Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
What is PEPTIC ULCER DISEASE (PUD)?
|
Group of UPPER GI disorder w/ varing degrees of EROSION OF THE GUT WALL.
|
|
|
When do PEPTIC ULCERS develop?
|
When ther is an IMBALANCE btwn MUCOSAL DEFENSIVE factors & AGGRESSIVE factors.
|
|
|
Where does the MOST COMMON ULCERATION occur?
|
in the LESSER CURVATURE of the STOMACH & DUODENUM.
|
|
|
What are MOST CASES of Peptic Ulcer Disease caused from?
|
Infection w/ HELICOBACTER PYLORI.
|
|
|
What are the DEFENSIVE factors in the stomach?
|
MUCUS, BICARBONATE, BLOOD FLOW, PROSTAGLANDINS
|
|
|
What are the AGGRESSIVE factors that contribute to PUD?
|
HELICOBACTER PYLORI, NSAIDs, GASTRIC ACID, PEPSIN, SMOKING.
|
|
|
Where is the mucus secreted from? What does it form?
|
Secreted by cells of the GI MUCOSA to form a BARRIER
|
|
|
Where is the BICARBONATE secreted? Where does it go?
|
sECRETED BY epithelial cells OF THE stomach & duodenum. From the PANCREAS in to the DUODENUM.
|
|
|
Why is BLOOD FLOW important?
|
B/C it is ESSENTIAL FOR MUCOSAL INTEGRITY.
|
|
|
What is the function of the PROSTAGLANDINS?
|
Stimulate secretion of Mucus & Bicarb and promote VASODILATION & SUPPRESS GASTRIC ACID.
|
|
|
What do drugs for peptic ulcer disease used for?
|
Upper GI disorders, degrees of erosion of the gut wall.
|
|
|
How does a person get ulcers from H-PYLORI?
|
INGESTED, unaffected by acid, colonizes & remains for decades.
|
|
|
What is the MOST COMMON cause of Gastric & Duodenal ulcers?
|
HELICOBACTER PYLORI (H-PYLORI) which is a GRAM NEG. BACILLUS
|
|
|
D0 NSAIDS induce GASTRIC & DUODENAL ulcers?
|
YES
|
|
|
How does GASTRIC ACIDS contribute to Ulcers?
|
ACID injures MUCOSAL CELLS & ACTIVATES PEPSIN
|
|
|
What ais the name of the SYNDROME for HYPERSECRETION of acid to form ulcers?
|
ZOLLINGER-ELLISON SYNDROME
|
|
|
What is PEPSIN and how does it induce ulcers?
|
PROTEOLYTIC ENZYME present in GASTRIC JUICE that can injure Unprotected cells.
|
|
|
How does SMOKING effect Ulcers?
|
DELAYS ULCER HEALING & ^ RISK of RECURRENCE.
|
|
|
What are the GOALS of Drug Therapy for PUD?
|
ALLEVIATE SYMPTOMS
PROMOTE HEALING PRVENT COMPLICATIONS PREVENT RECURRENCES |
|
|
What are the CLASSES of ANTIULCER drugs?
|
ANTIBIOTICS, ANTISECRETORY AGENTS, MUCOSAL PROTECTANTS, ANTACIDS
|
|
|
What do you test for H-pylori?
|
BREATH or SERUM test
|
|
|
What is the TREATMENT for H-PYLORI?
|
TWO ANTIBIOTICS-use with BISMUTH compounds(pepto) to COAT STOMACH
|
|
|
What do BISMUTH COMPOUNDS do to the H-PYLORI? Side Effects?
|
Disrupt Cell wall, INHIBIT UREASE activity & PREVENT H_PYLORI from ADHERING to GASTRIC SURFACE.**May COLOR TOUNGE or BLACKEN STOOL**
|
|
|
What do the antibiotics CLARITHROMYCIN & TETRACYCLINE do to H-PYLORI? Side effect of TETRACYCLINE?
|
INHIBIT PROTEIN SYNTHESES.
**STAINS TEETH, AVOID in PREGNANCY** |
|
|
What does AMOXICILLIN do to H-PYLORI? Side Effects?
|
DISRUPTS CELL WALL. **DIARRHEA**
|
|
|
What should a pt taking METRONIDAZOLE AVOID?
|
PREGNANCY & ETOH
|
|
|
What 2 drugs are used for NSAID induced PUD?
|
NISOPROSTOL-for PROPHYLAXIS
OMEPRAZOLE-just as effective but better tolerated |
|
|
How do you EVALUATE if medicine is working?
|
Monitor Relief of pain. Perform RADIOLOGIC/ENDOSCOPIC exam of Ulcer site. Test for H-PYLORI
|
|
|
What is the 1st choice TREATMENT of PUD?
|
HISTAMINE2(H2)-RECEPTOR ANTAGONISTS
|
|
|
Where are H2 cells found?
|
IN PARIETAL CELLS OF THE STOMACH
|
|
|
How does BLOCKING H2 RECEPTORS help PUD?
|
-REDUCES VOLUME & ACID CONCENTRATION (Hydrogen Ion Condcentration)
-SUPPRESSES BASAL ACID SECRETION -REDUCES STIMULATION OF ACID SECRETION BY GASTRIN & ACETYLCHOLINE. |
|
|
How is CIMETIDINE(tagamet) given?
|
PO, IM, IV
|
|
|
Where is CIMETIDINE (tagamet) MOTABOLISED? EXCRETED?
|
MOTABOLISED IN LIVER
EXCRETED IN URINE |
|
|
What is important to remeber when giving CIMETIDINE (tagamet)?
|
FOOD DECREASES ABSORBTION.
