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Pharmacology > Week 12 GI Secretion > Flashcards

Week 12 GI Secretion Flashcards

1
Q

Histamine 2 Antagonist prototype drug

A

CIMETIDINE

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2
Q

Antacid prototype drug

A

Sodium bicarbonate

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3
Q

Protein pump inhibitors prototype drug

A

omperazole

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4
Q

what neutralizes or reduces gastric acidity, resulting in an increase in gastric pH

A

Antacid

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5
Q

Therapeutic action: Histamine 2 antagonist

A

Inhibits the actions of histamine at H2 receptor sites of the stomach, inhibiting gastric acid secretion and reducing total pepsin output
- acts before gastric acids are secreted

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6
Q

indications: Histamine 2 antagonist

A

Short term; duodenal or benign gastric ulcers
- Pathological hypersecretory conditions
- prophylaxis; stress ulcers
- erosive GERD
- relief of heartburn/ indigestion

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7
Q

pharmacokinetics: Histamine 2 antagonist

A
  • oral, IV & IM
  • metabolized in liver, excreted in urine
  • can cross placenta/ breastmilk
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8
Q

adverse effects: Histamine 2 antagonist

A
  • dizziness, confusion, headache, somnolence, cardiac arrhythmias, cardiac arrest, diarrhea, impotence, gynecomastia, rash
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9
Q

contraindications: Histamine 2 antagonist

A
  • Allergy
  • caution; pregnancy/ breastfeeding & hepatic/renal dysfunction
  • prolonged use may mask underlying condition
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10
Q

drug-drug interaction: Histamine 2 antagonist

A

Slows metabolism of certain drugs, increases risk for toxicity
- warfarin
- phenytoin
- Beta-adrenergic blockers
- benzodiazepines
- tricyclic antidepressants

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11
Q

nursing considerations: Histamine 2 antagonist

A
  • Administer w/ or before meals & at HS
  • use increased safety measures when ambulating d/t dizziness
  • monitor liver & renal function
  • get a detailed description of the GI problem & determine underlying medical problem
  • perform physical exam to get baseline data, determine drug effectiveness, & evaluate for adverse effects
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12
Q

Therapeutic action: antacids

A

Neutralizes or reduces gastric acidity, resulting in an increase in gastric pH

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13
Q

indications: antacids

A
  • Systemic relief of upset stomach from hyperacidity
  • prophylaxis of GI bleed & stress ulcers
  • adjunctive of severe diarrhea
  • metabolic acidosis
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14
Q

pharmacokinetics: antacids

A

oral & IV
- readily available in may preparations
- excreted unchanged in the urine
- crosses placenta/ breastmilk

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15
Q

adverse effects: antacids

A

Related to acid/base & electrolyte imbalance
- fluid retention & HF
- systemic alkalosis; headache, weakness, confusion, tetany
- hypokalemia

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16
Q

contraindications: antacids

A
  • Allergy
  • caution use with the following instances; electrolyte imbalances, GI obstruction, renal dysfunction, acid-base imbalance, pregnancy/ lactation
17
Q

nursing considerations: antacids

A
  • Watch for acid rebound!
  • Pts should seperate taking antacids and other oral med by 1-2hrs
    -Ensure pts chew tablets thoroughly & follows w/ water
  • continually assess sign of acid/ base or electrolyte imbalances
  • monitor serum electrolyte levels & renal function test
  • inspect & auscultate abdomen
18
Q

Therapeutic action: PPI’s

A

Blocks the final step of acid production and decreases gastric acid levels in the stomach

19
Q

indications: PPI’s

A

Short term; duodenal ulcers, benign gastric ulcers, s/s of GERD
Long term; pathological hypersecretory conditions
Combo therapy; w/ amoxicillin & clarithromycin for treatment of H. Pylori

20
Q

pharmacokinetics: PPI’s

A
  • oral med
  • metabolized in the liver, excreted in the urine & bile
  • unknown if crosses placenta/ breastmilk
21
Q

adverse effects: PPI’s

A
  • headache, dizziness, vertigo, insomnia, rash, diarrhea, abdominal pain, n/v, upper resp infection s/s, cough
22
Q

contraindications: PPI’s

A

Allergy
- caution should NOT be used in pregnant women
- Be cautious when using in patients younger than 18 years old

23
Q

drug-drug interactions: PPI’s

A

Slows metabolism of certain drugs, increases risk for toxicity
- Benzodiazepine
- phenytoin
- warfarin

24
Q

nursing considerations: PPI’s

A
  • Administer before meals, and DO NOT open, chew or crush
  • inspect & palpate abdomen to r/o underlying conditions
  • perform physical exam to get baseline data, determine drug effectiveness, & evaluate for adverse effects
  • assess change in bowel elimination & GI upset
  • encourage small frequent meals
  • follow up 4-8wks if s/s have not resolved
25
Q

children considerations

A
  • Dose should be determined by the weight and age of the child
  • Proton pump inhibitors have been used to successfully decrease ulcer formation related to stress or drug therapy in children
  • Antacids may be used in children who complain of upset stomach or who are receiving therapy known to increase avid production
  • Use caution in order to prevent electrolyte disturbances or any interference with nutrition, which could be especially detrimental to children
26
Q

adult considerations

A

Caution adults not to overuse any of these agents and check with a healthcare provider if GI discomfort continues after repeated use
Monitor for electrolyte disturbances
Safety during pregnancy and lactation has not been established

27
Q

older adult considerations

A

Frequently prescribed one or more of these drugs
More likely to develop adverse effects
Due to GI tract changes that occur with aging, absorption of nutrients is more likely to be impacted with use of these medications
Start at a lower dose, monitor renal and hepatic impairment
Alerted to OTC preparations that may contain the same ingredients

28
Q

inhibits the actions of histamine at H2 receptor sites of the stomach, inhibiting gastric acid secretions and reducing total pepsin output

A

Histamine 2 Antagonist (cimetidine)

29
Q

Blocks the final step of acid production and decreases gastric acid levels in the stomach

A

PPI (omeprazole)

Pharmacology (16 decks)

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