lilley ch 50 acid-controlling drugs

Question 1

3 divisions of stomach

Answer 1

cardiac
pyloric
gastric

Question 2

3 cells of gastric gland

Answer 2

parietal
chief
mucous

Question 3

cells from gastric gland that produce and secrete hydrochloric acid. Site of action to treat acid-related
disorders

Answer 3

parietal cells

Question 4

cells from gastric gland that secrete pepsinogen which becomes pepsin when activated by pepsin. Pepsin
breaks down protein

Answer 4

chief

Question 5

cells from gastric gland that secrete mucous that serves

as a protective coating against digestive actions

Answer 5

mucous

Question 6

substance secreted from parietal cells that aids in the proper digestion of food and defenses against microbial
infection via the GI tract

Answer 6

hydrochloric acid (HCl)

Question 7

what foods/drinks stimulate parietal cells to secrete HCl (4)

Answer 7

food
caffeine
chocolate
alcohol

Question 8

Hyperproduction of hydrochloric acid is stimulated

by what two things

Answer 8

large fatty meals

emotional stress

Question 9

acid-related disease: Gastric or duodenal ulcers that involve digestion of the GI mucosa by the enzyme pepsin

Answer 9

peptic ulcer disease

Question 10

what med treats H pylori

Answer 10

PPIs and combo of antibiotics

Question 11

what factors may lead to stress-related mucosal damage (6)

Answer 11

• decreased blood flow
• mucosal ischemia
• hypoperfusion
• reperfusion injury
• NG tube
• ventilator

Question 12

2 meds given to prevent stress-related mucosal damage

Answer 12

histamine receptor-blocking drug

PPIs

Question 13

3 types acid-controlling drugs

Answer 13

antacids
H2 antagonists
PPIs

Question 14

type of acid-controlling drug:
-Basic compounds used to neutralize stomach acid
-Salts of aluminum, magnesium, calcium, and/or
sodium

Answer 14

antacids

Question 15

what minerals can make you constipated (2)

Answer 15

aluminum

calcium

Question 16

what mineral counteracts constipation

Answer 16

magnesium

Question 17

antacids containing magnesium should not be given to what patients

Answer 17

renal failure

Question 18

what 3 things do antacids stimulate secretion of

Answer 18

mucus
bicarbonate
prostaglandins

Question 19

what can antacids provide acute pain relief for (4)

Answer 19

• peptic ulcer
• gastritis
• gastric hyperacidity
• heartburn

Question 20

contradictions to taking antacids (2)

Answer 20

severe renal failure/electrolyte disturbances

GI obstruction

Question 21

what antacid can be given to patient with renal failure

Answer 21

aluminum salts

Question 22

examples of magnesium salt antacids (2)

Answer 22

• milk of magnesia

- mylanta

Question 23

example of calcium salt antacid

Answer 23

tums

Question 24

antacid: quick onset but short duration

may cause metabolic alkalosis

Answer 24

sodium bicarbonate

Question 25

example of antiflatulence drug

Answer 25

simethicone

Question 26

adverse effect with overuse of antacids

Answer 26

metabolic alkalosis

Question 27

adverse effect with aluminum and calcium antacids

Answer 27

constipation

Question 28

adverse effect with magnesium antacids

Answer 28

diarrhea

Question 29

adverse effects with calcium antacids (2)

Answer 29

kidney stones | rebound hyperacidity

Question 30

adverse effect with calcium carbonate antacids

Answer 30

gas and belching

Question 31

2 drug interaction effects caused by antacids

Answer 31

- increased stomach pH | - increased urinary pH

Question 32

4 examples H2 receptor antagonists

Answer 32

- cemitidine (tagamet) - nizatidine (axid) - famotidine (pepcid) - ranitidine (zantac)

Question 33

what are H2 receptor antagonists commonly used for (5)

Answer 33

- GERD - PUD - erosive esophagitis - adjunct therapy to control upper GI bleed - zollinger ellison syndrome

Question 34

2 adverse effects cimetidine

Answer 34

impotence | gynecomastia

Question 35

adverse effect of ranitidine and famotidine

Answer 35

thrombocytopenia

Question 36

when should H2 receptor antagonists be given if taken with antacids

Answer 36

1-2 hours before antacids

Question 37

what can decrease effectiveness of H2 receptor antagonists

Answer 37

smoking

Question 38

5 examples of proton pump inhibitors

Answer 38

```  Lansoprazole (Prevacid)  Omeprazole (Prilosec)  Rabeprazole (AcipHex)  Pantoprazole (Protonix)  Esomeprazole (Nexium) ```

Question 39

indications for PPI use (4)

Answer 39

- peptic ulcers - GERD - zollinger ellison syndrome - H pylori induced ulcers

Question 40

adverse effects of PPIs (4)

Answer 40

- osteoporosis - pneumonia - depletion of magnesium - link with dementia and lupus

Question 41

what 2 things can delay/decrease absorption of PPIs

Answer 41

food | sucralfate

Question 42

drug interactions with PPIs (4)

Answer 42

warfarin diazepam phenytoin clopidogrel

Question 43

what does sucralfate (carafate) do

Answer 43

mucosal protectant

Question 44

what does misoprostol (cytotec) do

Answer 44

decreases ulcers in patients taking NSAIDs

Question 45

what does simethicone (mylicon) do

Answer 45

gas reduction

Question 46

what conditions might restrict use of antacids (5)

Answer 46

- pregnancy - renal failure - GI obstruction - heart failure - fluid imbalances

Question 47

when should other meds be given if patient is taking antacid

Answer 47

1-2 hours after antacid