LP3 Chapters Review
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| What are the nine categories for gastrointestinal drugs? | -Antacids, -Agents for ulcers and GERD, -Gastric mucosal agents, -GI antispasmodic or anticholinergics, -Agents for IBD, -Antidiarrheal, -Antiflatulents, -Laxatives and cathartics, -Antiemetics
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| What does pyrosis mean? | Heartburn
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| what does dyspepsia mean? | acid indigestion
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| What percent of the population does pyrosis and dyspepsia effect? | 40%
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| How do antacids work? | They partially neutralize gastric hydrochloric acid
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| T or F: antacids are also used at times as supplemental agents in the management of esophageal reflux | True
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| Antacid products may contain....? | Aluminum, calcium carbonate, magnesium
*most also contain sodium
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| Antacids should not be taken within __ hrs of taking other medications. | 2 hrs
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| Antacids should not be taken for more than ___ weeks. | 2 weeks
* may cause GI bleeding, GI malignancy, and increase excess acid in the stomach
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| What conditions require the avoidance of antacids? | Cardiac, renal, liver disease or fluid retention
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| What should patients with esophageal reflux who are taking medications be instructed to do to relieve their symptoms? | Avoid constrictive clothing, treat obesity, reduce meal size, avoid laying down after meals, restrict alcohol use, eliminate smoking, and elevate the head of the bed during sleep.
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| The histamine receptors found in the stomach are called? | H2 receptors
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| H2 receptor antagonists reduce gastric acid secretion by acting as ______ ______? | histamine2 blockers
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| What does GERD stand for? | gastroesophageal reflux disease
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| contraindications for H2 blockers? | Renal disease, pregnancy, lactation
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| What is GERD caused by? | Excessive reflux of acidic gastric into the esophagus, resulting in irritation or injury to the esophagal mucosa characterized by heartburn and acid indigestion.
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| PPI | Proton pump inhibitor
(antisecretory agent)
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| What are proton pump inhibitors used for ? (short term) | the short term relief of GERD, the short term treatment of confirmed gastric and duodenal ulcers, and for erosive esophagitis and heartburn
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| Long term use of proton pump inhibitors? | Severe GERD, preventing NSAID-induced ulcers, and hypersecretory conditions.
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| Patients undergoing ulcer therapy should be instucted regarding? | -Avoid cigarettes, importance of communication with physician, reduce stress, take meds on regular basis, take meds as they are instructed.
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| How should sucralfate be taken? | 1 hr before meals, on an empty stomach, and not within 2h of other meds
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| How should misoprostol be taken? | With meals and at bedtime with food, and avoiding magnesium products to lessen the incidence of diarrhea.
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| How should PPIs be taken? | On an empty stomach
*rabeprazole and pentoprazole can be taken without regard to meals
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| Patients treated with bismuth subsalicylate should be instructed regarding: | Do not take for longer than 48h or with fever, diet should be bland w/o roughage, get plenty of fluids, do not take if aspirin allergy, or if already taking an aspirin product, contact dr with any issues or blood in stool.
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| Patient info for antidiarrheal drugs: | Short term use only (48h), get plenty of water, bland diet (BRAT)
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| Patients taking bulk forming laxatives info: | Dissolve completely in water, administer immediately before thickening occurs
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| Patients taking stool softeners info: | Discontinue with any diarrhea or abdominal pain, do not use longer than 1 week, interaction with mineral oil, take large quantities of water
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| Patients taking mineral oil info: | Avoid prolonged use, interaction with docusate, never take at bedtime
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| Patients taking stimulant laxatives info: | Strong warning on prolonged use and dependence.
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| Patient info for constipation issues | high fiber diet, plenty of water, develop good bowel habits, exercise, use only mildest laxatives for a short amount of time
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| Side effects of antacids? | constipation, diarrhea, kidney stones, osteoporosis, belching and flatulence
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| Contraindications of antacids? | Hear failure, kidney disease, cirrhosis of liver, dehydration
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| side effects of h2 blockers? | diarrhea, dizziness, rash, headache, mild confusion
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| Side effects of PPIs? | diarrhea, constipation, nausea, vomiting, abdominal pain, increased risk for pneumonia or intestinal infection (C-dif)
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| How does misoprostol (a gastric mucosal agent) work? | It inhibits gastric acid secretion and protects the mucosa from irritants
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| How does sucralfate (a gastric mucosal agent) work? | It reacts with hydrochloric acid in the stomach to form a paste that adheres to the mucosa
*taken on empty stomach
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| Helicobacter pylori plays a major role in the development of what conditions? | gastritis, gastric and duodenal ulceration, and gastric cancer
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| side effects of salicylates | anorexia, nausea, vomiting, diarrhea, dyspepsia, abdominal pain, headache, weakness, dizziness, rash
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| contraindications of salicylates | allergy to salicylates, renal and hepatic impairment
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| glucocorticoids- example and what it is used for | prednisone, used to treat IBD patients who are inadequately controlled with salicylates.
