
Q

intestinal intestinal reflex

A

irritation in the Si in one area which can cause paralytic ileus

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22
Q

swallow reflex

A

stimulated by pressure of receptors in back of throat by a food bolus

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23
Q

vomiting reflex center

A

in medulla - 2 centers
emetic zone
CTZ zone (Chemoreceptor trigger zone)

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24
Q

How does stimulation of the CTZ zone induce vomiting

A

tactile stimulation of back of throat
excess St distention
increased intracranial pressure by direct stimulation
stimulation of vestibular receptors in inner ear
stimulation of stretch receptors in uterus and bladder
intense pain fiber stimulation
direct stimulation of various chemicals

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25
Q

head injury causes what physiological changes

A

increasing intracranial pressure

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26
Q

stimulation of vestibular receptors can cause what physiology response

A

motion sickness, nausea, vomiting

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27
Q

physical response before vomiting

A

increased saliva, mucus production in upper GI, sweating, HR, deeper breathing, nausea
decreased gastric acid production

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28
Q

TPN and ingredients

A

total parenteral nutrition
hypertonic solution
contains AA, lipid emulsions, carbs (dextrose), electrolytes, vitamins, minerals

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29
Q

vitamins

A

organic substances needed to promote growth and maintain health

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30
Q

indications for vitamins

A

alcoholics
pregnancy, breast feeding
chronic Kd/Lv disease
therapy with certain meds that affect vitamin metabolism

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31
Q

water soluble vitamins

A

B & C

easily dissolved and excreted in urine - required daily

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32
Q

thiamine B1

A

promotes muscle and nervous system

found in enriched whole grains

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33
Q

Riboflavin B2

A

RBC production and body growth

found in milk, yeast, liver

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34
Q

Niacin B3

A

helps form coenzymes

found in meat

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35
Q

Pyroxidine B6

A

RBC synthesis, CHO and lipid metabolism, neurotransmitter synthesis
found in grains, egg yolk

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36
Q

Folic Acid B9

A

DNA snthesis, homocysteine metabolism, neurotransmitter formation, helps complete formation of spine
green leafy

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37
Q

B12

A

found in meat, seafood, eggs

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38
Q

Vit C

A

found in citrus fruits

deficiency leads to scurvy

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39
Q

Lipid soluble vitamins

A 
ADEK
can be toxic in excess amounts
must be ingested with other lipids
stored in Liver and fat tissue
absorbed in Si
40
Q

Vit A

A

eye health, skin, skeletal health

excess leads to orange skin, loss of hair, peeling skin

41
Q

Vit D

A

absorption of Ca

42
Q

Vit E

A

antioxidant

43
Q

Vit K

A

clotting factors

44
Q

Minerals

A

inorganic substances that are needed to maintain body metabolism
ingested

45
Q

drugs that affect mineral metabolism

A

thiazides or loop diuretics - lose K
corticosteroids, oral contraceptives - retain Na; lowers plasma zinc, increases copper
oral hypoglycemics, lithium carbonate - impairs uptake of iodine by thyroid

46
Q

what is a hemoglobin molecule composed of

A

4 heme molecules

47
Q

role of sodium

A

fluid and electrolyte balance
maintenance of extracellular fluid balance
acid/base balance
muscle contraction - enters the fast channels during depolarization - nerve transmission

48
Q

K role

A

fluid, electrolyte balance, cell integrity, maintain Ht beat (Ca/Na in, K out)
found in banana, potato

49
Q

Cl role

A

follows Na
part of HCl
acid/base, eletrolyte balance

50
Q

Ca

A

for nerve conduction, musc contraction, hemostasis,
prep: Ca Carbonate, citrate, gluconate, lactate
hypocalcemia

51
Q

PO

A

phosphorus
bone formation
part of ATP

52
Q

Mg

A

nueromusc function - uterine contractions

salts for laxatives

53
Q

Trace minerals

A 
only less than 20 mg required
Fe
iodine
fluorine
zinc
54
Q

Fe excess

A

hemochromatosis

55
Q

fe deficiency

A

anemia

56
Q

Iodine

A

for thyroid hormone
from iodized salt
deficiency - goiter
excess - suppresses thyroid function temporarily

57
Q

Lugol’s solution

A

iodine mixture

administered prior to thyroidectomy

58
Q

sodium iodine

A

for acute thyroid crisis

59
Q

fluorine

A

excess - toxic

for bones and teeth

60
Q

zinc

A 
helps with immunity
wound healing
male fertility
bone formation
excess destroys sense of taste and smell
61
Q

peptic ulcer disease risk

A 
family hx
type O
smoking
alcohol
caffeine
meds - corticosteroids, aspirin, nsaids
stress
h pylori
62
Q

types of ulcer

A

duodenal

gastric

63
Q

duodenal ulcer

A

burn upper abd
1-3 hrs after eating
disappears after ingesting
bleeding

64
Q

gastric ulcer

A 
more serious
less commmon
requires longer tx
relieved by food, but continues after meal
anorexia, vomit, weight loss
65
Q

drugs that affect GI secretions

A 
Histamine 2 antagonist
protein pump inhibitor
antacid
antipeptic agent
prostaglandin
digestive enzymes
66
Q

Cimetidine (Tagamet)

