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drugs for digestion

pharm final

QuestionAnswer
3 cells that produce acid in the stomach chief cells, parietal cells, mucoid cells
How do chief cells produce stomach acid? produce pepsionogen which converts to pepsin (protein)
What do parietal cells have proton pumps and H2 (histamine) receptors
How much HCl is produced daily 1 to 3 liters
pH of stomach 2.5 to 3.5
what happens to the production of stomach acid when the individual is anxious? stomach produces more acid
4 functions of parietal cells breaks food; activates pepsinogen; kills microbes; secretes intrinsic factor
What is intrinsic factor necessary for? B12 production
What do mucoid cells produce thick mucous lining around stomach and bicarbonate
Health alterations in GI system GERD, heartburn, belching, esophogitis
Age most affected by GERD infants and over 40 years old; obesity
Life style changes to prevent GERD elevating HOB; avoiding fatty or acidic foods; smaller meals at least 3 hours before sleep; eliminating tobacco and alcohol
What physiologic dysfunction causes GERD? cardiac sphincter is loose and acid gets up into esophagus
What is one cause of asthma in adults GERD; acid comes up; goes into lungs; coughing occurs
define peptic ulcer disease erosion of GI mucosa
risk factors for peptic ulcer disease smoking; caffine; family history; stress; drugs; H. pylori
drugs that can cause peptic ulcer disease glucocorticoids, NSAIDs, aspirin
symptoms of peptic ulcer disease gnawing or burning, upper abdominal pain, worse when stomach is empty (eating helps stomach pain)
why do NSAIDs cause peptic ulcer disease destroy mucous membrane in stomach
How does H. pylori survive in stomach has protective surrounding mucous that prevents stomach acid from damaging bacteria; then implants into stomach lining
relation of vagus nerve and acid production vagus nerve helps produce more acid
What bacteria causes 85% of peptic ulcers H. pylori
What does CLOtest detect? determines if H. pylori is present
goals of pharmacotherapy for GI problems relief, promote healing, prevent future occurrence
3 drugs for GI problems antacids; H2 receptor antagonists; proton pump inhibitor
Antacid dynamics neutralize stomach acid
4 minerals seen in antacids magnesium; aluminum; calcium carbonate; bicarbonate
antacid prototype aluminum hydroxide (Amphojel); calcium carbonate (Tums); magnesium hydroxide (MOM) sodium bicarbonate (Alka-Seltzer)
aluminum hydroxide (amphojel) antacid
aluminum hydroxide (amphojel) side effect constipation
calcium carbonate (tums) antacid
calcium carbonate (Tums) side effect constipation
magnesium hydroxide (MOM) antacid
magnesium hydroxide (MOM) side effects diarrhea
sodium bicarbonate (Alka-Seltzer) antacid
sodium bicarbonate (Alka-Seltzer) side effects metabolic alkalosis, hypernatremia, abdominal distention
Best choice of antacid calcium carbonate (Tums) = naturally occurring
What is a very strong antacid sodium bicarbonate (Alka-Seltzer)
calcium carbonate with magnesium hydroxide (Mylanta, Rolaids) combination antacid
magnesium with aluminum (Maalox) combination antacid
magnesium, aluminum, simethicone (Mylanta, Maalox Plus) combination antacid
Calcium, magnesium plus famotidine (pepcid complete) combination antacid
Clacium carbonate with magnesium hydroxide (Mylanta, Rolaids) side effects hypercalcemia, renal calculi, metabolic alkalosis, constipation
Magnesium with aluminum (Maalox) side effect hypermagnesemia
magnesium, aluminum, simethicone (Mylanta, Maalox Plus) side effects hypermagnesemia
What OTC medication is simethicone in? gas reliever Beno; gas-ex
Kinetics of antacids po
When do antacids start working 10-15 minutes
How long do antacids last 2 hours
Nursing education for antacids liquid better than tablet; don't give with milk or other medications
What nursing intervention should be performed when administering antacids in NG tube check patency and flush tube (interacts with other medications)
Excessive use of antacids can cause systemic problems, rebound acidity; phosphate depletion (osteoporosis)
use caution with antacids with what disorders kidney, heart failure
common ending for H2 receptor antagonist "tidines"
H2 receptor antagonist dynamics occupy histamine 2 receptors; prevents acid secretion
