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Define a peptic ulcer
in lower esophagus, gastric area, duodenum
Define gastric ulcer
in the abdomen
What causes peptic ulcer disease?
There are areas exposed to HCl and Pepsin
What are some causes of peptic ulcer disease?
- H. Pylori
What destroys cells in peptic ulcer disease?
What protects cells from peptic ulcer disease?
- Dilution of HCl acid
- Tight esophageal sphincter
- Cytroprotective prostaglandins
What are the anti-ulcer medications?
- Ulcer Adherent
- Histamine 2 receptor blockers
- Proton Pump Inhibitor (PPI)
- H.Pylori Agents
What is the prototype for antacids?
What is the MoA of antacids (Al +Mg)
- neutralization of HCl
- Decrease Pain
What are the interventions of antacids?
- Shake it
- Drink Water
- Do NOT mix with other meds
- 1 hr after meals
- 2 hrs after other meds
What is the prototype for Ulcer adherent?
What are the ADE of Sucralfate (Carafate)
- It's an ulcer adherent
- metallic taste
- dry mouth
- Patient non-compliance, it's annoying to remember to take it
When do you take Sucralfate (Carafate)?
1 hr ac and hs, 4-8 weeks
What is the prototype for Histamine 2 Receptor blocking agents?
What does Histamine 2 do?
Increases Gastric Acid Production
What is the MoA of Cimetidine (Tagament)
- inhibit gastric acid production
- Px and Tx Ulcers
What are the interventions for Cimetidine (Tagament)
- Give w/o regard to meals
- quit smoking
- 2hrs apart from antacid
What are the ADEs of Cimetidine (Tagament)
What is the prototype for Protein Pump Inhibitors?
What is the MoA of Omeprazole (Prilosec)?
Prevent/Stop the release of gastric acid
What are the ADE of Omeprazole (Prilosec)?
What are the ADE of long term use of Omeprazole (Prilosec)?
- Increased risk for boneloss and C Diff
- Decreased absorption of nutrients and meds
What does H.Pylori agents consist of?
Antibiotic and PPI
Describe the effect of a laxative
Describe the effect of a cathartic
What is an example of the class of bulk forming medications?
What is the action of Metamucil/Fibercon (Bulk Forming)
Adds bulk to increase peristalsis
What are the notes of Metamucil/Fibercon (Bulk Forming)?
acts within 24 hrs
What is an example of surfacants/stool softeners?
What is a note about surfacants/stool softeners (Colace)?
- no laxative effect
- Prevents straining
What is an example of a saline cathartic?
Milk of Mg
What does saline cathartics/Milk of Mg do?
Increases osmotic peristalsis
What is a note about saline cathartics/Milk of Mg?
Rapid Bowel Cleaning
What is an example of an irritant/stimulant cathartic
What does an irritant/stimulant cathartic do?
irritates GI mucosa to increase peristalsis
What is a not about irritant/stimulant cathartics?
- *most abused*
- quicker than bulk forming
What is an example of a lubricant laxative?
What does a lubricant laxative do?
lubricates the intestines
What is a note about lubricant laxatives?
Works within 8 hours
What are some causes of Diarrhea?
- excessive use of lax
- lack of digestive enzymes
- intestinal cancer
- intestinal infection
- inflammatory bowel disease
- highly spice foods
- drug therapy
What are the non-specific therapies for Diarrhea?
What are specific therapies for diarrhea?
- Digestive Enzymes
What is important to remember about anti-emetics?
- always assess for bowel sounds first
- Px rather than Tx nausea