"Gastroesophageal Reflux Disease" - lower esophageal sphincter is weakened/relaxed, allowing gastric juices to flow into esophagus -chronic - mucosal damage produced by abnormal reflux in esophagus - symptoms: heartburn, regurgitation, sore throat, etc...

Lecture 13- Medications for Digestive Disorders Flashcards by Emily C

What are some common GI issues?

Ulcers
heartburn
GERD
Diarrhea
Constipation
Vomiting
Gastroparesis –> food moves out of stomach too slowly

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What is a peptic ulcer?

from bacteria (Helicobacter pylori) in stomach
use of anti-inflammatory painkillers (NSAIDs or aspirin)
alcohol and caffeine can cause them too!

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What are the signs and symptoms of peptic ulcers?

All about the FOOD you eat
all about the TIME you eat

abdominal pain around 3 hours of taking a meal
loss appetite and weight loss
bloating
nausea and vomiting

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How do we treat peptic ulcers when NSAIDs or aspirin caused them?

stop taking the meds (unless otherwise by doctor)
use PPIs (Proton pump inhibitors) –> help reduce acid in stomach
or use H2 antagonists –> help reduce acid in stomach

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How do we treat peptic ulcers when Helicobacter pylori caused it?

use of TWO antibiotics
1. metronidazole and clarithromycin
2. amoxicillin and clarithromycin

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How do we prevent heartburn?

watch what you eat!!
Exercise!!
Timing of food
how fast you eat

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How do we treat heartburn and excessive acid from least strength to most strength (3) ?

Antacids
H2-receptor antagonists
proton pump inhibitors

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What are the 4 antacids generic names and trade names?

aluminum hydroxide
calcium carbonate with magnesium hydroxide –> Rolaids
Magnesium hydroxide/aluminum hydroxide with simethicone
sodium bicarbonate

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What do antiacids do?

neutralize digestive acids

FIRST drug recommended for heartburn and mild symptoms

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What does antiacids consist of?

magnesium
calcium
aluminium

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What can antacids cause in the intestines?

interact with drugs –> REDUCE absorption
can be avoided if take drugs ONE hour BEFORE or THREE hours AFTER taking the antacid

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What are the two ADVERSE EFFECTS of Antacids?

diarrhea

constipation

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Why should “Tums” be used in caution with older adults?

likelyhood of having following conditions:
- renal disease
- ventricular fibrillation
- CVD
- hypercalcemia —> kidney failure

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What is GERD?

“Gastroesophageal Reflux Disease”

lower esophageal sphincter is weakened/relaxed, allowing gastric juices to flow into esophagus

-chronic

mucosal damage produced by abnormal reflux in esophagus
symptoms: heartburn, regurgitation, sore throat, etc…

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What are the two H2 receptor antagonists generic and trade names?

famotidine —> PEPCID
ranitidine –> ZANTAC

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What does H2 receptor antagonists do?

BLOCK H2 receptors to REDUCE gastric secretions for 6-24 hours
prevent heartburn episodes

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What is the ADVERSE EFFECTS of H2-receptor antagonists?

GI probs
cardiac arrhythmias

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Why was ZANTAC taken off the market?

because of presence of a carcinogen –> NDMA (N-nitrosodimethylamine)

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What are the 4 Proton Pump Inhibitors generic and trade names?

esmoprazole
lansoprazole
omeprazole
misoprostol

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What do Proton Pump Inhibitors do?

BLOCK HCL production!!!
heals ulcers, relieves GERD
-most effective!
if it is MODERATE or SEVERE symptoms

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What are the ADVERSE effects of PPIs?

GI related
long term –> risk of fractures, pneumonia, clostridum difficile dirrehea, hypomagnesia, vitaminB12 deficiency , chronic kidney disease, dementia

What is Misoprostol?

a prostoglandin
affect GI motility and gastric acid secretion
ONLY for people who are both taking NSAIDs and are at high-risk NSAID-induced ulcers

What is the 4 types of diarrhea?

