Drugs For Gastrointestinal

Front 1

3 types of secretory cells the aline portions of the stomach

Back 1

chief cells, parietal cells, and mucous cells

Front 2

chief cells

Back 2

secrete pepsinogen-a pre form of pepsin, digestive enzyme for protein

Front 3

parietal cells

Back 3

secrete hydrochloric acid-begins digestion of protein by changing pepsinogen to pepsin

Front 4

mucous cells

Back 4

secrete mucous to coat the stomach wall, protective function

Front 5

gastroesophageal reflux disease..GERD

Back 5

indegestion...symptoms...lump in throat, burning, bloating, belching, regurgitation, heartburn(chest pain)

Front 6

causes of GERD

Back 6

weakened lower esophageal or cardiac sphincter, delayed gastric emptying, hiatel hernia, obesity, overeating, tight clothes, excessive acid secretion

Front 7

causes of over producrion of acid secretion

Back 7

smoking, alcohol, carbonated beverages, coffee and spicy foods

Front 8

Peptic ulcer disease PUD

Back 8

imbalance between body's natural defenses and stomach acid. occur commonly in the duodenum but can occur gastric or esophageal

Front 9

PUD symptoms

Back 9

burning, gnawing, or aching pain, bloating, N/V, and anorexia..Pain usually present when stomach is emptying and is relieved by food or antacids.
May lead to bleeding or hemorrhage

Front 10

causes of PUD

Back 10

over secretion of acid or under secretion of mucous, injury to the mucosal barrier and infection to the mucosal wall by bacteria (Helicbacter pylori) H pylori...
The bacteria lives below the mucosal barrier so can survive the acid PH for years..can eat through the stomach...blodd test for H. Pylori

Front 11

risk factors for PUD

Back 11

1.genetic, blood type O
2.stress
3.smoking-increases acid production, alters blood flow in the stomach wall and retards postaglandins synthesis
4. NSAIDS, ASA, glucocorticoids inhibit prostaglandin synthesis and irriatate the stomach wall
5. food and alcohol, caffeine
6. infection with H. Pylori

Front 12

Treatment for GERD

Back 12

weight loss, avoid acidic foods, stop smoking, avoid alcohol,eat amaller meals, do not eat within 2 hours of bedtime, sleep with head elevated, avoid tight clothes-at the waist

Front 13

Treatment for PUD

Back 13

is simiallarly to Gerd treatment.
If patient is on NSAID's consider switching to another drug

Front 14

Pharmacologic treatment:Gerd and PUD

Back 14

1. antacids to neutralize
2. coating agents to protect
3. H2 antagonists to reduce acid production
4. gastric acid pump inhibitors block and thus reduce acid production
5. prokinetic agents to increase LES tone, increase peristalsis and emptying stomach
6. antispasmodic agents(anticholinergic) to reduce production of sliva, HCl, pepsin, bile, enzymes and to decrease GI motility and secretions.

Front 15

Antacids-

Back 15

lower acisdity of gastric secretions..raise PH higher
does not reduce acid production

Front 16

common uses of antacids

Back 16

heartburn, excessive eating and drinking and PUD

Front 17

antacids contain

Back 17

aluminum, magnesium or calcium

Front 18

antacids somtimes contain?

Back 18

simethicone(antiflatulent to treat gas(flatus)

Front 19

how long should you use antacids?

Back 19

no more than 2 weeks, because further treatment may be needed

Front 20

when should low sodium antacids be used?

Back 20

Pt. with edema, CHF, HTN, renal failure, pregancy or salt restreicted diets

Front 21

low sodium antacids

Back 21

Riopan, Maalox and Mylanta

Front 22

calcium and aluminum in antacids cause what? Name one..

Back 22

constipation, TUMS

Front 23

which antacids contain both magnesium and aluminum?

Back 23

Maalox and Mylanta

Front 24

magnisium in antacids cause what? name one product?

Back 24

Diarrhea, Phillips MOM

Front 25

antacid Pepcid complete contains what?

Back 25

calcium carbonate, magnesium hydroxide and famotidine(H2 receptor blocker)

Front 26

patients with renal failure should not use large quanities of what?

Back 26

antacids containing magnesium

Front 27

antacids may influence the absorption of certain meds

Back 27

tetracycline, iron, lanoxin, cipro

Front 28

simethicone is what?

