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Pharm W12 BM
| Question | Answer |
|---|---|
| Tx of Ulcer | Reduce gastric acid secretion (antisecretory); Reduce gastric acid irritation on mucosal lining (antacid); Create a protective barrier; ABT |
| How can GERD be managed? | Low stress, no spicy food, small portions, no alcohol, not laying down after meal, |
| What class of drug is most common/effective against GERD? | Proton pump inhibitor, Omeprazole (prilosec) |
| How do proton pump inhibitor work? | It decreases acid production |
| Why is a perforation in the GI tract dangerous? | Bleeding and infection |
| What SS would you expect? | little blood in stool, content from the GI coming out, low BP. |
| Natural causes of increase acid production | stress |
| Factors that increase acid production (worsen heart burn) | position, food, life style choices, stress, small portion |
| Over the counter antacids | for occasional acute heart burn, less frequent. |
| Uses of antacids/side effect/containing what minerals? | Sodium, Magnesium, Aluminum, Calcium; Sodium bad for HTN, SE, diarrhea for Mg, constipation for Na and Al |
| Which cause constipation? | Sodium and Aluminum; Mg no constipation |
| Clients at high risk for diarrhea/constipation | For diarrhea Younger, on ABT, Vomiting; for Constipation, elderly, over medicated, sedentary lifestyle, poor diet, stress, dehydration |
| Treatment for H Pylori | Triple therapy, 2 ABT and a bismuth, because H Pylori is a bacterial infection |
| Natural barriers to regurgitation of gastric acids | Gravity, saliva, sphincters, mucous lining |
| Why is opiate bad choice to treat diarrhea? | It acts on the central nervous system can lead to constipation, they are narcotics. Effects are worse than diarrhea. |
| How can diarrhea be dangerous? | Dehydration, alter fluid and electrolyte balance, should be reported after 2 days, hydration and I/O right away |
| How can constipation be dangerous? | blocage |
| H2 Receptor antagonists | tx duodenal ulcer and GERD, Reduce gastric acid secretion, Cimetidine, ranitidine (Zantac), famotidine, nizatidine |
| SE H2 receptor antagonists | Can affect liver |
| What produces and secrete mucus? | Prostaglandins |
| Prostaglandin inhibitors inhibit | The mucus and cause ulcers |
| Used of proton pump inhibitor | Acute of GERD, in combination with ABT for all ulcers |
| Proton Pump Inhibitors | Mediate the exchange of potassium ions (K+) for hydrogen ions (H+) within parietal cells and reduce acid secretion |
| Proton pump inhibitors | Omeprazole (prilosec) |
| What is H Pylori | Bacteria that can cause ulcer. |
| Treatment for H Pylori | Triple therapy, 2 ABT and a bismuth, because H Pylori is a bacterial infection |
| Proton pump inhibitor vs antacid | PPI decrease production of acid, antacid neutralize acid already produced |
| Antacids | Neutralize acid already produced by combining to it and make a salt |
| GI stimulants | tx for GERD, promote emptying of stomach, stimulate peristalsis, selectively stimulate cholinergic receptors in GI |
| Metoclopramide/Reglan. Cisapride, never used | GI stimulant, usually after surgery to prevent vomiting, SE diarrhea |
| Vomiting (Emesis) Mechanism | Vomiting occurs by CNS stimulation of the chemoreceptor trigger zone (CTZ) and vomiting center (VC) |
| Drugs that prevent vomiting | Antiemetics, Phenergan is usually used with Narcotics to increase effects |
| Increase in intestinal motility produces | Watery stool (diarrhea) |
| Decrease in intestinal motility produces | Compacted stool difficult to expel (constipation) |
| Major causes of constipation | Emotional stress and poor diet (w/o fiber) |
| What do Adsorbents do? | Decrease diarrhea by binding irritating substances. Bismuth |
| What do Anticholinergics do? | Inhibit parasympathetic nervous system, slow intestinal motility facilitate water absorption: atropine, belladonna, scopolamine |
| Most frequent adverse effect of antidiarrheal | Constipation |
| Mechanism of Emollients | Allow water to penetrate the fecal mass to help soften and lubricate. Mineral oil |
| Mechanism of Osmotic (saline) laxatives | Contain sodium ions that attract water into the feces. Sodium phosphate salts, magnesium citrate, SEdehydration |
| Strongest laxative | Osmotic |
| Mechanism of Stimulants laxatives | Irritate the intestinal lining and promote histamine release increasing intestinal motility; bisacodyl, castor oil, senna preparations |
| Stool softeners | Gentle, soften and moisturize stools. Docusate sodium, docusate calcium, docusate potassium (prevention) |
| Mechanism of Swelling agents | Natural fibers or grains that soak up water and expand. Give the muscle something to grab on to push stool in the system. Bran, prunes, psyllium hydrophilic (prevention) |
| Best laxative class for prevention | Stool softener and swelling agents |
| MOM | Mg Antacid, Shake the bottle first, do not cause constipation, but BM, SE diarrhea. |
| Mineral oil | Emollients, Allow water to penetrate the fecal mass |
| Senna, Castor oil, Bisacodyl | Stimulants laxatives, irritate the intestinal lining and promote histamine release increasing intestinal motility |
| Docusate sodium | Stool softeners, soften and moisturize stools |
| Bismuth | For triple therapy, Adsorbent antidiarrheal, Antacid |
| Scopolamine | Anticholinergics, Inhibit parasympathetic nervous system, prevention for motion sickness, |
| Lomotil (combo drug) | Combination of Diphenoxylate, Atropine for Antidiarrheal |
| Dimenhydrinate and Meclizine | Antihistamine, Treat or prevent nausea, vomiting, and dizziness caused by motion sickness |
Created by:
fausfez
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