Osmotic
secretory
Inflammatory and infectious
associated with Deranged motility

What is Osmotic Diarrhea?

excessive amounts of solutes are retained –> water will not be absorbed therefore wet poos

What is Secretory diarrhea?

When secretion of water into the intestinal lumen exceeds absorption

What is Inflammatory and infectious diarrhea?

disruption of epithelium due to microbial or viral pathogens

What is diarrhea associated with deranged motility?

intestinal contents must be adequately exposed to the epithelium and retained long enough to allow absorption

What determines diarrhea?

The CONSISTENCY of the poo

What are two antidiarrheals generic and trade names?

1. bismuth subsalicylate --> Pepto-bismol 2. loperamide --> Imodium

What does Pepto-bismol do?

- anti-inflammatory and antiacid - for "heartburn, indigestion, upset stomach, DIARRHEA"!

What does loperamide/ Imodium do?

- anti-diarrheal - opioid-receptor agonist - does NOT cross blood brain barrier, therefore does NOT effect CNS

How can we get constipation (5 things)?

1. Diet 2. medications (opioids) 3. metabolic and muscular 4. structural and functional abnormalities 5. pyschological --> stress

What are 4 types of meds to treat constipation?

1. Osmotic laxatives 2. Stool Softeners and lubricants 3. laxative stimulants 4. fibre products/bulk-forming laxatives

What is one osmotic laxative medication generic name and trade name?

milk of magnesia

What do osmotic laxative meds do?

- pull water into the large intestine, creating bulk and causing a more liquid stool --> pressure leads to stimulate contractions - for violent overnight relief / short term relief

can you develop a dependence for osmotic laxatives?

YES!! - decreases strength of physiological muscles in rectum and colon - after you go off of them, you have to go back because you cannot physically push poop out

What is the name of a stool softener used as a medication to treat it constipation?

Glycercin

What do Stool Softeners do?

allow fluids to mix into the stool - make it easier to pass coats stool and bowel wall with a water-resistant film (lubricants)

Should you drink lots of fluids when taking stool softeners?

YES

What are two names of Stimulant laxatives used to treat constipation?

1. bisacodyl --> DULCOLAX 2. Senna --> Black- draught

What do Stimulant laxatives do?

contain an irritant that stimulates the lining of bowel --> CONTRACTIONS!!

Should you use laxatives for long term use?

What is the name of a bulk-forming laxative?

Metamucil

What does bulk-forming laxatives do?

make stool larger, helps intestines contract--> bowel movement! slow-acting (12 hours-3 days)

What are EMETICS?

induce vomiting (for emergency purposes)

What an ANTIEMETICS?

to prevent vomiting

What are the 8 antiemetics you can use?

1. 5-HT3 receptor antagonists 2. dopamine antagonists 3. antihistamines 4. cannabinoids 5. benzodiazepines 6. anticholinergics 7. steroids 8. Herbs --> ginger or pepperint

What are the 4 antiemetics from the table we should know?

1. Haldol (dopamine antagonist) 2. reglan (misc agent) 3. Dramamine (antihist) 4. Benadryl/Gravol (antihist)

What is Gastroparesis?

-aka = delayed gastric emptying - slows or stops the movement of food from stomach to small intestine -symptoms: a. nausea b. feel full after eating very little c. vomitting undigested food several hours after meal

What can aggravate Gastroparesis?

greasy or rich foods large quantities of foods with fiber drinking beverage high in fat or carbonation

How do you treat gastroparesis?

1. reglan --> medication to stimulate stomach muscle contractions 2. erythromycin --> increase contractions that move food through stomach 3. Botox --> into the pylorus to keep it open longer 4. modify eating habits 5. electrical stimulation

What has the FDA come out about the medication "reglan"?

rare reports causing .... "irreversible neurological side effect of tardive dyskinesia" (affects movement)