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PUD/GERD meds Flashcards

1
Q

Proton Pump inhibitor drugs

A

“Zoles’s”
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)

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2
Q

Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Indiction:

A

PUD and GERD

-Working with 2 antibiotics to treat H. Pylori

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3
Q

MOA of Zoles

A

Reduces acid secretion in stomach by binding irreversibly to the enzyme of Na+K+ ATPase Pump

Pump secretes acid, and PPIs inhibit the final pathway of acid secretion by blocking it

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4
Q

Adverse effects of Zoles
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)

A

CNS

  • headache
  • dizziness

GI

  • flatulence
  • N/V/D
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5
Q

Nursing Concerns for Zoles
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)

A
  • Take 20-30 min before first meal (proton pump activated by food)
  • Short half life (about 1.5 hr) but suppress acid for 24 hrs (irreversible)
  • 4 days to achieve maximal effects (not all pump inactivated by first dose)
  • Food intake with beneficial bacteria/normal flora like yogurt
  • Keep head of bed elevated 30 degrees if you experience heartburn
  • DO NOT crush, break or chew tablets/capsule
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6
Q

Assessment for Patients taking Zoles

A
  • Complete medical history, allergies and drug interactions
  • Routine liver function tests for prolong use. Interactions
  • Vit B12 & Folic Acid can cause malabsorption, Avoid smoking, EtOH, and breastfeeding
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7
Q

Histamine 2 Antagonist

A

“Dines”
Ranitidine (Zantac)
Cimetidine (Tagamet)
Famotidine (Pepcid)

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8
Q 
"Dines"
Ranitidine (Zantac) 
Cimetidine (Tagamet)
Famotidine (Pepcid)
are for?
A

PUD and GERD

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9
Q

MOA for “Dines”
Ranitidine (Zantac)
Cimetidine (Tagamet)
Famotidine (Pepcid)

A
  • Block H2 Receptors on parietal cells in stomach to decrease acid production
  • Suppress day time/nocturnal basal gastric acids
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10
Q 
Adverse effects for 
"Dines"
Ranitidine (Zantac) 
Cimetidine (Tagamet)
Famotidine (Pepcid)
A 
*Strong Effects on elderly and those with Renal Disease
CNS: 
Confusion
Restlessness
Hallucinations
Depression
GI: 
Elevated Liver Enzymes 
N/V/D
CV: Arrhythmias
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11
Q 
Nursing Concerns for 
"Dines"
Ranitidine (Zantac) 
Cimetidine (Tagamet)
Famotidine (Pepcid)
A
  • Rapid absorption from small intestine (30 min onset of action)
  • Short half-life/rapid excretion (from 1 to 4 hr)
  • No known effects on the fetus
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12
Q 
Interactions with
 "Dines"
Ranitidine (Zantac) 
Cimetidine (Tagamet)
Famotidine (Pepcid)
A
  • DO NOT take with Antacids→ diminished absorption

- DO NOT confuse with H2 Antagonists (Benadryl against allergic rhinitis)

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13
Q

Antacids

A

Aluminum Hydroxide (AlternaGel)

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14
Q

Aluminum Hydroxide (AlternaGel) is used for?

A

PUD and GERD

also treats symptoms of heartburn

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15
Q

MOA for Aluminum Hydroxide (AlternaGel)

A
  • Alkaline Substance that neutralizes stomach acid to bring the pH above 3 and inactivates pepsin
  • Most isn’t absorbed; Works directly on stomach acid and is secreted in the feces
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16
Q

Adverse affects for Aluminum Hydroxide (AlternaGel) with Sodium bicarbonate (Alka-Seltzer, baking soda)

A

fluid retention and contraindicated with congestive heart failure

17
Q

Adverse affects for Aluminum Hydroxide (AlternaGel) with Magnesium hydroxide (Milk of Magnesia)

A

Fatigue, diarrhea, hypotension, dysrhythmias, hypermagnesemia in renal disease

18
Q

Adverse affects for Aluminum Hydroxide (AlternaGel) with Calcium carbonate (Titralac, Tums)

A

Constipation, aggravated kidney stones, milk-alkali syndrome, rebound hyperacidity and metabolic alkalosis

19
Q

Adverse affects for Aluminum Hydroxide (AlternaGel)

A

Constipation and Hypophosphatemia (Phosphate depletion)

20
Q

Some Combinations of 2 Antacids can lead to __________ ?

A

Metabolic Alkalosis

21
Q

Nursing Concerns for Aluminum Hydroxide (AlternaGel)

A
  • Complete Medical History
  • Stomach pain assessed and evaluated
  • Lab values including Electrolyte and Renal Function
  • Symptoms of gastric bleed
22
Q

Interactions for Antacids (Aluminum Hydroxide (AlternaGel))

A
  • Take antacids at least 2 hours before other PO medications
  • Adequate Nutrition while taking
23
Q

Initital Regimen for Helicobacter Pylori

A

1 PPI and 2 antibiotics

Omeprazole (PPI), Clarithromycin (Biaxin), and Amoxicillin (Amoxil)

24
Q

for PUD & GERD: Sucralfate (Carafate) MOA

A

enhancing mucosal defense and promoting healing

25
Q

Bismuth compounds (Pepto-Bismol) is for

A

PUD, GERD, H, Pylori, Diarrhea

26
Q

Metoclopramide (Reglan) is for

A

GERD & N/V

27
Q

MOA for Metoclopramide (Reglan)

*Antidopaminergic

A
  • blocking dopamine 2 receptors on chemoreceptor trigger zone to inhibit vomiting reflex
  • faster emptying of stomach and decreasing esophagus relaxation on GI tract

Pharmocology (28 decks)

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