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52 Cards in this Set
- Front
- Back
What does the stomach do to the esophagus?
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heartburn, esophagitis, strictures
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What injures the gastric mucosa?
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gastric acid, H pylori, alcohol
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What protects the gastric mucosa?
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mucous protective barrier, prostaglandins, mucosal blood flow, growth factors
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What increases gastric mucous secretion?
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inflammation
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What decreases gastric mucous secretion?
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H pylori
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What inhibits prostaglandins?
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ASA and NSAIDs
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What reduces mucosal blood flow?
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ASA and NSAIDs, severe illness
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What do you see with gastric ulcers?
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epigastric pain, worse after eating
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What causes gastric ulcers?
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ASA, NSAIDs
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How long does it take for gastric ulcers to heal?
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12 weeks
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What happens with gastric ulcers?
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come and go without treatment, acid suppression reduces recurrence
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Where is the pain with duodenal ulcers?
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epigastric or right upper quadrant
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What changes duodenal ulcers?
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better after eating, NSAIDs can increase, come and go without treatment, acid suppression reduces recurrence
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How long does it take for duodenal ulcers to heal?
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4-8 weeks
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What does the fundus of the stomach secrete?
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acid, enzymes, intrinsic factor
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What does the antrum of the stomach secrete?
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acid control, produces gastrin
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What does the fundus and body do to food?
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pushes food towards antrum
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What does the antrum do to food?
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grinding
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What does the vagus nerve do to the stomach?
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acid production, gastrin production, stomach relaxation
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What does a vagotomy do?
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reduces acid, relaxation, affects emptying
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What does the vagus nerve produce?
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ACh to parietal cells, fundal endochromaffin cells antral G cells
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Where does gastrin come from?
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antrum via blood, nearby cells
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Where are parietal cells?
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upper stomach
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What delivers the acid secretion message to the surface?
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ACh, gastrin, histamine, Ca
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What pump produces gastric acid?
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H/K/ATPase pump
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How does gastric acid change with food?
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acid secretion goes up with meals, pH drops due to food buffering effect
pH is lowest prior to a meal |
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How does acid change at night?
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increase in acid secretion, drop in gastric acid
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What neutralizes acid?
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baking soda, tums milk of magnesia, amphogel, maalox and mylanta
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What is baking soda?
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NaHCO3
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What is tums?
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CaCO3
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What is Maalox?
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milk of magnesia and amphogel
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What is Mylanta?
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amphogel and milk of magnesia
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What are the side effects of calcium carbonate?
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hypercalcemia and increased acid
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What are the side effects of magnesium antacids?
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diarrhea
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What are the side effects of laumninum antacids?
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constipation, binds phosphorus, brain effects with chronic use
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What happens if you block ACh?
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non-specific, side effects
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What drugs are H2 blockers?
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cimetidine, ranitidine
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What is the significance of H2 blockers?
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first easy meds to treat/prevent gastroduodenal ulcers, treat mild reflux
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What is the mechanism of action of H2 blockers?
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competitive antagonist at H2 receptor
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How do you give H2 blockers?
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po or IV, adjust for renal dysfunction
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Why do you use H2 blockers?
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duodenal and gastric ulcers prevent recurrence of DU or GU, mild GERD
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What drug is a proton pump inhibitor?
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omeprazole
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What is omeprazole?
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proton pump inhibitor
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What's special about omeprazole?
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most effective acid suppressant, effective for GERD, heals gastroduodenal ulceration, OTC
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What is the MOA of omeprazole?
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H-K ATPase inhibitor
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What are the important pharmacokinetics of omeprazole?
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need to protect it from acid, short serum half life, only works on active pumps, suicide substrate with long effect
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What are the side effects of omeprazole?
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diarrhea, headache, belly pain
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What are the rare side effects of omeprazole?
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increased risk of C dif colitis, acute interstitial nephritis, bone weakness/fractures, poor absorption of acid dependent factors
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Why would you use omeprazole?
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heal gastric or duodenal ulcers, treat reflux, Zollinger-Ellison syndrome, stress ulcer prophylaxis
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What is the drug of choice for Zollinger-Ellison Syndrome?
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omeprazole
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What does misoprostol do?
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PGE1 analog, acts at PGE2 receptors, prevents NSAID uclers
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Why wouldn't you use misoprostol?
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diarrhea, belly pain, can cause abortion
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