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68wm6 p2 dis of stom
Disorders of the Stomach (minimal drug information)
| Question | Answer |
|---|---|
| Define Gastritis: | Inflammation of the lining of the stomach |
| ACUTE Gastritis can cause what? | *epigastric pain *nausea and vomiting *headache *loss of appetite |
| If the gastritis etiology is bacterial or viral in origen, what are the clinical manifestations? | *vomiting *diarrhea *fever *abdominal pain |
| What are are prescribed to control nausea and vomiting? | Antiemetics |
| What are prescribed to neutralize gastric acidity? | Antacids |
| What are prescribed to reduce the secretion of gastric acid? | H2 antagonists |
| Peptic Ulcer Disease (PUD) is the cause of what pecentage of emergency admissions? | 5% |
| What percentage of PUD stops spontaniously? | 80% |
| What percentage of PTs with PUD die? | 10% |
| Rebleading of PUD increases mortality by how much? | 10x |
| What is Peptic Ulcer Disease (PUD)? | An ulceration of the mucous membranes of deeper structures of the GI tract |
| What are the most common sites of PUD? | Stomach and duodenum |
| Who do the most cases of PUD occur in? | Men between ages of 20-50 |
| What causes PUD to develope? | Prolonged hyperacidity or a chronic reduction in mucous. |
| What is thought to be the single greatest risk factor for PUD formation? | H.pylori bacteria |
| H.pylori bacteria are found in what percentage of gastric ulser PTs? | 70% |
| H.pylori are found in what percentage of duodenal ulcer PTs? | 95% |
| In what PUD ulcer is bleeding more frequent and hematemisis is more common? | Gastric ulcer |
| In what PUD ulcer is bleeding more chronic and melena more common? | Duodenal ulcer |
| What PUD ulcer is caused by hypersecretion of acid? | duodenal ulcer |
| A perforation from PUD can cause inflammation of the peritoneum and what related symptoms? | *pain *emesis *fever *hypotension *hematemesis |
| What can cause pyloric obstruction? | Edema and scarring |
| What can a pyloric obstruction cause? | Persistant vomiting which can lead to fluid/electrolyte imbalance |
| What test can be used to detect H.pylori bacteria? | Breath test |
| If a gastric ulcer is hemorrhaging, what may the doctor order? | complete bedrest, blood transfusions and gastric lavage with saline solution |
| What is Prostaglandin E Analogue used for? | inhibits gastric acid secretion and protect gastric mucosa? |
| Define Antrectomy: | removal of the entire antrum (lower stomach) to eliminate the main stimuli for acid production |
| Define Gastroduodenostomy (Billroth 1): | part of the stomach (2/3 to 3/4) is removed and the remaining portion of the stomach is connected to the duodenum. |
| Define Gastrojejunostomy (Billroth II): | a process whereby the jejunum is anastomosed to the stomach to provide a second outlet for gastric contents. |
| What surgury is used to remove ulcers and cancer located in the antrum of the stomache? | Antrectomy or gastroduodenostomy (Billroth I) |
| What surgery is used to remove ulcers or cancer of the fundus? | Gastrojejunostomy (Billroth II) |
| The severing of what nerve reduces secretions and movements of the stomach? | Vagus Nerve |
| What does the Jejunum absorb? | carbohydrates and proteins, as well as vitamins such as vitamin K and minerals such as iron |
| Where is the jejunum located? | middle segment of the small intestine, between the ileum and the duodenum |
| Define Total Gastrectomy: | removal of the entire stomach and the esophagus is joined to the jejunum. |
| What is dumping syndrome? | Rapid gastric emptying causing distention of the duodenum or jejunum produced by a bolus of hypertonic food. |
| How should a person with dumping syndrome eat? | *Eat six small meals a day that are high in protein and fat and low in carbohydrates *Eat slowly *Avoid fluids during meals |
| What medications decrease stomach motility? | Anticholinergics |
| What is the only drug approved in the United States for the prevention of gastric ulcers induced by NSAIDs and aspirin? | Cytotec |