CROSSES BBB 1HR BEFORE/AFTER ANACIDS |
|
|
What are teh ADVERSE EFFECTS of CIMETIDINE (tagamet)
|
IMPOTENCE, REDUCED LIBIDO, Gynecomastia, in elderly-Renal/hepatic impaiment, CNS depression/excitation, confusion
|
|
|
With what drugs does CIMETIDINE(tagamet) interact with? How?
|
WARFARIN, DILANTIN, THEOPHYLINE-INCREASES EFFECTS
|
|
|
What is important to remember about RANITIDINE(zantac)?
|
MORE POTENT than cimetidine w/ fewer side effects & interactions, BLOCKS H2 RECEPTORS ON PARIETAL CELLS, FOOD has NO effect. WAIT 1hr before or after ANACIDS.
|
|
|
How is RANITIDINE (zantac) given?
|
PO, IM, IV
|
|
|
What is RANITIDINE BISMUTH CITRATE (TRITEC) a mix of?
|
PEPTO + RANITIDINE
|
|
|
What are the PROTON PUMP INHIBITORS?
|
OMEPRAZOLE(prilosec), ESOMEPRAZOLE(nexium), LANSOPRAZOLE(prevacid), RABEPRAZOLE(aciphex), PANTOPRAZOLE(protonix)
|
|
|
What is OMEPRAZOLE(prilosec) used for? Why?
|
SHORT TERM therapy of PUD **Long term showed possible CA**
|
|
|
How does OMEPRAZOLE(prilosec) work?
|
IRREVERSIBLY INHIBITS the ENZYME needed to produce stomach acid.
|
|
|
What is the 1/2 life of OMEPRAZOLE(prilosec)? What does it reduce?
|
2HRS.**REDUCES ACID PRODUCTION BY 97%**
|
|
|
What are the ADVERSE effects of OMEPRAZOLE(prilosec)?
|
HA, GI
|
|
|
How is OMEPRAZOLE(prilosec) administered?? Where does it dissolve?
|
PO**CAPS dissolve in STOMACH, GRANULES dissolve in DUODENUM
|
|
|
What DRUG INTERACTIONS does OMEPRAZOLE(prilosec) have? How?
|
ATAZANAVIR(anti-viral), KETOCONAZOLE(nizoral), ITRACONAZOLE(sporonox) **OMEPRAZOLE(prilosec) REDUCES ABSORBTION of these drugs.
|
|
|
When should you take LANSOPRAZOLE(previcid)?
|
BEFORE BREAKFAST
|
|
|
What is SUCRALFATE(carafate) used for?
|
PROTCTIVE BARRIER AGAINST PEPSIN & ACID
|
|
|
How does SUCRALFATE(carafate) work?
|
forms a STICKY GEL that ADHERES to ULCER
|
|
|
When should you take SUCRALFATE(carafate)? How is it eliminated?
|
1HR BEFORE MEAL. **STOOL**
|
|
|
What are the ADVERSE effects of SUCRALFATE(carafate)? DRUG INTERACTIONS?
|
CONSTIPATION **ANTACIDS interfere with effectiveness take 30MIN APART
|
|
|
What is MISOPROSTOL(cytotec) used for?
|
ONLY for PREVENTION of gastric ulcers caused by NSAID use.
|
|
|
How does MISOPROSTOL(cytotec) work?
|
ANALOG OF PROSTAGLANDIN E1 (helper), misoprostol seres as a replacement of prostaglandins.
|
|
|
What are the ADVERSE effects of MISOPROSTOL(cytotec) use?
|
DIARRHEA
DYSMENNORHEA |
|
|
Who is MISOPROSTOL(cytotec) cautioned in? What MUST you take with it?
|
NO PREGNANCY/CHILD BEARING YEARS**BIRTHCONTROL**
|
|
|
What is an ANTACID? What is it used for?
|
ALKALINE COMPOUNDS used to NEUTRALIZE STOMAC ACID. **PUD, Gastroesophageal reflux disease**
|
|
|
What are the THERAPUTIC uses of ANTACIDS?
|
PUD, Give BEFORE anesthesia to PREVENT aspiration pneumonitis, PROPHYLACTICALLY used to prevent STRESS ULCERS
|
|
|
ADVERSE effects of ANTACIDS?
|
CONSTIPATION d/t aluminum hydroxide or DIARRHEA d/t mg hydroxide. HTN/heart failure d/t Na.
|
|
|
What are the 4 groups of ANTACIDS?
|
1. ALUMINUM COMPOUNDS
2. MG COMPOUNDS 3. Ca COMPOUNDS 4. Ns COMPOUNDS |
|
|
What is important to remember in MG Compounds?
|
RAPID/LONG ACTING, gives DIARRHEA, AVOID in pts. with potential INTESTINAL prob., Used as LAXITIVE
|
|
|
What is important to remember about ALUMINUM HYDROXIDE?
|
SLOW/LONG ACTING, ALOT OF Na, give you CONSTIPATION, ABSORBS tetracyclines, warfarin, dig-may cause HYPOPHOSPHATEMIA
|
|
|
What is important to remember about Ca CARBONATE?
|
RAPID/LONG ACTING, gives you ACID REBOUND/CONSTIPATION/ ERUCTATION & FLATULENCE
|
|
|
What is important to remember about Na BICARB?
|
UNFIT FOR ULCER TREATMENT. RAPID/SLOW ACTING. ^ INTRAABDOMINAL PRESSURE: ABSORPTION OF Na, EXASTERBATES HTN/Heart FAILURE, get SYSTEMIC ALKALOSIS
|
