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VN 140 GI
| Question | Answer |
|---|---|
| stomach secretes | hydrochloric acid (HCL), bicarbonate, pepsinogen, intrinsic factor, mucus and prostaglandins |
| what does parietal cells of gastric gland secrete? | HCL; this is the primary site for acid controller drugs |
| what does chief cell of gastric gland secrete? | pepsinogen (it becomes pepsin w/c breaks down protein |
| what does mucoid cell of gastric gland secrete? | mucous; it provides protection from HCL |
| Hydrochloric Acid | secreted by parietal cells; maintains stomach at a pH of 1 to 4; secretion stimulated by: large fatty meals, excessive amt of alcohol and emotional stress |
| acid-related diseases | caused by imbalance of the three cells of the gastric gland and their secretions |
| what is the most common of acid-related diseases: | hyperacidity |
| what is the most harmful of acid-related diseases: | peptic ulcer disease (PUD) |
| antacids | promotes the gastric mucosal defense mechanisms; it does not stop stomach from producing acid. It neutralizes it. |
| if dr ordered antacids for pt, why do they need to take it even if they are already eating well? | it neutralizes their stomach |
| bicarbonate | helps buffer acidic properties of HCL |
| Prostaglandins | prevent activation of proton pump |
| how much would antacid neutralize if raising gastric of pH of 1.3 to 1.6 | 0.5 |
| how much would antacid neutralize if raising gastric of pH of 1 point (1.3 to 2.3) | 0.9 |
| antacid examples | TUMs, rolaids, mylanta |
| antacids | can be used alone or in combination; depends on severity of problem |
| ANTACID - aluminum salts | it forms carbonate, hydroxide, phosphate; HAS CONSTIPATING effect; often used with MAGNESIUM to counteract constipation. |
| ANTACID - aluminum salts - aluminum carbonate | Basaljel |
| ANTACID - magnesium salts | it forms carbonate, hydroxide, oxide, trisilicate; COMMONLY CAUSE A LAXATIVE EFFECT; usually used w other agents to counteract this effect |
| ANTACID - magnesium salts | dangerous when used with renal failure - the failing kidney cannot excrete extra magnesium, resulting in accumulation |
| ANTACID - magnesium salts - magnesium hydroxide | MOM (milk of magnesia) |
| ANTACID - calcium salts | forms many, but carbonate is most common; MAY CAUSE CONSTIPATION; its use may cause in kidney stones |
| ANTACID - calcium salts | long duration of acid may cause increased gastric acid secretion (hyperacidity rebound); often advertised as an extra source of dietary calcium |
| ANTACID - calcium salts - calcium bicarbonate | Tums |
| ANTACID - sodium bicarbonate | highly soluble, quick onset, but short duration. MAY CAUSE METABOLIC ALKALOSIS. Sodium content may cause problems in patients with CHF, hypertension or renal insufficiency |
| antiflatulents | used to relieve the painful symptoms associated with gas; several agents are used to bind or alter intestinal gas, and are often added to antacid combination products |
| OTC antiflatulents (simethicone) | activated charcoal; alters elasticity of mucus-coated bubbles, causing them to break |
| ANTACID side-effect | minimal, depend on compount use |
| ANTACID side-effect for Aluminum and calcium | constipation |
| ANTACID side-effect for Magnesium | diarrhea |
| ANTACID side-effect for calcium carbonate | produces gas and belching; often combined with simethicone |
| ANTACID drug interaction | CHELATION (chemical binding or inactivation of another drug) and CHEMICAL INACTIVATION (produces insoluble complexes). Result is reduced drug absorption. NEED to separate from other meds |
| ANTACID drug interaction | increased stomach pH and increased urinary pH |
| increased stomach pH | increased absorption of basic drugs and decreased absorption of acidic drugs |
| increased urinary pH | increased excretion of acidic drugs and decreased excretion of basic drugs |
| what antacid should patients with CHF or hypertension should use? | low sodium antacids such as Riopan, Maalox or Mylanta II |
| H2 ANTAGONISTS | reduced acid secretion and available OTC |
| H2 ANTAGONISTS most popular drugs | Tagamet, Pepcid, Axid, Zantac |
