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NURS 2514 > Upper and Lower GI Pharmacology > Flashcards

Upper and Lower GI Pharmacology Flashcards

1
Q

Name the acid controlling drugs (5)

A
  1. H2 Receptor Antagonist
  2. Proton pump inhibitors
  3. Antacids
  4. Antibacterial drugs
  5. Other antiulcer drugs
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2
Q

What is the example drug for H2 Receptor Antagonist drug?

A

Ranitidine

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3
Q

What is the example drug for PPI? (Proton pump inhibitor)

A

Omeprazole

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4
Q

What is the example drug for antacids?

A

Aluminum hydroxide

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5
Q

What are the example drugs for antibacterial drugs? (4)

A
  1. Amoxicillin
  2. Clarithromycin
  3. Metronidazole
  4. Tetracycline
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6
Q

What are the example drugs for antiulcer drugs? (2)

A
  1. Sucralfate

2. Misoprostol

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7
Q

TRUE or FALSE. H2 Receptor antagonist produces allergy symptoms.

A

FALSE. H1 receptors produce allergy symptoms not H2 receptors.

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8
Q

Where are the H2 receptors located?

A

In the parietal cells of the stomach

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9
Q

What happens when you block the H2RA (Histamine-2 Receptor Antagonist) receptors?

A

Reduces volume of gastric juice and decreases concentration of acid

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10
Q

How can it be administered to the patient?

A
  1. PO
  2. IM (not used a lot)
  3. IV (urgent)
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11
Q

What are the indications for H2RA?

A

Healing & Prevention of gastric/duodenal ulcers, treatment of GERD

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12
Q

H2RA is (a) metabolized and (b) excreted by what?

A

(a) Liver

(b) Kidney

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13
Q

What are the adverse effects of Ranitide?

A
  1. CNS; confusion, hallucination, CNS depression (crosses bbb poorly. so this is rare)
  2. Increased risk for pneumonia (increased pH) - When pH is more basic, it increases bacteria to survive
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14
Q

TRUE or FALSE. Ranitidine commonly have side effects

A

FALSE. Side effects of Ranitidine are uncommon

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15
Q

What are the contraindications and precautions of Ranitidine? (2)

A
  1. Some H2RAs (cimetidine) inhibit hepatic drug-metabolizing enzymes but this effect is minimal with Ranitide. *Dosage may need to be adjusted in drugs with narrow safety margins.
  2. Antacids slightly decrease absorption of ranitidine (greater effect on cimetidine)
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16
Q

What are other H2RA’s? (3)

A

Cimetidine (first H2RA, inhibit drug metabolism enzymes), Famotidine, Nizatidine

17
Q

What are nursing considerations and assessment? (4)

A
  1. Assess for epigastric pain or signs of GI bleeding (hematemesis, frank blood or occult blood in stool)
  2. Assess for signs of confusion (esp. in older adults)
  3. CBC periodically (rare side effect)
  4. Administer antacids an hour apart (antacid decrease absorption so you have to take an hour before or after)
18
Q

What does PPI: Omeprazole cause?

A

Causes irreversible inhibition of H+, K+ ATPase, the enzyme (ezyme produce H+ but changes to K+) that generates gastric acid

19
Q

A single dose of PPI: Omeprazole inhibits acid production by what (a) percentage for how (b) long?

A

(a) 97%

b) 2 Hours - More effective than H2RA (65%

20
Q

Is the effect of Omeprazole reversible or irreversible and why?

A

Irreversible. There is no new acid until new enzyme is made which may take days to weeks depending on the person.

21
Q

What does is it mean when a drug is acid-labile?

A

Capsules contain enteric coated granules that dissolve in duodenum.
Easily destroyed in an acidic enviroment.

22
Q

What are the indications of Omeprazole? (3)

A

Treatment of gastric/dupdenal ulcer, treatment of GERD, prevention of stress ulcers is hospitalized patients

23
Q

What are the minor adverse effects of Omeprazole? (4)

A
  1. Headache
  2. Diarrhea *
  3. Nausea
  4. Vomiting
24
Q

What are the major adverse effects of Omeprazole?

A
  1. Pneumonia ( ^ pH - basic)
  2. Fractures (decrease in calcium absorption, esp. in older adults)
  3. Rebound acid (body creates more acid) hyper-secretion (dyspepsia)
  4. **Hypomagnesemia (decrease Mg absorption with long term use)
25
Q

(a) What happens when a patient stops taking PPI? (b) How can the effects be minimized?

A

(a) They experience dyspepsia brought on by rebound hyper-secretion of gastric acid.
(b) Acid rebound can be minimized by using PPI at the lowest effective dose for the shortest time needed and by tapering the dose when stopping treatment.

26
Q

How can dyspepsia be managed?

A

Antacid and with H2RA

27
Q

What are the contraindications and precautions of Omeprazole (2)

A
  1. Elevated gastric pH caused by PPI’s can decrease the absorption of some drugs (HIV/AIDs drugs, antifungal drugs)
  2. PPIs inhibit the isoenzyme of CYP450 which activates clopidogrel (decrease antiplatelet effect)
28
Q

Can you combine HIV/AIDs drug and antifungal drugs?

A

Preferably not. Elevated gastric pH caused by PPIs can decrease the absorption of some drugs.

PPI interferes with absorption of antifungal drugs

29
Q

What happens if you combine Omeprazole with Clopidogrel?

A

The risk of GI bleeding will be reduced but antiplatelet effects may reduced as well.

30
Q

What are the benefits in combining PPI with clopidogrel?

A

The benefits outweight any risk from reduced antiplatelet effects hence, combining PPI with clopidogrel is okay.

Use only on patients with GI bleeding

31
Q

What are the nursing considerations and assessment for omeprazole? (4)

A
  1. Administer doses before meals (needs time to dissolve)
  2. Assess for epigastric/abdominal pain
  3. Monitor bowel function for diarrhea, abd cramping
  4. Monitor serum, CBC and Mg
32
Q

What does sucralfate do?

A

Protects against ulcers by creating a mucosal barrier against acid and pepsin

33
Q

What type of (a) reaction and (b) environment does sucralfate go under in order to form a sticky gel?

A

(a) Chemical reaction in an (b) acidic environment

34
Q

How long does sucralfate adhere to the ulcer for?

A

6 Hours

35
Q

(a) How does sucralfate get eliminated? (b) Can it be reabsorbed?

A

(a) Through feces

(b) Not absorbed into blood stream

36
Q

What is sucralfate’s indication?

A

Gastric & Duodenal Ulcers

NURS 2514 (11 decks)

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