Back 28

antiflatulent...Available as:
Gas X

Front 29

endings for Histamine H2 receptor blocker

Back 29

" tidine"

Front 30

H2 receptor blockers do what?

Back 30

act by blocking H2 receptors( on parietal cells that produce gastric acid)
PH rises-acid production reduced

Front 31

H2 receptor blocker Meds?
4 available

Back 31

axid
pecid
tagamet
zantac

Front 32

what H2 receptor blocker is seen used in Hosptials
IV continuous 11 mg an hour

Back 32

zantac

Front 33

which H2 receptor blocker shouldnt be taken with food-all other have to be...

Back 33

axid

Front 34

H2 receptor blockers may cause?

Back 34

dizziness, HA, diarrhea or constipation

Front 35

what H2 receptor blocker may cause gynecomastia and breast sorness?

Back 35

Tagamet

Front 36

what should not be used with H2 receptor blocker at the same time?

Back 36

antacids

Front 37

What does GI prostaglandin meds do?

Back 37

repalce prostaglandins for patients on prostagladin inhibitors.

Front 38

GI prostaglandin inhibitors patients use on a daily basis?

Back 38

ASA, NSAID's, or glucocorticoids

Front 39

what do prostaglandins do in the stomach?

Back 39

work to inhibit gastric acid and pepsin secretion to protect the stomach and duodenal lining, Also increase mucus secretion for protection

Front 40

GI prostaglandin are contraindicated for who and why?

Back 40

Pregnancy due to it induces uterine contractions.
Now used for inducing Labor

Front 41

names of GI prostaglandin Meds?

Back 41

Cytotec (misoPROSTol)

Front 42

a combination drug-GI prostaglandind

Back 42

Arthrotec=voltaren(diclofenac)+cytotec(misoprostol)
NSAID + GI Prostaglandin

Front 43

Proton Pump inhibitor PPI or Gastric Acid Pump Inhibitors GAPI
the ending?

Back 43

"prazole"

Front 44

names of PPI or GAPI Meds
trade names

Back 44

Prevacid, Prilosec, Protonix, Nexium, Aciphex

Front 45

what does PPI or GAPI meds do?

Back 45

reduce production of gastric acid by blocking the enzyme responsible for secreting HYDROCHLORIC ACID in the stomach

Front 46

The PPI's reduce acid to a greater extent and have longer duration than do what meds?

Back 46

H2 receptor blockers

Front 47

How many days will it take PPI or GAPI to relieve pain?

Back 47

Several days of therapy before they gain relief of pain.

Front 48

Lenght of treatment of PPI's or GAPI's

Back 48

4 weeks of treatment and can be on for months

Front 49

side effects are uncommon with PPI's or GAPI but may include?

Back 49

HA, Abdominal pain, N/V/D

Front 50

Which PPI or GAPI med is opened and sprinkled in apple juice and then fluched with apple juice in a G-Tube

Back 50

Do not crush unless following specific manufacturers instructions. Can open capsule and sprinkle on food. For G-Tube, can open capsule and mix with 40 ml of apple juice and flush with apple juice after administration_ PREVACID

Front 51

Average PH level in stomach

Back 51

6

Front 52

Coating agents?

Back 52

Carafate(sulcralfate)

Front 53

what does Carafate a coating agent, do?

Back 53

forms a complex(a sugar + antacid) that adheres to an ulcer, protecting the ulcerated lining from acid, enzymes

Front 54

does coating agent (Carafate)inhibit gastric acids secretions?

Back 54

NO. they just protect from

Front 55

how to take Carafate-coating agent?

Back 55

take on EMPTY STOMACH and before meals@least 30 minutes before.
4 times a day

Front 56

Prokinetic agent-
anti-emetic

Back 56

Reglan(metoclopramide)

Front 57

(kine) in prokinetic agent means what?

Back 57

movement

Front 58

Prokinetic agents do what?

Back 58

stimulates GI motility by stimulating cholinergic nerve fibers

Front 59

Prokinetic agent-REGLAN is used to treat what?

Back 59

GERD, used as an antiemetic, to aid in small bowel intubatoin to stimulate gastric and intestinal emptying of barium.

Front 60

what does prokinetic agents block?

Back 60

Dopamine and Sertonin, so can cause extrapyramidal symptoms and depression

Front 61

what are extrapyramidal symptoms cause by prokinetic agents?