H2 receptor antagonist prototype ranitidine HCl (Zantac)
ranitidine Hcl (Zantac) H2 receptor antagonist
H2 receptor antagonist kinetics IV, po at bedtime
H2 receptor antagonist therapeutic uses prevent or healing of ulcers
Side effects of H2 receptor antagonist cimetadine (Tagamet) confusion, drowsiness, headache in elderly, fatigue, gynecomastia
Nursing education for H2 receptor antagonist do not take with antacids, report any blood in stool
Why are H2 receptor antagonist not given with antacids if taken together, one will undo the other
Long term use of H2 receptor antagonist causes what? anemia; B12 and iron deficiency
Tongue condition seen with anemia red tongue; atrophic glossitis
what chemicals in body contribute to proton pump acetylcholine, gastrin, histamine
common ending for proton pump inhibitors "prazole"
PPI dynamics reduce acidity by binding histamine, potassium + ATPase (proton pump enzyme)
PPI prototype emeprazole (Prilosec); pantoprazole (protonix)
emeprazole (prilosec) PPI
pantoprazole (protonix) PPI
Therapeutic uses for PPIs erosive esophatitis, short term for ulcer, GERD
How long should PPIs be used no more than 3 months
kinetics of PPI po, prior to eating
CNS side effects of PPI increase dizziness
GI side effects of PPI diarrhea, abdominal pain, nausea, vomiting
Integumentary side effects of PPI rash = urticaria
Side effects from long term use of PPI increased gastric cacner; infections (pneumonia in elderly) c. diff infections
nursing education for PPI give before meals; do not crush/break; avoid smoking/alcohol/spicy foods; eat food with probiotics (yogurt)
why do PPIs predispose patients to infections acid in stomach kills of bacteria on food = PPI block acid production = cause infection
cytoprotective agent dynamics coat ulcer surfaces (acid shield); protects ulcer when eating so stomach acid does not pour into ulcer
cytoprotective agent prototype sucralfate (Carafate)
sucralfate (Carafate) cytoprotective agent
therapeutic usage for cytoprotective agents peptic ulcer disease
Kinetics for cytoprotective agents po with water; before meals/bedtime; up to 6 hours
When should antacids be given if taken with cytoprotective agents 30 minutes before cytoprotective agents or 1 hour after cytoprotective agents
misoprostol (Cytotec) cytoprotective agent; can cause miscarriages or cervix to dilate
misoprostol (cytotec) dynamics synthetic prostaglandin E1 to suppress gastric acid and heal gastric ulcers
misoprostol (cytotec) kinetics po with or after meals
physiological conditions contributing to nausea/vomiting infection; pain; anesthetic; migraine; trauma; inner ear; motion sickness; diabetes; pregnancy; food poisoning; drugs; chemotherapy
psychological conditions contributing to nausea/vomiting nervousness, stress, unpleasant smells
selection of antiemetics depends on... cause and severity of nausea and vomiting
herbal antiemetic peppermint, ginger
anticholinergic: Antihistamine antiemetic therapeutics motion sickness; nausea
anticholinergic: antihistamine prototype diphenhydramine (Benadryl); Scopolamine (Transderm)
diphenhydramine (Benadryl) anticholinergic: antihistamine
scopolamine (Transderm) anticholinergic: antihistamine
side effects of anticholinergic: antihistamine drowsiness, dry mouth
phenothiazine dynamics blocking brain dopamine receptors, inhibit signal to vomiting center
phenothiazine prototype prochlorperazine (compazine); promethazine (Phenergan)
prochlorperazine (comazine) phenothiazine
promethazine (Phenergan) phenothiazine
Kinetics of phenothiazine po, rectal suppository
side effects of phenothiazine dry eyes, dry mouth, drowsiness, constipation
SSRIs therapeutic uses vomiting related to surgery, radiation therapy or chemotherapy
SSRIs prototype ondansetron (Zofran)
benefit of ondansetron (Zofran) does not cause drowiness
neurokinin receptor antagonist antiemetic (po)
cannabinoid antiemetic (product of marijuana)
aprepitant (Emed) neurokinin receptor antagonist
Dronabinol (marinol) cannabinoids
glucocorticoids antiemetic
dexamethasone (Decadron) clucocorticoids
benzodiazepine antiemetic
lorazepam (Ativan) benzodiazepine (IV)
when are patients given dronabinol (Marinol) nausea/vomiting related to HIV or chemotherapy
