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Pharm II > objective 2.5 (1) > Flashcards

objective 2.5 (1) Flashcards

1
Q

what does the stomach secrete?

A
  • Hydrochloric acid (HCl)
  • Bicarbonate
  • Pepsinogen
  • Intrinsic factor
  • Mucus
  • Prostaglandins
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2
Q

what are the glands of the stomach?

A

cardiac
pyloric
gastric

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3
Q

Produce and secrete hydrochloric acid; Primary site of action for
many of the drugs used to treat acid-related disorders

A

parietal cells

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4
Q

Secrete pepsinogen, a proenzyme; pepsinogen becomes pepsin when
activated by exposure to acid; Pepsin breaks down proteins (proteolytic)

A

chief cells

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5
Q

Mucus-secreting cells (surface epithelial cells); Provide a protective
mucus coat; Protect against self-digestion by hydrochloric acid and digestive
enzymes

A

mucous cells

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6
Q

Secreted by parietal cells when stimulated by food, caffeine,
chocolate, and alcohol; Maintains stomach at pH of 1 to 4; Acidity aids in the
proper digestion of food and defenses against microbial infection via the
gastrointestinal tract.
* Secretion also stimulated by:
* Large fatty meals, Emotional stress, Excessive amounts of Caffeine, chocolate, and alcohol
increase stimulation and cause problems, ie. PUD

A

hydrochloric acid

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7
Q

Gastric or duodenal ulcers that involve digestion of the
GI mucosa by the enzyme pepsin

A

peptic ulcer disease

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8
Q

Bacterium found in GI tract of 90% of
patients with duodenal ulcers and 70% of those with gastric ulcers.
* Triple therapy includes a proton pump inhibitor (PPI) and antibiotics

A

helicobacter pylori

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9
Q

GI lesions are a common finding in Critical
Care Unit patients, especially within the first 24 hours after admission.
* Factors include decreased blood flow, mucosal ischemia, hypoperfusion,
and reperfusion injury

A

stress-related mucosal damage

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10
Q

antacids, H2 antagonists, and PPIs

A

acid controlling drugs include

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11
Q
A
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12
Q

used to reduce the pain and reflux
associated with acid-related disorders.
* Raising the gastric pH 1 point (1.3 to 2.3) neutralizes
90% of the gastric acid.
* Antacids are basic compounds used to neutralize
stomach acid.
* Salts of aluminum, magnesium, calcium, or sodium
bicarbonate, or all of these.

A

antiacids

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13
Q

what is the MOA of antacids?

A
  • Work by neutralizing gastric acidity.
  • To give acute relief of symptoms associated with peptic ulcer, gastritis,
    gastric hyperacidity, and heartburn
  • They do not prevent the overproduction of acid.
  • Promote gastric mucosal defensive mechanisms
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14
Q

protective barrier against hydrochloric acid

A

mucus

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15
Q

helps buffer acidic properities of hydrochloric acid

A

bicarbonate

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16
Q

prevent activation of proton pump

A

prostaglandins

17
Q

what are the drug effects of antacids?

A
  • Reduction of pain and reflux associated with acid-related disorders
  • Raising the gastric pH 1 point (1.3 to 2.3) neutralizes 90% of the gastric acid.
  • Reducing acidity reduces pain as a result of:
  • Base-mediated inhibition of the protein-digesting ability of pepsin
  • Increase in the resistance of the stomach lining to irritation
  • Increase in the tone of the cardiac sphincter
18
Q

what are the contraindications of antacids?

A

Severe renal failure or electrolyte disturbances: potential toxic
accumulation of electrolytes in the antacids themselves.
* Gastrointestinal obstruction: Antacids may stimulate GI motility.

19
Q

such as simethicone are used to
relieve the painful symptoms associated with gas

A

antiflatulents

20
Q

Have constipating effects so often used with magnesium to counteract
constipation.
Often recommended for patients with renal disease (more easily excreted)
Examples: Antacid plus, Diovol, Gelusil, Maalox.

