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52 Cards in this Set

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