GI Tract: Pharm Final

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GI Tract: Pharm Final
2015-08-05 12:16:36
GI Tract: Pharm Final
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  1. Define a peptic ulcer
    in lower esophagus, gastric area, duodenum
  2. Define gastric ulcer
    in the abdomen
  3. What causes peptic ulcer disease?
    There are areas exposed to HCl and Pepsin
  4. What are some causes of peptic ulcer disease?
    • Stress
    • Meds
    • H. Pylori
    • Smoking
  5. What destroys cells in peptic ulcer disease?
    • HCl
    • Pepsin
    • H.Pylori
  6. What protects cells from peptic ulcer disease?
    • Mucus
    • Dilution of HCl acid
    • Tight esophageal sphincter
    • Cytroprotective prostaglandins
    • Alkalization
  7. What are the anti-ulcer medications?
    • Antacid
    • Ulcer Adherent
    • Histamine 2 receptor blockers
    • Proton Pump Inhibitor (PPI)
    • H.Pylori Agents
  8. What is the prototype for antacids?
    • Al+Mg
    • Medox
    • Mylanta
    • Gelusel
    • Di-Gel
  9. What is the MoA of antacids (Al +Mg)
    • neutralization of HCl
    • Decrease Pain
  10. 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
  11. What is the prototype for Ulcer adherent?
    Sucralfate (Carafate)
  12. What are the ADE of Sucralfate (Carafate)
    • It's an ulcer adherent
    • N
    • Constipation
    • metallic taste
    • dry mouth
    • Patient non-compliance, it's annoying to remember to take it
  13. When do you take Sucralfate (Carafate)?
    1 hr ac and hs, 4-8 weeks
  14. What is the prototype for Histamine 2 Receptor blocking agents?
    Cimetidine (Tagament)
  15. What does Histamine 2 do?
    Increases Gastric Acid Production
  16. What is the MoA of Cimetidine (Tagament)
    • inhibit gastric acid production
    • Px and Tx Ulcers
  17. What are the interventions for Cimetidine (Tagament)
    • Give w/o regard to meals
    • quit smoking
    • 2hrs apart from antacid
  18. What are the ADEs of Cimetidine (Tagament)
    • Headache
    • Dizziness
    • N/D
  19. What is the prototype for Protein Pump Inhibitors?
    Omeprazole (Prilosec)
  20. What is the MoA of Omeprazole (Prilosec)?
    Prevent/Stop the release of gastric acid
  21. What are the ADE of Omeprazole (Prilosec)?
    • N/D
    • Headache
  22. What are the ADE of long term use of Omeprazole (Prilosec)?
    • Increased risk for boneloss and C Diff
    • Decreased absorption of nutrients and meds
  23. What does H.Pylori agents consist of?
    Antibiotic and PPI
  24. Describe the effect of a laxative
  25. Describe the effect of a cathartic
    Strong effect
  26. What is an example of the class of bulk forming medications?
    • Metamucil
    • Fibercon
  27. What is the action of Metamucil/Fibercon (Bulk Forming)
    Adds bulk to increase peristalsis
  28. What are the notes of Metamucil/Fibercon (Bulk Forming)?
    acts within 24 hrs
  29. What is an example of surfacants/stool softeners?
  30. What is a note about surfacants/stool softeners (Colace)?
    • no laxative effect
    • Prevents straining
  31. What is an example of a saline cathartic?
    Milk of Mg
  32. What does saline cathartics/Milk of Mg do?
    Increases osmotic peristalsis
  33. What is a note about saline cathartics/Milk of Mg?
    Rapid Bowel Cleaning
  34. What is an example of an irritant/stimulant cathartic
    • Cascara
    • Senekot
    • Dulcolax
  35. What does an irritant/stimulant cathartic do?
    irritates GI mucosa to increase peristalsis
  36. What is a not about irritant/stimulant cathartics?
    • *most abused*
    • quicker than bulk forming
  37. What is an example of a lubricant laxative?
    Mineral Oil
  38. What does a lubricant laxative do?
    lubricates the intestines
  39. What is a note about lubricant laxatives?
    Works within 8 hours
  40. 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
  41. What are the non-specific therapies for Diarrhea?
    • Opiate Derivatives
    • Misc
  42. What are specific therapies for diarrhea?
    • Antibiotics
    • Digestive Enzymes
  43. What is important to remember about anti-emetics?
    • always assess for bowel sounds first
    • Px rather than Tx nausea