PHAR 100 CH 16

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leti563
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80962
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PHAR 100 CH 16
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2011-04-21 01:14:45
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PHAR
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gASTROINTESTINAL DRUGS
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  1. DIGESTIVE SYSTEM
    • Digestion begin in the mouth.
    • Absorption of nutrients occurs in the small intestine.
    • Reabsorption of water occurs in the large intestine.
  2. INTESTINAL BACTERIA FUNCTIONS
    • 1. Trainning our immune system
    • 2. Inhibiting growth of pathogenic organisms.
    • 3. Manufacture of vitamins- Vitamin K
  3. HISTAMINE 1
    Allergies
  4. HISTAMINE 2
    Stomach Acid
  5. Gastric Protection
    GASTRIC ACID
    Kills many infectuous organisms. But also harmful to unprotected digestive tissue.
  6. Gastric Protection
    Mucous
    Protects the linig of the GI tract from gastric acid.
  7. Gastric Protection
    Epithelial Cells
    Constantly forming new cells that line the stomach.
  8. STOMACH DISEASES
    • Peptic ulcer disease (PUD)
    • Gastro Esophageal Reflux Disease (GERD)
    • Hiatal Hernia
  9. PEPTIC ULCER DISEASE
    • Over 60% associated w infection by
    • bacterium.
    • 20% caused by Anti inflamatory medicines.
    • 15% smoking related.

    Treatment antibiotics and anti ulcer drugs.
  10. GERD
    Gastro-Esophogeal Reflux Disease-


    HEARTBURN
  11. DRUGS FOR THE STOMACH
    Act to change the acid environment within the stomach:
    • Antacids
    • Histamine-2 Blocking agents
    • Proton pump inhibitors
    • Gastric mucosal agents
  12. ANTACIDS
    • Neutralize (Buffer) stomach acid.
    • Many OTC brands
    • Relieve pain, Promote ulcer healing.
    • SE: Constipation
  13. ANTACIDS INTERACTIONS
    Antacids decrease effectiveness of almost all other oral medications.
  14. HISTAMINE 2 BLOCKING AGENTS
    (TIDINES)

    Decrease acid production by blocking the action of histamine-2 in the parietal cells of the stomach.

    • cimetidine (Tagamet)
    • ranitidine (Zantac)
  15. HISTAMINE-2 BLOCKING AGENTS SIDE EFFECTS
    • Mental confusion in elderly
    • May decrease intrinsic factor production
  16. PROTON PUMP INHIBITORS
    "prazoles"
    For short term use only

    • omeprazole (Prilosec)
    • rabeprazole (Aciphex)

    SE's: Lower intrinsic factor- Pernicuous anemia.
  17. GASTRIC MUCOSAL AGENTS
    misoprostol (Cytotec)
    • Contains Prostaglandin- E
    • PG-E Stimulates mucous production in the stomach.
  18. GASTRIC MUCOSAL AGENTS
    Cytotec SE's:
    • Uterine contractions
    • Spontaneous abortion
  19. NEVER give to pregnant woman
  20. GASTRIC MUCOSAL AGENTS
    sucralfate (Carafate)
    • Bins to acids and forms a paste that sticks to ulcer sites.
    • Give on empty stomach
    • SE's: RARE
  21. CAUSES OF DDIARRHEA
    • Viral- Most common
    • Bacterial- Salmonella (FOOD), cholera (WATER), Dysentary.
    • Malabsorption
    • Irritable bowel
  22. ANTIDIARRHEAL AGENTS
    Inddications: To reduce the # of loose stools.
    Dyphenoxylate with atropine (Lomotil)
  23. ANTIDIARRHEAL AGENTS
    loperamide (Imodium)
    Decreases smooth muscle action. Allows more water absorption from stool.

    Many OTC brands

    Contraindications: Colitis
  24. ANTIDIARRHEAL AGENTS
    Lactobacillus acidophilus (Lactinex)
    Natural bacterium that hels restore normal intestinal flora in patients taking antibiotics.
  25. ANTIFLATULANTS
    simethicone (Mylicon, Gas-X)
    Indications: Post operative gas, infant colic
  26. LAXATIVES
    CONSTIPATION MOST COMMONLY OCCURS FROM THE FOLLOWING:
    • Improper diet- too little resiue/ fiber
    • Insufficient fluid intake.
    • Lack of activity
  27. LAXATIVES (6 TYPES)
    • Bulk forming laxatives
    • Stool Softeners
    • Emollients
    • Saline Cathartics
    • Stimulant Cathartics
    • Ostomic Laxatives
  28. BULK FORMING LAXATIVES
    psyllium (Metamucil)
    • Common OTC preparation
    • Seeds swell to form a gel that softens the stool.
  29. STOOL SOFTENERS
    ducosate (Colace)
    • Fecal softener
    • Non irritating and non bulk creating
    • Safer in cardiac patients (less straining)
  30. EMOLLIENTS
    mineral oil (Fleets)
    Caution lower absorption of ADEK with long term use.
  31. SALINE CATHARTICS
    magnesium citrate
    • Commonly used in preoperative bowel preps.
    • Increases bowel water retention
    • Stimulates evacuation.

    SE's: Electrolyte imbalnace, Not for long term use.
  32. STIMULANT CATHARTICS
    • Prouce strong intestinal contractions.
    • Habit forming: Caution in patients with eating disorders.
  33. OSMOTIC LAXATIVES
    sorbitol (D-Glucitol)
    • Promotes water retention in stool
    • (Similar to saline cathartics)

    Stimulates evacuation
  34. ANTIEMETICS INDICATIONS
    Nausea, Vommitting, motion sickness.

    • ondansetron (Zofran)
    • prochlorperazine (Compazine)
  35. .
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