Term
| Name 4 defensive facts the body has in order to protect itself against PUD. |
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Definition
1. Mucus
2. Bicarbonate
3. Bloodflow
4. Prostagladins |
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Term
| What do Prostagladins do? |
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Definition
| Stimulate secretion of mucus and bicarbonate and promotes vasodilation. |
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Term
| What neutralizes hydrogen ions that penetrate the mucus? |
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Definition
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Term
| How does mucus protect the body against PUD? |
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Definition
| It forms a barrier to protect cells from pepsin and acid |
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Term
| What is the percentages of patients with PUD that are infected with H. pylori? |
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Definition
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Term
| What is the substance in gastric juice that is converted into CO2 and ammonia that is potentially toxic to the mucosa? |
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Definition
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Term
| How do NSAID's form ulcers? |
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Definition
| By inhibiting prostaglandin synthesis (Remember that prostaglandins stimulate secretion of mucus and bicarbonate and promote vasodilation) |
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Term
| With out _______, there are no ulcers! |
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Definition
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Term
| What proteolytic enzyme does gastric acid activate? |
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Definition
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Term
| What lifestyle habit delays ulcer healing and increases the risk of recurrence? |
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Definition
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Term
| What are the 5 classes of drug therapy used for treating ulcers? |
|
Definition
1. Antibiotics
2. Antisecretory agents: H2RA & PPI's
3. Mucosal protectants
4. Antisecretory agents that enhance mucosal defenses
5. Antacids |
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Term
| What are the 3 ways drugs promote ulcer healing? |
|
Definition
1. Eradicate H. Pylori
2. Reduce gastric acidity
3. Enhance mucosal defenses |
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Term
| H. Pylori associated ulcers must be treated with at least 2 of this type of drug. |
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Definition
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Term
| What is the most common cause of gastric and duodenal ulcers? |
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Definition
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|
Term
| What is the second most common cause of gatric ulcers? |
|
Definition
|
|
Term
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Definition
| An enzyme present in gastric juice that can injure unprotected cells in the GI tract |
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Term
| What is the preferred method of treatment for NSAID induced ulcers? |
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Definition
| Any anti-ulcer medication and discontinuation of NSAID. H2RA's and PPI's are the preferred agents. |
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Term
| What are the 4 ways to test for H. Pylori? |
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Definition
1. Endoscopic biopsy test (staining)
2. Breath test
3. Serologic test (culturing then assessing)
4. Stool test |
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Term
| What are your 2 antibiotic DOC for eradicating H. Pylori? |
|
Definition
1. Clarithromycin (Biaxin)
2. Amoxicillin |
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Term
| Which antibiotic acts topically to disrupt the H. Pylori cell wall? |
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Definition
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Term
| Which antibiotic has side effects of black discoloration of stool and tongue? |
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Definition
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|
Term
| Which drug specifically works best at a neutral pH? |
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Definition
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|
Term
| How does Clarithromycin work and what are 2 of the side effects? |
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Definition
-Inhibits bacterial protein synthesis
-Distortion of taste, GI upset |
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Term
| Which antibiotic has side effects of staining of teeth and photosensitivity, and should not be used in pregnancy or children under 8? |
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Definition
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Term
| Which antibiotic may result in severe nausea and vomiting if taken with alcohol? |
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Definition
| Metronidazole (Flagyl)- (Also should be avoided in pregnancy) |
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Term
| Most commonly used antibiotic regimens contain 2 antibiotics and an __________ agent. |
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Definition
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Term
| Name 2 antisecretory agents. |
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Definition
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Term
| What are your drugs of choice for treating symptoms of gastric and duodenal ulcers? |
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Definition
| Histamine 2-receptor antagonists |
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Term
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Definition
| They block H2 receptors; which results in lowered gastric acid secretion |
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Term
| What are 2 ADRs for men from taking Cimetidine (Tagamet)? |
|
Definition
1. Breast enlargement
2. Impotence |
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|
Term
| What side effects are unique to Cimetidine (Tagamet)? |
|
Definition
*1. Antiandrogenic (gynecomastia, reduced libido, impotence)
2. CNS
3. Pneumonia |
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Term
| Which H2 blocker should not be mixed with antacids? |
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Definition
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|
Term
| What is the only H2 blocker with major drug interactions? |
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Definition
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Term
| Which H2 blocker is similar to Cimetidine but is more potent, has fewer side effects and fewer drug interactions? |
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Definition
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|
Term
| What are the most effect drugs used for suppressing the secretion of gastric acid? |
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Definition
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Term
| Which PPI causes REVERSIBLE inhibition of the enzyme that generates gastric acid resulting in short term effects? |
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Definition
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|
Term
| Which PPI may increase digoxin levels by 20% if mixed with other drugs? |
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Definition
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|
Term
| What is the MOA for PPI's? |
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Definition
| Irreversible inhibition of the enzyme that generates gastric acid |
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Term
| How does Sucralfate (Carafate) promote healing? |
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Definition
| It creates a protective barrier (sticky gel) against acid and pepsin. |
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Term
| Which drug is an analog of prostaglandin E1, is used for preventing gastric ulcers caused by long-term therapy with NSAIDs, and promotes abortions? |
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Definition
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Term
| What do antacids do and how do they promote healing? |
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Definition
| They neutralize stomach acid by raising the pH./ They don’t promote healing only produce symptomatic relief. |
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Term
| Which type of antacid can exacerbate hypertension and heart failure? |
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Definition
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Term
| Name the 4 major groups of antacids. |
|
Definition
1. Aluminum
2. Magnesium
3. Calcium
4. Sodium |
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|
Term
| Which 2 types of antacids do you usually combine? |
|
Definition
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|
Term
| Name the side effects of antacids. |
|
Definition
1. Diarrhea
2. Constipation
3. Increase water retention |
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