lilley ch 50 acid-controlling drugs Flashcards

1
Q

3 divisions of stomach

A

cardiac
pyloric
gastric

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2
Q

3 cells of gastric gland

A

parietal
chief
mucous

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3
Q

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

A

parietal cells

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4
Q

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

A

chief

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5
Q

cells from gastric gland that secrete mucous that serves

as a protective coating against digestive actions

A

mucous

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6
Q

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

A

hydrochloric acid (HCl)

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7
Q

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

A

food
caffeine
chocolate
alcohol

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8
Q

Hyperproduction of hydrochloric acid is stimulated

by what two things

A

large fatty meals

emotional stress

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9
Q

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

A

peptic ulcer disease

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10
Q

what med treats H pylori

A

PPIs and combo of antibiotics

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11
Q

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

A
  • decreased blood flow
  • mucosal ischemia
  • hypoperfusion
  • reperfusion injury
  • NG tube
  • ventilator
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12
Q

2 meds given to prevent stress-related mucosal damage

A

histamine receptor-blocking drug

PPIs

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13
Q

3 types acid-controlling drugs

A

antacids
H2 antagonists
PPIs

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14
Q

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

A

antacids

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15
Q

what minerals can make you constipated (2)

A

aluminum

calcium

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16
Q

what mineral counteracts constipation

A

magnesium

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17
Q

antacids containing magnesium should not be given to what patients

A

renal failure

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18
Q

what 3 things do antacids stimulate secretion of

A

mucus
bicarbonate
prostaglandins

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19
Q

what can antacids provide acute pain relief for (4)

A
  • peptic ulcer
  • gastritis
  • gastric hyperacidity
  • heartburn
20
Q

contradictions to taking antacids (2)

A

severe renal failure/electrolyte disturbances

GI obstruction

21
Q

what antacid can be given to patient with renal failure

A

aluminum salts

22
Q

examples of magnesium salt antacids (2)

A
  • milk of magnesia

- mylanta

23
Q

example of calcium salt antacid

A

tums

24
Q

antacid: quick onset but short duration

may cause metabolic alkalosis

A

sodium bicarbonate

25
Q

example of antiflatulence drug

A

simethicone

26
Q

adverse effect with overuse of antacids

A

metabolic alkalosis

27
Q

adverse effect with aluminum and calcium antacids

A

constipation

28
Q

adverse effect with magnesium antacids

A

diarrhea

29
Q

adverse effects with calcium antacids (2)

A

kidney stones

rebound hyperacidity

30
Q

adverse effect with calcium carbonate antacids

A

gas and belching

31
Q

2 drug interaction effects caused by antacids

A
  • increased stomach pH

- increased urinary pH

32
Q

4 examples H2 receptor antagonists

A
  • cemitidine (tagamet)
  • nizatidine (axid)
  • famotidine (pepcid)
  • ranitidine (zantac)
33
Q

what are H2 receptor antagonists commonly used for (5)

A
  • GERD
  • PUD
  • erosive esophagitis
  • adjunct therapy to control upper GI bleed
  • zollinger ellison syndrome
34
Q

2 adverse effects cimetidine

A

impotence

gynecomastia

35
Q

adverse effect of ranitidine and famotidine

A

thrombocytopenia

36
Q

when should H2 receptor antagonists be given if taken with antacids

A

1-2 hours before antacids

37
Q

what can decrease effectiveness of H2 receptor antagonists

A

smoking

38
Q

5 examples of proton pump inhibitors

A
  Lansoprazole (Prevacid)
  Omeprazole (Prilosec)
  Rabeprazole (AcipHex)
  Pantoprazole (Protonix) 
  Esomeprazole (Nexium)
39
Q

indications for PPI use (4)

A
  • peptic ulcers
  • GERD
  • zollinger ellison syndrome
  • H pylori induced ulcers
40
Q

adverse effects of PPIs (4)

A
  • osteoporosis
  • pneumonia
  • depletion of magnesium
  • link with dementia and lupus
41
Q

what 2 things can delay/decrease absorption of PPIs

A

food

sucralfate

42
Q

drug interactions with PPIs (4)

A

warfarin
diazepam
phenytoin
clopidogrel

43
Q

what does sucralfate (carafate) do

A

mucosal protectant

44
Q

what does misoprostol (cytotec) do

A

decreases ulcers in patients taking NSAIDs

45
Q

what does simethicone (mylicon) do

A

gas reduction

46
Q

what conditions might restrict use of antacids (5)

A
  • pregnancy
  • renal failure
  • GI obstruction
  • heart failure
  • fluid imbalances
47
Q

when should other meds be given if patient is taking antacid

A

1-2 hours after antacid