A 
H2 receptor antagonist
suppresses volume and acidity of ST acid
treats GERD
800 mg @ bedtime or QID
weaker than proton pump inhibitors
67
Q

c/i of Tagamet

A

concurrent antacid therapy - NO!
breast feeding
Kd Lv dysfunciton
elderly

68
Q

interactions of tagamet

A

antacids inhibit absorption

smoking increases HCL secretion

69
Q

A/R of Tagamet

A

h/a, dizziness, confusion, decrease libido.

watch for abd pain, FRANK AND OCCULT BLEEDING, avoid irritants

70
Q

Other H2 receptor drugs

A

Pepcid

Zantac

71
Q

Omeprazole (Prilosec)

A 
Proton Pump Inhibitor
for PUD and GERD
blocks enzymes that secrete HCl
works better and longer than H2 receptors
for erosive esophagitis
associated with C Diff & Hip Fx
can administer with antacid
72
Q

A/R of Prilosec

A 
h/a
diarrhea
abd pain
n/v
dizziness
rash
constipation
dry mouth
flatulence
73
Q

Prilosec interactions

A

interfere with metabolism of valium, dilantin, coumadin.

interfere with absorption of drugs that need gastric pH

74
Q

other protein pump inhibitors

A

Prevacid

Protonix

75
Q

Sodium Bicarbonate (Bell/Ans)

A

antacid
was for GERD and PUD
alkaline, inorganic compounds of Al, Mg, Ca
neutralizes st acid
Al compounds may interfere with phosphate metabolism and cause constipation

76
Q

which compounds cause constipation

A

Al

Ca

77
Q

which compounds may cause diarrhea

A

Mg

78
Q

Common antacids

A

Mylanta
Maalox
Amphojel

79
Q

nursing consideration for antacids

A

monitor for systemic alkalosis
administer 1-2 hours before other oral meds
assess for OTC, Rx, KD insufficiency

80
Q

Antibiotic therapy used with antacids

A 
for H Pylori
Amoxicillin (Amoxil)
Clarithromycin (Biaxin)
Metronidazole (Flagyl) - antifungal
Tetracycline (Achromycin)
81
Q

Sucalfate (carafate)

A

Antipeptic agent
coats ulcer crater
for short term and prevention

82
Q

cautions, with antipeptics

A 
c/i hypersensitivity
caution - breast feeding, chronic renal failure
a/r -constipation
interaction - binds with other drugs
NOT WITH OTHER AL BASED PRODUCTS
frank/occult bleeding
83
Q

Misoprostol (Cytolec)

A

Prostaglandin
inhibits HCl secretion and increases HCO3 and Mucus
prevents NSAID induced gastric ulcer
treats duodenal ulcer

84
Q

c/i of prostaglandin

cautions, A/R

A

Pregnancy
lactation
n/v, diarr, abd pain, flatulence, dyspepsia, constip.
miscarriage, excess bleeding, spotting, cramps, hypermenorrhea, dysmenorrhea.

85
Q

Pancrelipase (Pancrease)

A

Digestive Enzyme
need artificial saliva with elecrolytes
help digest and absorb fat, protein, carbs
replacement therapy

86
Q

digestive enzyme cautions and a/r

A

c/i - enzymes -> gastric irritation
pregnancy and lactation
contact dermatitis, N, abd cramps, diarr, skin irritation

87
Q

saliva allergy

A

cautions: CHF, hypertension, Kd fail

a/r - complications from abn electrolytes, increased levels of Mg, Na, K

88
Q

vomiting center

A

medulla

senses toxins and triggers reflex

89
Q

n/v drug classes

A 
phenothiazine - compazine
antihistamines - benadryl
cannabinoids - marinol
glucocorticoids - decadron
benzodiazepine - ativan
serotonin receptor antagonists - zofran
90
Q

Prochloroperazine (compazine)

A

phenothiazine - antiemetic
helps nausea
used for kids as suppository

91
Q

Metoclopramide (Reglan)

A

NON Phenothiazine - antiemetic
improves emptying gastric area, for diabetic paralytic ileus
for n/v motion sickness, diabetic gastroparesis, tube feeding to promote emptying
NOT WITH DIGOXIN

92
Q

ONdansetron - Zofran

A

serotonin 5-HT3 receptor blocker
blocks receptors assoc with n/v in CTZ
used for chemo and post op
c/i -preg/lact, myalgia, urin retent

93
Q

C/I & A/R of antiemetic

A 
GI obstruction
angle closure glaucoma
bone marrow depression
Lv Ht dz
watch for anticholinergic effects - 
hyptension, constip, blurred vision, dryness of eyes, mouth, rectal irritation, drowsy, photosens, urin retent.
94
Q

Meclizine (Antivert)

A

ANtichol/antihistamine
block impulse to CTZ
for n/v, motion sickness

95
Q

Aprepitant (Emend)

A

substance P neurokinin 1 receptor antagonist
in CNS block receptors assoc with n/v
combo with other agents - for chemo
encourage fluids!

a/r - anorexia, fatigue, constip, diarr, LV enzyme elevation, dehydration

96
Q

Ipecac syrup

A

emetics
induce vomit
2003 warning - not recommended anymore
c/i semicomatose, unconscious - risk for aspiration
a/r - arryth, diarr, drowsy, cardiotoxicity

follow with 1-2 glasses of water

Pharmacology (8 decks)

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