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68wm6 p2 dis of stom

Disorders of the Stomach (minimal drug information)

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