nursing interventions for antiemetics change position slowly; avoid driving or hazardous tasks
Client safety/nursing education for antiemetics drowsiness (risk for fall); report vomiting of blood or severe abdominal pain;
nonpharmacological ways to reduce nausea ice chips, cool cloth around neck
is constipation a disease or symptom symptoms
causes of constipation lack of exercise, dietary fiber, fluids, medications, foods, health problems, aging
medications causing constipation opiods, anticholinergic, antihistamine, antacids, iron
foods causing constipation white flour, dairy products, chocolate, bananas
health problems causing constipation hypothyroidism, diabetes, irritable bowel
why does aging cause constipation slower transit time
rationale for using Laxatives prophylactic for surgery; prevent straining; cathartic
another name for straining valsalva maneuver
effects of straining on body increases BP, abdominal pressure, intraoccular pressure, intracranial pressure
define cathartic cleanse bowel prior to procedures
dynamics of bulk forming laxatives absorb water to fecal mass
Therapeutic uses for bulk forming laxatives first choice for prevention and treatment of constipation
bulk forming laxative prototypes psyllium mucilloid (Metamucil); methycellulose (Citrucil)
psyllium mucilloid (Metamucil) bulk forming laxative
methycellulose (Citrucil) bulk forming laxative
side effects of bulk forming laxatives cramping
teaching for bulk forming laxatives take with 1-2 glasses water; may take 24-48 hours to work
stool softeners/surfactant dynamics more water and fat absorbed in stool
therapeutic uses for stool softeners/surfactant persons at risk for constipation
stool softener/surfactant prototype docusate (Colace)
docusate (Colace) stool softener/ surfactant
side effects of stool softener/ surfactant abdominal cramping, diarrhea
Caution for Colace don't give colace to person on sodium restriction or abdominal pain
stimulant dynamics irritate the bowel to increase peristalsis
stimulant prototype bisacodyl (Dulcolax)
side effects of stimulants abdominal cramping, fluid and electrolyte loss, laxative dependency if taken frequently
bisacodyl (Dulcolax) stimulant
Educaiton for stimulants enteric coating: no dairy products or coating will break down - gastric irritation
dynamics of saline/osmotic not absorbed, pull water into fecal mass
saline/osmotic prototype sodium biphosphate (Fleet enema); polyethylene glycol (Miralax)
sodium biphosphate (Fleet enema) saline/osmotic
polyethylene glycol (Miralax) saline/osmotic
isotonic prototype polyethylene glycol (PEG) and electrolytes (GoLytely) powder mixture
polyethylene glycol (PEG) and electrolytes (GoLytely) powder mixture isotonic
therapeutic uses for isotonics bowel cleansing before colonoscopy
preparation for isotonic powder mixture reconstitution (4 liters - 1 glass every 10 minutes) refirgerate
When does isotonic powder mixture start working within 1 hour of starting
Diarrhea a disease or symptoms symptom
Causes of diarrhea infections, toxins and pathogens, medications
medications causing diarrhea antibiotics, lactose
diarrhea contributes to what fluid and electrolyte loss
Natural therapy for diarrhea lactobacillus acidophilus (probiotic bacterium)
ABC diet for diarrhea apples, banana, carrot (contain pectin)
BRAT diet for diarrhea bananas, rice, applesauce, tea (toast) older diet
antidiarrheal: opioid dynamics slow peristalsis
antidiarrheal: opioid prototype codeine, diphenoxylate with atropine (Lomotil)
codeine antidiarrheal: opioid
diphenoxylate with atropine (Lomotil) antidiarrheal: opioid
OTC antidiarrheal: opioids ioperamide (Imodium) - analogue of meperidine (demerol)
Schedule V antidiarrheal: opioid diphenoxylate with atropine (Lomotil)
side effects of antidiarrheal: opioid drowsiness, dry mouth, constipation, paralytic ileus
dynamics of bismuth salt (Pepto-Bismol) bind and absorbs toxins
nursing education for diarrhea/constipation monitor for electrolyte imbalance, fever, record frequncy of stools, presence of blood, ice or hard candy for dry mouth, avoid colas (high sugar), stop medicaiton when diarrhea stopped
Why should you avoid colas (high sugar) with diarrhea contributes to more diarrhea
Created by: 1818554924