A

aluminum salts

21
Q

Buffers the acidic properties of hydrochloric acid
Highly soluble with quick onset but short duration.
May cause metabolic alkalosis
Sodium content may cause problems in patients with heart failure,
hypertension, or renal insufficiency.

A

sodium bicarbonate

22
Q
  • Commonly cause diarrhea; usually used with other drugs to counteract this effect.
  • Not used in renal failure, failing kidney cannot excrete extra magnesium,
    Magnesium builds up.
  • Examples: Magnesium hydroxide and mineral oil
A

magnesium salts

23
Q
  • Many forms but carbonate is most common
  • May cause constipation, kidney stones – advertised as a dietary calcium
    source.
  • Also not recommended for patients with renal disease—may accumulate to
    toxic levels
  • Long duration of acid action—may cause increased gastric acid secretion
    (hyperacidity rebound).
A

calcium salts

24
Q

what are the AE of antacids?

A

Minimal and depend on the compound used.

25
Q

what are the drug interactions of antacids?

A

adsorption of other drugs to antacids
chelation
increased stomach pH
increased urinary pH

26
Q

reduce acid secretions in the
stomach.
* Available OTC in lower-dosage forms.
* Ranitidine hydrochloride (Zantac)
* Famotidine (Pepcid)
* Competitively block the H2 receptor of acid-producing
parietal cells.
* Reduce hydrogen ion secretion from the parietal cells and
increase in the pH of the stomach.

A

H2 receptor antagonists (blockers)

27
Q

what are the indications of H2 receptor antagonists

A
  • Relief of many of the symptoms associated with hyperacidity-
    related conditions.
  • Gastroesophageal reflux disease (GERD)
  • Peptic ulcer disease (PUD)
  • Erosive esophagitis
  • Adjunct therapy to control upper gastrointestinal bleeding
28
Q

what are the AE of H2 receptor antagonists?

A
  • Dizziness, confusion and disorientation in elderly patients.(i.e.
    with Zantac)
  • Thrombocytopenia has been reported with ranitidine
    hydrochloride (Zantac) and famotidine.
29
Q
  • May increase drug levels and inhibit the absorption of
    drugs that require an acidic GI environment for
    absorption.
  • Largely replaced by ranitidine and famotidine.
  • May induce erectile dysfunction and gynecomastia.
A

cimetidine

30
Q
  • The parietal cells release positive hydrogen ions (protons) during
    hydrochloric acid production – called proton pump.
  • These drugs block the pump and stop hydrogen ion secretion from
    the parietal cells.
  • H2 blockers and antihistamines do not stop the action of this pump
A

proton pump inhibitors

31
Q

what are the proton pump inhibitors?

A
  • Rabeprazole (pariet)
  • Pantoprazole (pantoloc)
  • Omeprazole (losec)
  • Lansoprazole (prevacid)
32
Q

what are proton pump inhibitors used to treat?

A
  • Gastroesophageal reflux disease
  • Erosive esophagitis
  • Treatment of active duodenal, benign gastric ulcers, and NSAID induced ulcers.
  • Stress ulcer prophylaxis
  • Treatment of H. pylori–induced infections
  • Given with antibiotics
33
Q

what are the AE of proton pump inhibitors?

A
  • May increase the risk for Clostridium difficile.
  • Osteoporosis and risk of wrist, hip, and spine fractures in long-term users.
  • Risk for pneumonia.
  • Depletion of magnesium.
  • Food may decrease absorption of the PPIs, take on an empty stomach.
34
Q
  • Cytoprotective drug, used for stress ulcers, peptic ulcer disease.
  • Forms a protective barrier over the base of ulcers to protect
    from pepsin.
  • Do not administer with other drugs
A

sucralfate

35
Q
  • Prostaglandin E analog that has cytoprotective activity.
  • Used for the prevention of NSAID-induced gastric ulcers.
  • Thought to inhibit gastric acid secretion
A

misoprostol

36
Q
  • Antiflatulent drug
  • Result is decreased gas pain and increased passing of gas
    (burping or via rectum)
A

simethicone

Pharm II (22 decks)

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