Acid Control Drugs- Anayansi
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| Types of Acid controlling drugs | Antacids, H2 antagonists, proton pump inhibitors
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| What is the drug effect of an antacid? | prevent pain associated with acid related disorders by neutralizing stomach acids
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| What are the basic compounds used to neutralize stomach acid? | salts of aluminum, magnesium, calcium, sodium
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| Aluminum | has constipating effect
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| what is aluminum usually used with to counteract constipation? | magnesium
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| why are aluminum or sodium salts usually recommended for patients with renal disease? | they are easily excreted
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| Magnesium salts can cause | diarrhea
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| Products containing aluminum and magnesium | Maalox, Mylanta
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| what is the mechanism of antacids? | helps neutralize acid secretions (does NOT prevent the overproduction of acids)
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| Antiacids stimulate the production of? | mucus, bicarbonate, prostaglandins
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| What antacid is not recommended for a patient with heart problems? | sodium bicarbonate
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| Why is magnesium dangerous to use on a patient with renal disease? | because the failing kidneys cannot excrete extra magnesium
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| What is a common antacid product made of calcium salts? | carbonate
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| What is an effect of calcium salts? | constipation, kidney stones
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| Why is calcium salts not recommended for a patient with renal disease? | it can accumulate to toxic levels
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| which antacid medication can cause alkalosis? | sodium bicarbonate
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| what is the effect of sodium bicarbonate? | it buffers the acid properties of hydrochloric acid
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| A patient with renal failure should avoid which antacids? | calcium and magnesium salts
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| A patient with which kind of diseases should avoid taking antacids with sodium salts? | heart failure, hypertension, renal insufficiency
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| What is an adverse effect of calcium carbonate? | produces gas and belching
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| what is the medication usually added to antacids to relieve gas? | simethicone
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| Antacids are indicated to relieve the symptoms of what? | peptic ulcer, gastritis, gastric hyperactivity and heartburn
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| An adverse effect of Aluminum and Calcium is? | constipation
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| Because antacids reduce stomach acidity, what can be an adverse effect? | systemic alkalosis (most common with sodium bicarbonate)
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| A common adverse effect of calcium containing products is what? | rebound hyperactivity or acid rebound, in which the patient experiences hyperacidity when antacid use is discontinued
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| what is one side effect that a patient can experience after using antacids for a while and then discontinue its use? | acid rebound or rebound hyperactivity
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| A bleeding ulcer maybe a sign of prolonged used of what type of medication? | Antacids
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| what would be the interaction between benzodiazepines and antacids? | increased activity of benzodiazepine and decreased activity of antacid
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| what would be the interaction between tetracycline and antacid? | there would be a reduced effect of tetracycline
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| interacting drugs should be taken how long before or after an antacid? | 1-2 hours
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| What should patients taking quinolone antibiotics (ciproflaxin, levoflaxin, moxiflaxin) should know about taking antacids as well? | Antacids reduce the antibiotic absorption by 50%; therefore when taking both meds antacids should be taken either 2 hours before or 2 hours after the antibiotic
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| What is the effect of Histamine 2 receptor blockers antagonist (blockers) | suppresses acid secretions in the stomach
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| "tidines" are what kind of antacids? | H2RA's
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| What is the primary cite for many of the drugs used to treat acid related disorders? | Parietal cells
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| Hydrochloric acid is secreted by what cells? | Parietal cells
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| What can stimulate the secretion of parietal cells? | food, caffeine, alcohol, chocolate, also stress
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| confusion and disorientation in an elderly patient can be an adverse effect of what type of medication? | H2RA's
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| What should a patient who smokes be aware of when taking H2RA's? | it has been shown to decrease its effectiveness
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| "prazoles" are what kid of antacids? | proton pump inhibitors?
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| Cimitidine (Tagamet) has higher risk of drug interactions especially in the elderly patients. why? | because it binds to a group of hepatic enzymes that metabolize many drugs. By inhibiting this metabolism, the blood concentration of certain drugs may raise
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| Prevacid, Prilosec, Protonix, Nexium, AcipHex, are all what types of medications? | Proton pump inhibitors (PPI's)
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| Which kind of antibiotic can be given with antibiotics to treat patients with H. pylori infections? | Proton pump inhibitors (PPI's)
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| PPI's are the first line therapy for which conditions? | erosive esophagitis, symptomatic GERD (that has not responded well to H2RA's), short term tx of active duodenal ulcers, active benign gastric ulcers, Zollinger-Ellison syndrome, NSAID induced ulcers and stress ulcers prophylaxis
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| Osteoporosis, wrist, hipe and spine fractures can be an adverse effect of the use of which type of antacid? | Proton pump inhibitors (PPI's)
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| Proton pump inhibitors (PPI's) may predispose patients to what kind of GI tract infection? | C.difficile
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| what can be a concern for a patient taking warfarin and PPI at the same time? | increased change of bleeding
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| Proton pump inhibitors (PPI's) may increase the serum levels of what medications? | diazepam and phenytoin
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| What is one recommendation you can give your patient when taking PPI's? | take on an empty stomach (30-60 minutes before a meal) because food may decrease the absorption
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| Your patient has an NG tube and the doctor has ordered Protonix (delayed release granules for NG administration), what is the one thing you have to check on the NG tube before administering the medication? | that the NG tube be at least 16-french or the granules may clog the tube
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| What medication is used for stress or peptic ulcers? | sucralfate (Carafate)
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| Nausea, constipation and dry mouth can be adverse effects of which medication used to treat stress ulcers? | sucralfate (Carafate)
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| Your patient is ordered sucralfate along with other medications. Can you give all medications at the same time? | no, other medications should be given at least 2 hours before sucralfate
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| Your patient has developed an ulcer due to a prolonged use of NSAIDS, what medication would you expect the doctor to prescribe? | Misoprostol (Cytotec)
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| Which medication is a prostaglandin E analog? | Mistoprostol (Cytotec)
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| Simethicone is what type of medication? | Antiflatulent drug
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| What medication is used to reduce the discomfort of gastric or intestinal gas? | simerthicone
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| What preexisting conditions may restrict the use of antacids? | fluid imbalance, renal disease, GI obstruction, heart failure, pregnancy
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