PUD Flashcards
What is the goal when treating PUD and other disorders of chronic inflammation (GERD, Gastritis, etc)?
Goal is to reduce inflammation
What are the protective cells of GI tract?
Surface epithelial, mucosal neck, and stem cells
What are the digestive cells of GI?
Parietal, chief, and endocrine cells
Describe direct pathway of acid secretion
Ach, gastrin, histamine directly stimulate parietal cells to secrete acid
Describe the indirect pathway of acid secretion
Ach and gastrin stimulate ECL cells –> histamine release –> acid secretion
Half of this lecture is stuff we know from phys, micro, & path. Should you review these subjects for the test?
Yes.. So now we will move on to pharm stuff
Whats the overall goal of PUD tx? (3)
- Eradicate H. pylori with antibiotics
- Relieve symptoms with anti-secretory drugs or antacids
- Heal ulcers with PGs, bismuth, sucrasulfate
What do antacids do?
Neutralize acid in the stomach (duh)
What is the goal for antacid tx?
pH > 4
What are the antacid drugs?
- Maalox (Mg-Al hydroxide)
- Gaviscon (Maalox + algenic acid)
- Calcium carbonate (Tums)
What are antacids used for?
- Simple dyspepsia
2. Adjunctive with H2 blockers or PPIs
When are antacids taken?
A few hours post meal or before bedtime
What is probably the biggest consideration when prescribing antacids?
They can SIGNIFICANTLY affect the absorption of other drugs (b/c the increase the pH of the stomach). So you dont want to take them within a few hours of other drugs*****
Maalox is a combo of Mg hydroxide and Al hydroxide. What do these things do?
Mg hydroxide causes diarrhea. Al hydroxide causes constipation. You mix them together to balance the AEs. (Mg: M for Mudbutt)
What do H2 antagonists do? (3)
- Block histamine receptors.
- Inhibit basal, cephalic, and nocturnal gastric acid secretion.
- Reduces volume and [H+] of gastric acid
Name the H2 antagonists
- Cemetidine: 1x potency
- Ranitidine & Nizatidine: 4-10x potency
- Famotidine: 20-50x potency
- *All have same efficacy