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| Side effects of bismuth subsalicylate | constipation, discoloration of tongue and stool (black), ringing in ears
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| Opiate agonists- how do they work? | by slowing intestinal motility
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| One of the most common causes of infectious diarrhea in the U.S. | Clostridium difficile (C-dif)
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| Laxative used for? | promote evacuation of the intestine and are used to treat constipation
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| Bulk forming laxatives work by? | softening stool by absorbing water and increase fecal mass to facilitate defecation
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| Emollients work by? | promoting stool movement through the intestines by softening and coating the stool
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| Saline laxatives work by? | promote the secretion of water into the intestinal lumen
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| Stimulant laxatives work by? | producing strong peristaltic activity, and may also alter intestinal secretions
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| Osmotic laxatives work by? | drawing water from tissues into the feces and stimulates evacuation
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| Chloride channel activators are? | a unique oral agent for the treatment of constipation. It increases intestinal fluid secretion by activating chloride channels in the intestinal epithelium
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| What are antiemetics used for? | the prevention or treatment of nausea, vomiting, vertigo, or motion sickness
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| what are anticholinergics used for? | prophylaxis of motion sickness
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| antidopaminergics are used for? | nausea and vomiting
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| What does CTZ stand for? | chemoreceptor trigger zone
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| serotonin-receptor antagonists are used for? | control emesis, (pre-op and post-op), cancer patients
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| What does PONV stand for? | post-operative nausea and vomiting
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| What does CINV stand for? | chemotherapy-induced nausea and vomiting
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| What does MOM stand for? | milk of magnesia
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| what does PEG stand for? | polyethylene glycol
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| T or F, diphenoxylate with atropine (Lomotil) is a controlled substance? | True
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| Most common antacids? | calcium carbonate (Tums)
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| T or F: antacids decrease the absorption of other meds? | True
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| H2 blockers have what common suffix? | -tidine
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| PPIs should be taken how? | before meals and swallowed whole
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| What comes first, H2 blockers or PPIs? | H2 blockers
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| T or F: PPIs do not interact with cardiac meds? | False
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| PPIs should be taken on an ____ stomach | empty
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| What is the type of med used mainly for ulcers, and it inhibits pepsin? | gastric mucosal agents
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| four main categories of reproductive hormones? | gonadotropic, androgens, estrogens, progestins
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| reproductive hormones are secreted by? | the pituitary gland
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| gonadotropic hormones include? (3) | -follicle stimulating hormone (FSH)
-luteinizing hormones (LH)
-luteotropic hormone (LTH)
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| what do follicle stimulating hormones do? | -stimulates the development of ovarian follicles in the female
-stimulates sperm production in the testes
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| What do luteinizing hormones do? | works with FSH to induce secretion of estrogen, ovulation and development
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| What do luteotropic hormones do? | stimulate secretion of progesterone by the corpus luteum and secretion of milk by the mammary gland
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| androgens include? (2) | testosterone and androsterone
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| routes for administering testosterone? | buccal, parenteral, and transdermal
----topical is used first, and injection is used if topical doesn't work
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| androgens are used for? | replacement, congenital and aquired hypogonadism, treatment of endometriosis and breast diseases
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| side effects of local testosterone? | skin irritation, acne
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| where is local testosterone administered? | inner thigh, tricep
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| follow up testing after testosterone administration? | every 6 weeks
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| contraindications of androgens | cardiac, renal, and liver dysfunction,diabetes
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| all non-combination products in the androgens class are classified as....? | Clll controlled substances
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| phosphodiesterase inhibitors (PDE) are? | a class of drugs given orally for the treatment of male ED, they work by relaxing smooth muscle increasing blood flow to the area
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| PDEs should not be used with what? | nitrates or alpha-blockers(this combined with PDEs lower blood pressure)......also grapefruit juice
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| Estrogen is? | the female sex hormone. produced in the ovaries and secondary in adrenal glands. responsible for secondary sexual characteristics, and secretion of hormones FSH and LH from pituitary gland
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| What is used to treat menopausal symptoms? | Estrogen, along with progesterone( HT= hormone therapy)
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| ET stands for? | Estrogen therapy
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| Estrogen alone has been linked with the risk of what condition? | endometrial carcinoma
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| EPT stands for? | estrogen and progestin therapy
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| Side effects of estrogen? | thromboembolic disorders, hypertension, myocardial infarction, stroke
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| Progesterone is secreted by? | the corpus luteum and adrenal glands
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| progestins are used? | in the treatment of amenorrhea, endrometriosis, and functional uterine bleeding...also contraceptives
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| contraceptives work how? | suppressing the release of the pituitary hormones (FSH and LH)
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| progestin only contraceptives work by? | inhibiting ovulation, changing the amount of thickness of the cervical mucus to inhibit sperm transport
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| Patient education for contraceptives? | backup needed within 1st month of oral and first two weeks with depo...take at same time everyday, use back ups with antibiotics, and ACHES
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| What does ACHES stand for? | A-abdominal pain
C-chest pain
H-headaches
E-eye problems
S-severe leg pain
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| progestin-only contraceptives are recommended for patients who......? | do not tolerate estrogen or in whom it is contraindicated.
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| progestin-containing IUD- example and coverage lasts for ___ years? | Mirena, 5years
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| postcoital contraception must be administered within...? | 72 hours
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| There are three ways to start contraception. list them. | first day start, sunday start, today start.
*most physicians do the sunday start
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| estrogen and progestin is used for....? | birth control, replacement therapy, and certain cancers
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| How do you know that a med is a contraceptive? | it has the term "estradiol" on the label
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