T2-Antiulcer Medications

Question 1

What are some stomach acid problems?

Answer 1

GERD, heartburn, erosive esophagitis, ulcers

Question 2

What are the 5 causative factors of stomach acid problems?

Answer 2

H. Pylori (ulcers only)
NSAIDS
Gastric Acid
Pepsin
Smoking

Question 3

What nonpharmacologic measures can you teach your client for stomach problems?

Answer 3

• Avoid spicy food and caffeine
• Alcohol may exacerbate symptoms
• Lowering stress and anxiety may cause ulcers to heal quicker
• Avoid smoking

Question 4

What is the MOA of proton pump inhibitors?

Answer 4

Inhibiting the H-K-ATPase pump so H doesn’t go to the stomach, so the stomach doesn’t turn more acidic

Question 5

What is the MOA of H2 receptors?

Answer 5

Blocking the H2 receptor, which activates the H-K-ATPase pump

Question 6

What is the suffix for proton pump inhibitors?

Answer 6

-prazoles

Question 7

Are prazoles well tolerated?

Answer 7

Yes

Question 8

What is the adverse effect of prazoles?

Answer 8

Acid rebound

Question 9

When does acid rebound occur?

Answer 9

Mainly when you are taking it chronically and then stop

Question 10

What can you do to prevent acid rebound?

Answer 10

Taper when stopping

Take an antacid or H2 blocker to help

Question 11

How long can acid rebound last?

Answer 11

Several months

Question 12

What are some of the CONTROVERSIAL adverse effects to proton pump inhibitors? (4)

Answer 12

Pneumonia
C. diff
Nutritional deficits (b12, iron, magnesium, calcium)
Osteoporosis/fractures (due to the deficits)

Question 13

When should you take a prazole?

Is it okay to crush a prazole?

Answer 13

BEFORE BREAKFAST; no–they are DR tabs

Question 14

Why should you take a prazole before breakfast?

Answer 14

The pump has to be on to break it. Food activates the pump. Take the med first so your “warriors” are ready for battle. Eat your food (the enemy that activates the pump). Your warriors are already in your system ready for battle, so they will be there to turn off the pump.

Question 15

Does prazoles bind reversibly or irreversibly to the pump?

Answer 15

IRREVERSIBLY–pump is permanently broken!

Question 16

What is the suffix for H2 blockers?

Answer 16

-Tidines

Question 17

What are the adverse effects of H2 blockers?

Answer 17

• Tolerance (body is going to keep making gastrin to activate the pump since the H2 receptor is blocked)
• Rebound effect
• Confusion (if levels are too high)

Question 18

Can you take an antacid with H2 receptor?

Answer 18

No, not at the same time

Question 19

Why can’t you take an antacid with an H2 receptor at the same time?

Answer 19

H2 won’t absorb

Question 20

If you want to take both an antacid and H2 blocker, how far should you space taking the different meds?

Answer 20

Take the H2 first so there is time for it to absorb, THEN ONE HOUR LATER, take your antacid

Question 21

What is the MOA of sucralfate?

Answer 21

Creates a protective barrier over an ulcer

Question 22

What does the pH of the stomach have to be for sucralfate to work?

Answer 22

less than 4

Question 23

Does the stomach need to be slightly acidic or basic for sucralfate to work?

Answer 23

Acidic

Question 24

How long does the protective coating of sucralfate work?

Answer 24

~6 hours

Question 25

____ occurs in 2% of clients who take sucralfate.

Answer 25

Constipation

Question 26

Can sucralfate be taken with antacids?

Answer 26

NO

Question 27

Antacids are _____ that just raise the pH to make it less ____ and more ____. Antacids have to be taken frequently to provide all day relief.

Answer 27

Receptorless; less acidic, more basic

Question 28

What does excessive use of antacids cause?

Answer 28

Systemically can cause pH to rise

So normal blood is 7.35-7.45…if overuse of antacids systemically raises pH then that can lead to metabolic ALKALOSIS