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72 Cards in this Set
- Front
- Back
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Parietal cells do what?
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secrete hydrochloric acid (HCL) to digest food
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PH of the stomach is between
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1 and 4
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Stomach hyperchlorhydria (excess acid) is produced from __________
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eating high-fat meals
increased alcohol intake emotional turmoil |
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Lesion in the stomach is called a __________
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gastric ulcer
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Lesion in the small intestines is called a __________
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duodenal ulcer
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Peptic Ulcer Disease is associated with several risk factors including _________
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family history, blood type O, tobacco use and caffeine, glucocorticoids and NSAID's, pyschological stress
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The primary cause of peptic ulcers is
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H. Pylori
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Other causes of peptic ulcer disease (besides bacteria)
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secretion of excess gastric acid
hyposecretion of adequate mucus NSAIDs (most common in those that are not infected with H. pylori) |
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Gastroesphageal Reflux Disease (GERD) is caused by
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loosening of sphincter between the esophagus and stomach
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GERD causes intense
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heartburn
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GERD may lead to _______
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esophageal ulcers, esophagitis, or strictures
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_____ ulcers are more common than _________ ulcers
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duodenal; gastric
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Duodenal ulcers occur most commonly in what age group?
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30-50
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Usual symptom of duodenal ulcers
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gnawing ro burning upper-abdominal pain
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Usual symptom of duodenal ulcers occurs _____
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1-3 hours after a meal
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When is duodenal pain the worst?
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when the stomach is empty
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Other symptoms of duodenal ulcers _____
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nocturnal pain, nausea, vomiting
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With duodenal ulcers, bleeding may present as _____
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bright red in vomit or tarry black tools
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Gastric ulcers occur most commonly in what age group?
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over 60
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Common symptoms of gastric ulcers
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anorexia, weight loss, vomiting
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Symptoms of gastric ulcers may be relieved ________
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after food or may continue after meal...
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gastric ulcer remissions are ____
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infrequent or absent
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Ulcer commonly associated with cancer
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gastric ulcer
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Primary goal of treatment of GERD
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to reduce gastric-acid secretion
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Drug classes of drugs that treat GERD
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H2-receptor blockers
antacids proton pump inhibitors |
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sugery may be necessary for _______
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GERD
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Treatment of peptic ulcer disease includes
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lifestyle changes and pharmacotherapy
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treatment goals for PUD include elimination of ________, promotion of _________and prevention of ________
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elimiation of H. pylori
promotion of ulcer healing prevention of recurrence of symptoms |
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Drugs used to treat PUD
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h2-receptor antagonists
proton pump inhibitors antacids antiobiotics |
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H2 Receptor Antagonist decrease ___________ and ___________ and prevent _______
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decreases food response and acid production
prevents histamine from binding with parietal cells |
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H2 receptor antagonists treat and prevent
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GERD, heartburn, indigestion
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H2-receptor blockers slow ____
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acid secretion by the stomach
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Drug of choice in treating PUD and GERD
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h2- receptor antagonists
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Do not take _______ at the same time as H2 receptor blockers because _______
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antacids because it decreases the absorbtion of h2 receptors
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Clients using OTC h2 receptor antagonists should seek medical attention if ________
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symptoms persis or reoccur
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_______ may be a symptom of more serious disease (h2 receptor blockers)
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persistance epigastric pain or heartburn
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_______ and _________ have occured with IV cimetidine (h2 receptor blocker)
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dysrhythmias and hypotension
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Assess _____ and ______with h2 receptor blocker therapy
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liver and kidney function
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Evaluate client's ________ for possible _______ during long-tem use of h2 receptor blocker therapy
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CBC for possible anemia
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H2-receptor blocker prototype
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ranitidine (Zantac)
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Mechanism of Action for ranitidine (Zantac)
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acts by blocking H2-receptors in stomach to decrease acid production
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Primary use of ranitidine (Zantac)
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to treat peptic ulcer disease
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Adverse effects of rantidine (Zantac)
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possible reduction in number of RBC and WBC and platelets, impotence or loss of libido in men
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Why might men stop taking rantidine (Zantac)
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may cause impotence or loss of libido
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Proton pump inhibitors block ______
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H+, K+, and ATPase
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What type of drug is used for short term therapy of PUD and GERD
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proton pump inhibitors
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_________ have longer duration than ________
(drug types) |
proton pump inhibitor ; h2 receptors
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Action of proton pump inhibitors
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block the final step of acid production in the stomach
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Uses for proton pump inhibitors are _______ and ________
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GERD and gastric hypersecretory conditions
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Proton pump inhibitor prototype drug
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omeprazole (Prilosec)
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Mechanism of action of omeprazole (Prilosec)
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reduces acid secretion in the stomach by binding irreversibly to enzymes H+, K+ and ATPase
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Primary use of omeprazole (Prilosec)
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short term (4-8 weeks) therapy for PUD and GERD
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Adverse effects of omeprazole (Prilosec)
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Pain (abdominal), Rash, headache, nausea, diarrhea
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When do you administer proton pump inhibitors?
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30 minutes prior to eating, usually before breakfast
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PPIs may be administered in combination with _______
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antacids
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metaclopramide (Reglan) stimulates _____ and does not stimulate ________
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stimulates motility of upper GI tract;
does not stimulate production of gastric, biliary or pancreatic solutions |
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metoclopramide (Reglan) increases ________ and decreases ________
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increases peristalsis in the duodenum and jejunum;
gastroesophageal reflux |
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Adverse effects of metoclorpramide (Reglan)
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produces extrapyramidal effects (parkinson-like symptoms); CNS depression; GI upset
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metaclorpramide (Reglan) is used for _______
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nausea and vomiting; pre-op to empty stomach
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antiobiotic treatment for H. pylori infections often have a regimen that includes
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PPIs and bismuth compounds
*inhibit bacterial growth *prevent bacteria from adhering to the gastric mucosa |
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3 forms of antacids are_______
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aluminum, calcium, magnesium
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Antacid mechanism of action
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neutralization of gastric acidity
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Systemic antacids are most likely to cause
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acid-base and electrolyte disturbances
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Side effects/adverse effects of non-systemic antacids
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magnesium - diarrhea
aluminum - constipation calcium - constipation |
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Antacids decrease absorption and excretion of drugs that are ________
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dependent on gastric acid for absorbtion (i.e digoxin, chlorpromazine)
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When should antacids be administered?
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1-2 hours before/after other medications
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Antacid prototype
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aluminum hydroxide (Amphojel)
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aluminum hydroxide (Amphojel) mechanism of action
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neutralizes stomach acid by raising pH of stomach contents
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primary use of aluminum hydroxide (Amphojel)
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used in combination with other antiulcer agents for relief of heartburn due to PUD or GERD
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Adverse effects of aluminum hydroxide (Amphojel)
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minor; constipation
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With drugs for PUD or GERD assess what pre-existing conditions?
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smoking, alcohol intake, caffeine intake, and stress
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What does sucralfate do?
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coats ulcer and protects it from further erosion
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