| cimetidine | Tagamet (preferred for PUD) |
| famotidine | Pepcid |
| nizatidine | Axid |
| ranitidine | Zantac |
| H2 ANTAGONISTS | block histamine (H2) at the receptors of acid-producing parietal cells; production of hydrogen ion is reduced, resulting in decreased production of HCl |
| H2 ANTAGONISTS - drug effect | suppressed acid secretion in the stomach |
| H2 ANTAGONISTS -therapeutic effect | effective for gastric ulcer, GERD, upper GI bleeding; DUODENAL ulcer |
| H2 ANTAGONISTS -Side effect | cimetidine may induce impotence and gynecomastia |
| H2 ANTAGONISTS -nursing implication | assess for allergies and impaired renal or liver function; should be taken 1 hr before or after antacids |
| H2 ANTAGONISTS -nursing implication - Ranitidine | maybe given intravenously; follow administration guidelines |
| PROTON PUMP INHIBITORS | the parietal cells release positive hydrogen ions (protons) during HCL production. Process is called "Proton Pump". |
| PROTON PUMP INHIBITORS | H2 blockers and antihistamines do not stop the action of this pump |
| PROTON PUMP INHIBITORS - mechanism of action | premevents the movement of hydrogen ions from parietal cells into the stomach |
| PROTON PUMP INHIBITORS - drug effect - most comon | Prilosec and Protonix |
| PROTON PUMP INHIBITORS - omeprazole | Prilosec |
| PROTON PUMP INHIBITORS - pantoprazole | Protonix |
| PROTON PUMP INHIBITORS - therapeutic uses | GERD maintenance therapy; erosive esophagitis; short term treatment of active duodenal and benign gastric ulcers |
| PROTON PUMP INHIBITORS - side effects | safe for short-term therapy and incidence low and uncommon |
| PROTON PUMP INHIBITORS - when taking omeprazole | it should be taken before meals. It should be swallowed whole, not crushed, opened or chewed. IT CAN BE GIVEN WITH ANTACID |
| PROTON PUMP INHIBITORS - sucralfate | Carafate |
| PROTON PUMP INHIBITORS - misoprostol | Cytotec |
| sucralfate (Carafate) | cytoprotective agent; do not administer with other medications |
| misoprostol (Cytotec) | used for prevention of NSAID - induced gastric ulcers |
| Diarrhea | abnormal frequent passage of loose stools |
| ANTIDIARRHEALS - Adsorbents | coat walls of GI tract; bind to the causative bacteria or toxin, which are eliminated through stool. |
| ANTIDIARRHEALS - Adsorbents - bismuth subsalicylate | Pepto-Bismol |
| ANTIDIARRHEALS - Anticholinergics | decrease intestinal muscle tone and peristalsis of GI tract; result would be slowing the movement of fecal matter through the GI tract |
| ANTIDIARRHEALS - Opiates | decrease bowel motility and relieve rectal spasms |
| ANTIDIARRHEALS - Anticholinergics - side effect | urinary retention, hesitancy, impotence, headache, dizziness, confusion, anxiety, drowsiness, blurred vision |
| ANTIDIARRHEALS - Opiates - side effect | drowsiness, sedation, |
| constipation | abnormally infrequent and difficult passage of feces through the lower GI tract |
| LAXATIVE - mechanism of action | bulk-forming, emollient, hyperosmotic, saline, stimulant |
| LAXATIVE - bulk forming | high fiber, absorbs water to increase bulk |
| LAXATIVE - bulk forming - psyllium | Metamucil |
| LAXATIVE - Emollient | stool softeners and lubricants; promote more water and fat in the stools; it lubricates the fecal material and intestinal walls |
| LAXATIVE - Emollient - docusate salts | Colace or Surfak |
| LAXATIVE - hyperosmotic | increase fecal water content; result: bowel distention, increased peristalsis & evacuation |
| LAXATIVE - hyperosmotic - polyethylene glycol | GoLYTELY |
| LAXATIVE - saline | increase osmotic pressure with in the intestinal tract, causing more water to enter the intestines. Result: bowel distention, increased peristalsis and evacuation |
| LAXATIVE - stimulant | increases peristalsis via intestinal nerve stimulation |
| chenodiol | Chenix |
| emetics | produce vomiting by direct action on the vomiting center; mostly used in emergency situations. Ie ipecac |
| disulfiram | produce severe sensitivity to alcohol that results in a very unpleasant reaction |
Created by:
jekjes
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