Test # 4 GI disorders Flashcards
What is when there is a backflow of stomach acid into the esophagus - leads to scaring, heartburn
GERD - gastroesophageal reflux disease
When the lining of the esophagus is replaced with abnormal tissue. 10% of GERD pt - there had been a link to cancer in the esophagus
Barrett’s Esophagus
What are the two main causes of Peptic ulcer disease - 95%
Increased bacteria and NSAID use
One type of Antacid that is systemic and increases the pH of the blood
Sodium Bicarbonate
Two Antacids that do not cross into the blood - it stays orally
They are both more potent that Ca++
Aluminum Hydroxide + Mg Hydroxide
Maalox and Mylanta
What is an antacid that stays orally (does not cross into the blood) and may cause some consitpation
Ca Carbonate (Tums)
What are 3 H2 (histamine) receptor blockers that inhibit gastric acid secretion
Famotidine
Ranitidine
Nizatidine
What is one H2 (histamine) receptor blocker that inhibits gastric acid secretion
It also effects other drugs through the p450
and also inhibits metabolism of estrogen (men will get breast)!!!
Cimetidine
what are 5 proton pump inhibitors that inhibit secretion of gastric acid - they prevent “pumping” or releasing of acid.
works in 24hours but takes about 4-8wks for the stomach to heal back up
Omeprazole - NEIL Prilosec Esomeprazole - nexium Rebeprazole Lansoprazole - prevacid Pantoprazole
What is one drug that is a prostagladin and is used for the tx of NSAID induced injury (ulcer formation)
can cause birth defects and premature births
Misoprostol - cytotec
What is the last resort for tx of increase acid production in stomach - and Anticholinergic (muscarinic antagonist)
SE: burry vision, constipation, dry mouth, sedation (anti-slude)
Pirenzipine
a mucosal protectant - needs low pH to activate
forms a barrier around ulcer and allows it to heal
give 2 hrs before or after meals and other drugs
Sucralfate (carafate)
a mucosal protectant that protects ulcer to allow to heal.
Helps some with H.Pylori
use for less than 2 months - BLACK STOOLS
Chelated bismuth - Pepto Bismol
what are two meds to treat H. Pylori
they disrupt the bacteria cell wall
Bismuth
Amoxicillin
what are 2 drugs to tx H. Pylori
they inhibit protein synthesis
Clarithromycin
Tetracycline
What is one drug used to tx H. pylori that is given when there is a bacterial resistance or intolerance to other drugs
Metronidazone
what drugs are defined in the TRIPLE therapy use to treat H.Pylori.
It is a 7 day treatment
and is a tx of choice for people who have an ulcer and are positive for H. Pylori
Proton pump inhibitior + amoxicillin/tetraccycline + metronidazone/clarithomycin
What is in the QUADRUPLE therapy to tx H.Pylori
it is a 7 day course treatment
Proton pump inhibitior + amoxicillin/tetraccycline + metronidazone/clarithomycin
PLUS bismuth!!
What is the #1 cause of constipation?
laxative use!
always try diet first
what are 3 Bulk laxatives
they increase bowel content which causes a peristalsis reflex
indigestible - few days to work
Psyllium
Bran
Methycellulose
What laxatives work in1-3 hours (purge intestines)
the fluid is drawn into the bowel
saline and osmotic laxatives
Lactulose, prunes
milk of magnesia
epsom salt
polyethylene - saposatory
What are 3 stool softeners
lub the stool so it can slide out
Docusate sodium
Liquid paraffin
glycerin suppositories
what are 3 irritants that stimulate GI peristalsis
works in 6-8 hours for severe constipation
Bisacodyl - Dulcolax
Senna
Lubiprostone
An anti-diarrheal agent that is 50x more potent than morphine
decreases peristalsis - stimulates opioid receptor in bowel
NO CNS effect - does not cross BBB
Loperamide - Imodium
what are three other anti-diarrheal agents that stimulate opioid receptors to slow GI
What for increase in toxic effects bc drugs can get trapped in the system
Morphine
Codeine
Diphenoxylate
what is the # 1 cause in clinic setting diarrhea.
It secretes an enzyme and can perm. damage lining of GI
C. Diff
what is an antiflatulant that alters the mucous bubble
clinical only effectiveness is when used with loperamide (gas associated with diarrhea)
Simethicone
What drug induces emesis
only give if more than 30-60mins away from hospital
Syrup of Ipecac emetic
an antiemetic (M1 receptor antagonist)
ANTI-SLUDE Side effects
give only 1 bc extra may cause hallucinations
Scopolamine
what are two H2/D2 antagonists that are used for antiemetics
SE: blurred vision, dry mouth, extrapyramidal effects, seizures
Promethazine - phenergan
Prochlorperazine - Compazine
What are two antiemetic drugs that block the 5-HT2 receptor
HE and constipation
newest drug - safe -, effective, rapid
Ondansetron - Zofran
Grnaisetron