Back 61

restlessness, facial grimacing, oculogyric crisis, torticollis, rhytmic tongue protrusion

Front 62

what are the symptoms of extrpyramidal S/E trated with

Back 62

Benadryl
(Anticholinegic)

Front 63

Anti spasmic agents
(anticholinergics)

Back 63

Atropine(atropine sulfate)
Bentyl(dicylomine)
Robinul(glycopyrrolate)

Front 64

Antispasmatic agents have what effects?

Back 64

Anti SLUDD
anticholinergic effects!

Front 65

anticholinergic effects ARE?

Back 65

reduced secretions, mydriasis, blurred vision, constipation, urinary retention

Front 66

What are Antispasmatic agents used for?

Back 66

Irriable bowel syndrome IBS
biliary spasm
mild ulcerative colitis
diverticulitus
pancreatitis
infant colit
PUD peptic ulcer disease

Front 67

Antibiotics-Prevpac
What is it?

Back 67

combination pack for PUD
contains Prevacid, amoxicillin and clarithromycin

Front 68

Prevpac is used also for?

Back 68

H.Pylori infection can remain active for life if not treated.

Front 69

H. Pylori is treated how?

Back 69

2 or more antibiotics are used together to increase effectiveness of therapy. Theray continues for 7-14 days. some other antibiotics used (amoxil, biaxin, flagyl, tetracycline, etc)

Front 70

what is constipation?

Back 70

the infrequent, incomplete or painful elimination of feces

Front 71

what is diarrhea?

Back 71

the frequent, forceful passage of watery stools

Front 72

is diarrhea a symptom or a disease?

Back 72

symptom

Front 73

Non-pharmacologic treatment for constipation?

Back 73

water(fluida), excersixe and fiber

Front 74

when do you not give a patient laxatives?

Back 74

Pt. w/abdominal pain, fever, N/V, prexisting conditions, laxative abusers,. Advice not to over use because bowels will loss tone.

Front 75

why laxatives are used?

Back 75

cleansing prior to diagnostice procedures and surgery.

Front 76

when are stool softeners used?

Back 76

after MI, eye surgery or other surgery where streaining would be contraindicated

Front 77

Laxatives do what?

Back 77

promote emptying the bowels and cleansing(cathartics)implies stronger effect

Front 78

What are stimulant laxatives?

Back 78

work by IRRITATION of the intestines to increase peristalsis.

Front 79

name stimulant laxatives?

Back 79

Dulcolax
Peri-colace(laxative and stool softener)

Front 80

Waht are Saline laxatives?

Back 80

are HYPOTONIC and draw water INTO the intestines.

Front 81

how soon do Saline laxatives work and what are they used for?

Back 81

within 1-3 hours and often used for bowel preps for surgery and endoscopy

Front 82

name saline laxatives?

Back 82

Colyte, Golytely, Mag Citrate, Fleets phospho-soda-fast acting

Front 83

colyte-golytely-saline laxitive are OTC or prescription?

Back 83

prescription and come in Gallon

Front 84

Lubricant Laxatives?

Back 84

Minerl oil

Front 85

what do lubricant laxatives do?

Back 85

lubricate and soften stool

Front 86

how fast do lubricant laxatives work?

Back 86

Slow acting
inhibit absoprtion of fat soluble vitamins ADEK
this is why long term use is not adviced!

Front 87

Pt.'s using lubricant laxatives should watch for what and why?

Back 87

absorbs fat souluble vit. ADEK and K is invilved in preventing bleeding...so bleeding should be watched...if aspirated will cause lipid pneumonia

Front 88

what does bulk producing laxative do?

Back 88

absorb water, thus adding size to fecal mass.

Front 89

bulk producing is considered the safest why?

Back 89

not strong, no side effects, no lose of tone..it is a prophylactic..choice for chronic constipation

Front 90

bulf laxatives and how to take?

Back 90

metamucil,
benefiber
give with full galss of water or juice to prevent obstruction of the GI tract

Front 91

how does bulk laxative work?

Back 91

retains water in stool, increasing its bulk which stimulates peristalsis
SAFEST

Front 92

Fecal Softeners(stool softeners)

Back 92

Surfak(docusate calcium)
Colace(docusate sodium)

Front 93

how do stool softeners work?

