Mod 9- Drugs affecting GI Secretions

Question 1

Why can NSAIDs cause peptic ulcer disease?

Answer 1

they decrease the protective prostaglandins

Question 2

These drugs block the release of hydrochloric acid in response to gastrin

Answer 2

Histamine- 2 (H2) antagonists

Question 3

These drugs interact with acids at the chemical level to neutralize them

Answer 3

Antacids

Question 4

These drugs suppress the secretion of hydrochloric acid in the lumen of the stomach

Answer 4

Proton Pump Inhibitors

Question 5

These drugs coat any injured area in the stomach to prevent further injury from acid

Answer 5

GI Protectants

Question 6

These drugs inhibit the secretion of gastrin and increase the secretion of mucous lining of the stomach providing a buffer

Answer 6

Prostaglandins

Question 7

These H2 antagonists are approved for use in children (-idine)

Answer 7

famotidine

ranitidine

Question 8

This PPI is successful in decreasing ulcer formation r/t drugs/ stress in children

Answer 8

Lansoprazole

Question 9

This drug is an abortifacient and will cause abortion of a fetus

Answer 9

misoprostol

Question 10

What is the best gastrointestinal drug class for older adults

Answer 10

Proton pump inhibitors

Question 11

These types of drugs end in “-tidine”

Answer 11

Histamine -2 (H2) antagonists
cimetidine
ranitidine
famotidine

Question 12

These are used for Treatment of pathological hypersecretory conditions such as Zollinger–Ellison syndrome

Answer 12

H2 Antagonists

Question 13

T/F there are so many drug interactions with H2 Antagonists a drug guide should be consulted

Answer 13

TRUE

Question 14

At what time of day would we give H2 Antagonists

Answer 14

Administer oral drug with or before meals and at bedtime

Question 15

H2 Antagonists Prototype

Answer 15

Cimetidine

Question 16

These inorganic chemicals neutralize stomach acid by direct chemical reaction

Answer 16

Antacids

Question 17

These drugs end in “-carbonate”

Answer 17

Antacids
sodium bicarbonate
calcium bicarbonate

Question 18

Name two antacid salts

Answer 18

Magnesium Salts

Aluminium salts

Question 19

What is an ADE of antacids

Answer 19

Rebound acidity- stomach becomes alkaline then releases more acid

Question 20

When would you take antacids in relation to other drugs and why?

Answer 20

It affects the absorption of many other drugs so it should be taken 1 hour before or 2 hours after other drugs

Question 21

T/F Antacids should be swallowed whole without chewing or crushing

Answer 21

FALSE Chew tablets thoroughly and follow with water

Question 22

T/F Antacids can cause diarrhea and patients should be monitored for electrolyte imbalances

Answer 22

TRUE

Question 23

Antacid Prototype

Answer 23

sodium bicarbonate

Question 24

These drugs Act at specific secretory surface receptors to prevent the final step of acid production and thereby decrease the level of acid in the stomach

Answer 24

Proton Pump Inhibitors

Question 25

PPI End in what suffix

Answer 25

``` “prazole” Omeprazole Esomeprazole Lansoprazole Pantoprazole Rabeprazole ```

Question 26

When are PPIs indicated?

Answer 26

Short-term treatment of active duodenal ulcers, GERD, erosive esophagitis, and benign active gastric disease Long-term treatment of pathological hypersecretory conditions

Question 27

PPI can cause adverse effect on this system in the body

Answer 27

Upper respiratory tract- cough stuffy nose, hoarseness, epistaxis

Question 28

ADE of PPIs

Answer 28

CNS- HA dizziness, vertigo, insomnia apathy | GI- D, ab pain, tongue atrophy

Question 29

Drug/ drug interactions of PPIs

Answer 29

Benzodiazepines, phenytoin, warfarin- Increase toxicity of these meds Ketoconazole, theophylline- Decreased levels of these medications Sucralfate- PPIs not absorbed well Clopidogrel- Increase CV effect

Question 30

T/F PPIs should be chewed thoroughly when they are administered before meals

Answer 30

FALSE- swallowed whole

Question 31

We should check these systems as we know they are affected by PPIs

Answer 31

Neurological- orientation, affect, reflexes | Respiratory status- rate/ rhythm

Question 32

PPI prototype

Answer 32

Omeprazole

Question 33

This drug is indicated for Ulcer healing because it protects site against acid, pepsin, and bile salts

Answer 33

GI protectant- Sucralfate

Question 34

This is a potential build up that can lead to renal failure caused by GI protectants

Answer 34

Aluminum build up

Question 35

Drug/ drug interactions of GI protectants

Answer 35

Aluminum salts | Phenytoin, fluoroquinolone, or penicillamine

Question 36

When would we administer GI protectants during the day?

Answer 36

Administer the drug on an empty stomach 1 hour before or 2 hours after meals and at bedtime

Question 37

We shouldn't give antibiotics or antacids within ___ min. of a sucralfate dose

Answer 37

30 min.

Question 38

This is a prostaglandin used to prevent NASAID induced gastric ulcers and for tx of duodenal ulcers

Answer 38

Misoprostol

Question 39

These drugs work by inhibits gastric acid secretion and increases bicarbonate and mucous production in the stomach

Answer 39

Prostaglandins- misoprostol

Question 40

This drug causes "lady problems" + GI effects

Answer 40

Prostaglandins- Misoprostol

Question 41

We absolutely CANNOT give this drug to someone that is pregnant; we should arrange for serum pregnancy test on 3rd day of cycle

Answer 41

Prostaglandin- misoprostol

Question 42

What is the digestive enzyme pancrelipase used for?

Answer 42

Cystic fibrosis

Question 43

How does the digestive enzyme pancrelipase work?

Answer 43

Pancreatic enzymes are replacement enzymes that help the digestion and absorption of fats, proteins, and carbohydrates

Question 44

How does the digestive enzyme saliva substitute work?

Answer 44

Contains electrolytes and carboxymethylcellulose to act as a thickening agent in dry mouth conditions

Question 45

Why would we caution someone with CHF when taking a saliva substitue?

Answer 45

it can lead to abnormal absorption of electrolytes

Question 46

These electrolytes can increase as an ADE of saliva substitutes

Answer 46

magnesium, sodium, potassium

Question 47

Pancreatic enzymes can cause these ADE

Answer 47

GI irritation, nausea, abdominal cramps, and diarrhea

Question 48

These digestive enzymes can be given PRN

Answer 48

saliva substitutes

Question 49

These digestive enzymes should be given with meals and snacks

Answer 49

Pancreatic enzymes

Question 50

Digestive enzyme prototype

Answer 50

Pancrelipase