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Exam 4 > PUD > Flashcards

PUD Flashcards

1
Q

What is peptic ulcer disease?

A
  • a break in the mucous lining of GI tract

- occurs in the esophagus, stomach and duodenum

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2
Q

What age group do gastric ulcers commonly affect?

A

Older clients.

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3
Q

What type of ulcers are most common in peptic ulcer disease?

A

Duodenal ulcers

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4
Q

What is the duodenal?

A

First part of the small intestines.

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5
Q

Is PUD more frequent in men or women?

A

Men.

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6
Q

Why is PUD not common in women of child-bearing age?

A

Because the body protects the woman. When menopause hits, the protection leaves and women are just as susectible.

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7
Q

What is H. Pylori?

A

A bacteria that is a common cause of peptic ulcer disease.

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8
Q

Esophageal ulcers occur as a result of what?

A

The backward flow of HCI from the stomach into the esophagus(GERD).

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9
Q

Does stress cause ulcers?

A

No.

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10
Q

What do most ulcers result from?

A

Infection of H. pylori bacteria.

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11
Q

Infection of H. pylori bacteria and what are synergistic risks?

A

Concomitant use of NSAIDs.

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12
Q

What blood type is more susceptible to PUD?

A

TYPE O.

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13
Q

Where can peptic ulcers affect?

A

Stomach, esophagus, and duodenum.

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14
Q

Why do peptic ulcers occur mainly in the gastroduodenal mucosa?

A

Because this tissue cant withstand the digestive action of gastric acid and pepsin.

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15
Q

What are the risk factors of peptic ulcer disease?

A
  • Chronic H. pylori infection
  • chronic aspirin and NSAID use with concurrent use of glucocorticoids or bisphosphonates.
  • family history fo PUD
  • old age
  • unsanitary living conditions(poor hand hygiene)
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16
Q

Prevention of PUD is related to the etiology: What are some preventions?

A
  • meticulous hand washing
  • correct food prep, washing and cooking thoroughly
  • have long-term NSAID users get tested
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17
Q

What is the classic symptom of a peptic ulcer?

A

Dull, gnawing pain or burning sensation in the midepigastric area of the back.

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18
Q

When does gastric ulcer pain occur?

A

Immediately after eating.

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19
Q

When does duodenal ulcer pain occur?

A

2-3 hours after eating,

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20
Q

Is the presentation of gastric ulcer pain normal in older adults?

A

No, often they get different symptoms, even referred pain.

Older adults after think pain is a normal old thing.

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21
Q

What are the complications of a peptic ulcer?

A

Hemorrhage, pyloric obstruction or gastric outlet obstruction, perforation, signs of hypovolemia,

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22
Q

What are the diagnostic tests for PUD?

A
  • upper GI series
  • gastroscopy(test specimen for H.pylori)
  • noninvasive tests
  • CBC
  • stools for hemoccult
  • Gastric analysis if ZES is expected
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23
Q

What is Zollinger-Ellison syndrome?

A

A form of peptic ulcer disease caused by a gastrin-secreting tumor.

24
Q

What type of pharmacological therapy is used for H.pylori?

A

A combination. Multiple antibiotics, with PPI and H2 receptor blockers possibly.

25
Q

How can you treat an NSAID-induced ulcer?

A
  • discontinue NSAID if possible

- if you can’t (RA) dose with PPI

26
Q

What is the generic name for Macrolide?

A

Clarithromycin.

27
Q

What is the trade name for clarithromycin?

A

Macrolide.

28
Q

What type of drug is clarithromycin?

A

Broad-spectrum antibiotic.

29
Q

What is the MOA for Clarithromycin?

A

It inhibits protein synthesis by binding to the bacterial ribosome.
(Effective against most gram+ and many gram- bacteria)

30
Q

What is the primary use of Clarithromycin?

A

Whooping cough, legionnaire’s disease, infections by streptococcus, H.influenza, and mycoplasma pneumoniae

31
Q

What are the AE of Clarithromycin?

A

N/v, abdominal cramping, diarrhea, superinfections, resistant bacterial strains.

32
Q

How often is clarithromycin given?

A

Twice a day. Has a acid-resistant covering on it so it doesn’t dissolve too early.

33
Q

What class is amoxicillin a part of?

A

Penicillins.

34
Q

What is the MOA of amoxicillin?

A

Kill bacteria by disrupting the call wall.

35
Q

What kind of bacteria is amoxicillin most effective on?

A

Gram-positive bacteria.

36
Q

Do human cells have cell walls?

A

No. (Squamous cells)

37
Q

Of the cases of allergy to penicillin what percentage is the reaction anaphylactic?

A

0.04%

38
Q

What is amoxicillin used for?

A

Pneumonia, meningitis, skin, bone, joint, stomach infections, blood and valve infections, gas gangrene, tetanus, anthrax

39
Q

What are the AE f amoxicillin?

A

Bacteria can become resistant, possible allergy, lowered W/R blood cell count, and platelet levels.

40
Q

What is tetracycline?

A

The drug of choice for only a few diseases because of resistant bacterial strains(Rocky Mountain spotted fever, typhus, cholera, Lyme disease, peptic ulcers and chlamydia)

41
Q

What are the AE of tetracycline?

A

Superinfections, nausea, vomiting, diarrhea, discoloration of teeth, photosensitivity

42
Q

What is the antiprotozoal prototype drug?

A

Metronidazole (Flagyl)

43
Q

What reacts very badly with flagyl?

A

Alcohol consumption.

44
Q

What is the MOA for metronidazole?

A

To act as a antiprotozoal drug that also has antibiotic activity against anaerobic bacteria.

45
Q

What is the primary use of metronidazole?

A

Amebic diseases

46
Q

What are the AE of metronidazole?

A

Anorexia, nausea, diarrhea, dizziness, headache, dry mouth, unpleasant metallic taste, flushing of skin

47
Q

What are some miscellaneous drugs to treat PUD?

A
  • Sucralfate (Carafate)
  • Misoprostol (Cytotec) Prostglandin Analog
  • Bismuth compounds (Peptobismal)
48
Q

What does carafate do?

A

Coats ulcer and protects it from further erosion

49
Q

What does cytotec do?

A

Inhibits acid and stimulates production of mucus, can cause miscarriage.

50
Q

What do bismuth compounds (peptobismal) do?

A

Inhibit bacterial growth and prevent h.pylori from adhering to gastric mucosa.

51
Q

True or false.

H.pylori infection can remain active for life if not treated.

A

True

52
Q

There is a very high reoccurrence when H.pylori is not what?

A

Eradicated.

53
Q

What has greatly decreased the need for surgery with PUD?

A

Treatment of H.pylori

54
Q

What are some nonpharmacological therapies for PUD?

A

Good nutrition
Mild alcohol intake(not more than one a day)
Smoking is discouraged.

55
Q

Is surgical management still used for the treatment of PUD?

A

Not often

56
Q

What is the number one thing to do to maintain homeostasis?

A

Restore and maintain fluid volume.

57
Q

It’s important to assess these things in a pt with PUD:

A

-health hx
-pain
-relief measures being used
-n/v, stool characteristics
-meds
-smoking/alcohol
Physical examination
-general appearance
-abdominal exam
-VS

Exam 4 (13 decks)

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