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17 Cards in this Set
- Front
- Back
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What is peptic ulcer disease?
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Peptic ulcer disease is characterized as a group
of GI disorders that have as a common feature the erosion of the GI mucosa |
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what is the danger of pud?
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With enough erosion, blood vessels will be infiltrated,
resulting in GI bleed, and potential perforation, spilling GI contents into the peritoneal cavity |
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Describe what factors contribute to peptic ulcer disease.
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H. pylori
NSAIDS Acid Pepsin Smoking |
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Discuss the treatment goal for peptic ulcer disease.
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to create an environment that will be conducive to healing.
Or, in the case of H. pylori, eradicate the causative organism. |
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Discuss the role of medications in the treatment of peptic ulcer disease.
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medications used either block the H2 receptor on the parietal cell (thus reducing the amount of HCl produced) or they inhibit the proton pump which pushes HCl from the parietal cells into the gastric lumen
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Describe other interventions to complement drug therapy.
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diet changes including eating 5 small meals/day rather than 3 large ones.Avoid smoking, aspirin, nsaids, alcohol and stress/anxiety.
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What is the mechanisms of action of H2RAs in PUD therapy?
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Histamine-2 Receptor
Antagonists - Antisecretory agent – H2 receptor on the parietal cell stimulates the production of HCl, if this receptor is blocked, there is decreased production of HCl – These drugs are specific for the H2 receptor, and have no effect on H1 receptor, or the target of type 1 hypersensitivity reactions. |
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how long does it take for PUD to heal
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4-8 weeks of daily therapy
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what are the three H2RA's you need to know?
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famotadine/Pepcid
cimetidine/Tagamet ranitidine/Zantac |
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what is an important drug reaction related thing to know about cimetidine/tagamet?
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this drug is an
inhibitor of cP450, watch concomitant administration of other drugs |
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describe the mechanism of action of proton pump inhibitors
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acts on the pump that pushes HCl, once
made in the parietal cell of the stomach, into the gastric lumen. – • If this pump is inactivated, temporarily, then less stomach acid is pushed into the stomach – This means less irritation to ulcerated tissue directly by HCl, and less pepsin is created from pepsinogen |
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PPIs should be taken with or with out food? Why?
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Take on empty stomach, gastric acid destroys drug
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what is the healing time for PUD using PPIs?
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4-8 weeks of daily therapy
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how long is the proton pump inhibited?
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24 hours.
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what are the PPIs you should know?
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PPIs: omeprazole, esomeprazole
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how does sucralfate/Carafate work?
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A chemical Band-Aid: it is a combination of sulfated sucrose
and aluminum hydroxide – In an acidic environment, the drug undergoes changes that produces a sticky gel that adheres to the ulcer crater (the ulcer crater is + charged, the drug is – charged). This protects the ulcer from back diffusion of HCl, pepsin, bile salts |
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whats bad about sucralfate and what's good about it?
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effects only last 6 hours, Can interfere with the absorption of some drugs: phenytoin, theophylline, dig, warfarin, fluroquinolones
Good: No systemic absorption, so no side effects |
