Questions 23 thru 34 p2 Flashcards
What agents stimulate the parietal cell to produce acid?
- Histamine 2 (Autocoid/H2 Receptors)
- Gastrin (Gastrin Receptor)
- Acetylcholine/ACH (Cholinergic/Muscarinic Receptor)
What does PUD stand for?
Peptic Ulcer Disease
What are the 2 categories of ulcers?
- Gastric Ulcers
2. Duodenal Ulcers
Where are gastric ulcers located?
Upper Stomach
What are the 2 notable things about gastric ulcers?
- Eating food irritates them
2. Typically NSAID induced
Where are duodenal ulcers located?
Lower Stomach
What is notable about duodenal ulcers?
Eating Food RELIEVES pain
What are the goals of ulcer treatment?
- reduce acid and pepsin to allow mucosal lining to heal
- short term 4-8 weeks treatment
- maintenance therapy
What are the 5 factors that contribute to ulcers?
SASHE
- Smoking
- Alcohol
- Spicy Food
- H.Pylori
- Emotional Stress
Name the categories of drugs used to treat GERD and PUD
SHPPGAA
- Sucralfate
- H2 Blocker
- Prostaglandins
- PPI’s
- Gastric Stimulants
- Anti-cholinergics/Anti-spasmodics
- Antacids
What is the MOA for sucralfate?
MOA = enhance mucosal defenses by acting like a “band-aid”
What is sucralfate NOT?
- NOT anti-secretory
2. NOT antacid
What formulas does sucralfate come in?
- Tablet
2. Suspension
What drugs should you know for H2 Blockers?
- Rantidine
- Famotidine
- Cimetidine SE = gynecomastea
What is the MOA for H2 Blockers?
MOA = Block H2 Receptor and prevent Histamine 2 from stimulating parietal cell to secrete acid
What is the MOA for prostaglandins?
MOA = increase the synthesis of mucus
not much used anymore
What are the PPI drugs to know?
- Omeprazole/Prilosec
- Lansoprazole/Prevacid
- Esomeprazole/Nexium
What is the MOA for PPI’s?
MOA = directly inhibit the exchange of H+ for K+ which inhibits the production of HCL
What are the drugs to know for Gastric Stimulants?
- Metoclopramide
2. Cispride
What is the MOA of Gastric Stimulants?
MOA =
- induce contractions in upper GI to move food down
- contract lower esophogeal spinchter to prevent reflux
What are the drugs to know for anti-cholinergics used to treat ulcers?
- Atropine (belladonna alkaloid)
2. Glycopyrrolate (synthetic anticholinergic)
What is the MOA for anit-cholinergics for ulcers?
MOA =
- block cholinergic/muscarinic receptors from ACH which = decreased HCL secretion
- block autonomic ganglia = decreased motility
What are the drugs to know for anti-spasmotic?
Dicyclomine
What is the MOA of anti-spasmotic?
MOA = relaxes intestinal smooth muscle via nonspecific pathways, decreasing motility