Back 93

draws water into stools to soften. DOES NOT STIMULATE peristalsis and reguire 3 days for maximum effect

Front 94

stool softeners are used how?

Back 94

prophylactically to prevent constipation or straining...recovering MI patients, eye surgery, abdominal surgery patients...etc.

Front 95

miscillaneous GI agents for constipation.

Back 95

Amitiza(lubiprostone)
chloride channel activator to increase fluid secretion in the intestine. Treats chronic constipation and IBS in women
need a prescription

Front 96

miscillaneous GI agents for constipation.

Back 96

Relistor(methylnaltrexone) NEW
for opioid induced constipation.

Front 97

how does Relistor work?

Back 97

Blocks opioid from affecting the GI peristasis
Need a prescription

Front 98

antidirrheals-most effective

Back 98

opioids are most effective drugs for controlling severe diarrhea because of their rapid onset and effectiveness.. Doses used for diarrhea, do not produce dependence or serious side effects like respiratory depression, but can be abused

Front 99

prolong diarrhea may lead to what?

Back 99

acid-base or electrolyte imbalnce
dehyration

Front 100

diarrhea is not a disease but a symptom of?

Back 100

infection, effect of med's, inflammatory bowel disease, etc

Front 101

local acting-anti-diarrheals

Back 101

absorb excess water and irritants or bacteria that are causing the diarrhea

Front 102

local acting-anti-diarrheals

Back 102

Pepto-Bismol
Kaopectate

Front 103

Systemic anti-diarrheals do?

Back 103

act thru the ANS to reduce peristalsis and motility of the GI tract.

Front 104

Systemic anti-diarrheals

Back 104

Immodium
Lomotil(diphenoxylate with atropine) controled drug

Front 105

Lotomil contains?

Back 105

a substance similar to Demerol and has a potential for abuse. Will be in narcotic Cabinet. Contains Atropine also, both to dimish abouse and to bring in anti-cholinergic affects on peristalsis

Front 106

Which diarrhea medicine should be chosen if it is caused by bacteria, contaminents or irritants?

Back 106

Local acting-Pepto Bismal or Kaopectate first, then go to the Lommoudium or Lotomil

Front 107

Intestinal flora modifiers?

Back 107

help to correct the altered GI Flora. where the normal flora has been destroyed..recolonizes the GI tract

Front 108

Lactinex-how it work?

Back 108

where the normal flora has been destroyed..recolizes the GI tract.
granules you sprinkle on food

Front 109

Intestinal flora modifiers

Back 109

Lactinex- prescription
OTC-acidophilus, yogurt, and buttermilk

Front 110

Nausea

Back 110

uncomfortable, subjective sensation of absominal discomfort associated with desire to vomit and sometimes accompanied by dizziness

Front 111

serotonin antagonist
anti-emtic

Back 111

Zofran(onadansetron)
"setron" ending

Front 112

anti-emetic
Zofran serotonin antagonist used when?

Back 112

chemo radiation and post op-anesthisa
long term use could cause depression

Front 113

Dopamine antagonists anti-emetic
"azine" endings

Back 113

compazine
Phenergen-supposirtories
Reglan
anti-phcotic drugs.

Front 114

anti-emetic
anticholinergic agents
actually antihistamines

Back 114

Benadryl
Antivert(think of dizzy-vertigo)
Vistaril

Front 115

anti-emetic
anticholinergic agents
actually antihistamines
side effects?

Back 115

Sedation and anti-SLUDD
not usually effective w/ chemotherapy

Front 116

anti-emetic
Vistaril is given how as anti metic?

Back 116

Deep IM -1 1/2"., 22 gauge needle
can cause absess if not into tissue

Front 117

anti-emetic
Corticosteroids or glucocorticoids endinds?

Back 117

lone, sone
Decadron
Prednisone

Front 118

anti-emetic
benzodiazipine -endings? and what they do

Back 118

Lam, Pam
Ativan
Versed
Sedation, reduce anxiety, amnesic

Front 119

anti-emetic
Cannabinoids
a man made form of cannabis

Back 119

habit forming
Marinol(dronabinol)
*care w/ taking other CNS drugs
*approved only for patients w/cancer

Front 120

anti-emetic
Cannabinoids
a man made form of cannabis
Marinol

Back 120

DYSPHORIC effects
altered mental status