| What drugs should not be given within 72 hours of antacids? | Histamine (H2) receptor blockers |
| What drugs fall under Histamine (H2) receptor blockers? | *Tidines *cimetidine *ranitidine *famotidine *nizatidine |
| What drugs fall under Proton Pump Inhibitors? | *'Prazoles' *omeprazole *lansoprazole *pantoprazole *esomeprazole |
| What kind of drug is Sucralfate? | Mucosal healing agent |
| What are adverse effects of amoxicillin? | *CNS: headache *GI: nausea, vomiting, diarrhea *Hemat: anemia *Integ: rash |
| What drug decreases renal excretion and increase blood levels of amoxicillin? | Probenecid (used to Tx Gout) |
| What are three adverse effects of clarithromycin? | *CV: ventricular dysrhythmias *GI: nausea, vomiting, diarrhea *Hema: leukopenia, thrombocytopenia |
| What are three adverse effects of metronidazole? | *CNS: headache, dizziness *GI: nausea, vomiting, diarrhea *GU: albuminuria, neurotoxicity |
| What are three adverse effects of Tetracycline (doxycycline)? | *CNS: dizziness *GI: nausea, vomiting, diarrhea *Derm: photosensitivity |
| What decreases the absorption of Tetracycline (doxycycline)? | Antacids, calcium, iron and magnesium |
| What antibiotic may cause yellow-brown discoloration and softening of teeth and bones if administered prenatally or during early childhood? | Tetracycline (doxycycline) |
| How long should the PT avoid administration of calcium, antacids, magnesium-containing medications, sodium bicarbonate, or iron supplements after taking Tetracycline (doxycycline)? | 1-3 hours |
| What foods/drinks should a PT avoid taking with tetracycline? | Milk or other dairy products |
| What kind of contriceptive should females use while on Tetracycline (doxycycline)? | Nonhormonal contraceptives |
| All agents that increases gastric pH will reduce the absorption of what? | ketaconazole |
| When severe abdominal pain is accompanied by fever, what treatment of ulcers should not be given? | Antacids |
| What effect do antacids have on the urine? | Increases urine pH (slide also says electrolytes... does not specify how they are affected) |
| What should be done if constipation occurs with aluminum antacids? | Administer different antacid |
| List 3 adverse effects of bismuth | *CNS: confusion *EENT: hearing loss, tinnitus, metallic taste *GI: fecal impaction, dark stools |
| List 3 adverse effects of sucralfate | *CV: dizziness, drowsiness *GI: constipation, diarrhea *Derm: pruritus, rashes |
| Why should a pharmacist be consulted before N/G administration of antacids? | Because protein binding properties of sucralfate have resulted in formation of a bezoar (foreign mass) when administered with enteral feedings and other medications |
| ALL Histamine H2 Antagonists are distributed to where? | breast milk and cerebrospinal fluid |
| What is the most common Histamine H2 Antagonist adverse effect? | Confusion |
| With Histamine H2 Antagonists, a gastric pH of what should be maintained? | pH>5 |
| Why should I.V. dosage of Histamine H2 Antagonists be given slowly? | To prevent bradycardia |
| How slowly should Histamine H2 Antagonists be given? | 30min or slower |
| What PUD Tx may cause the stool and tongue to temporarily appear grey-black? | Ranitidine |
| Cimetidine (Tagamet) is an example of a what? | Histamine (H2) receptor antagonist |
| After how long do Proton-Pump Inhibitors decrease the symptoms of GERD? | 5-8 days |
| What is the action of protein pump inhibitors? | Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. |
| While a PT is on proton-pump inhibitors, what adverse effect must they report to the physician immediately? | onset of black, tarry stools |
| Within how long will proton-pump inhibitors decrease the symptoms of GERD? | 5-8 days |
| What is the action of Prostaglandin (misoprostol/Cytotec)? | acts as a prostaglandin analogue, decreasing gastric acid secretion and increasing the production of protective mucus |
Created by:
Shanejqb
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