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