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GI phamacology
GI nursing pharmacology
56
Pharmacology
Undergraduate 2
03/10/2011

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Term
what is the pH of the mucous gel that protects the stomach?
Definition
7
Term
The specialized cells of the ____ secrete the contents of the gastric lumen
Definition
gastric pits
Term
mucous secretion is triggered by:
Definition
mechanical stress, chemical irritation, and parasympathetic inputs
Term
which cells secrete the gastric acid?
Definition
parietal cells
Term
_____ cells secrete pepsinogen; which is turned to pepsin to break down protein
Definition
chief cells
Term
this disorder is characterized by backflow of stomach contents into the esophagus which has no protective layer and may cause erosion
Definition
Gastroesophageal Reflux Disease (GERD)
Term
Precipitants of GERD
Definition
fatty food, alcohol, caffeine, smoking, obesity, pregnancy
Term
In pts with recurring gurd, changes in the esophageal lining may occur. This is called ___________
Definition
Barrett's esophagus
Term
treatment of barretts esophagus
Definition
biopsy q 2 years
Term
normal gastric acid production, however the mucosal barrier is weak, and causes and erosion in the stomach lining- caused by NSAIDS
Definition
benign peptic ulcer
Term
mucosal barrier is normal but there is an abnormally high secretion of acid and this causes an erosion
Definition
malignant peptic ulcer
Term
over 95% of peptic ulcers are due to _____
Definition
heliobacter pylori, NSAIDs
Term
what is the primary goal in treating ulcers and gerd?
Definition
to reduce the stomach acid contents
Term
agent when taken orally, lowers the pH of the blood as well
Definition
systemic antacid; sodium bicarbonate
Term
these antacids stay only the stomach
Definition
nonsystemic antacid
Term
these are contraindicated in pts with impaired renal function and may cause diarrhea
Definition
aluminum hydroxide
mg hydroxide combos
Term
marketed as tums- may cause constipation
Definition
calcium carbonate
Term
inhibition secretion of gastric acid through compeitive inhibion of H2 receptors on the parietal cells. Allow ulcers to heal
Definition
H2 receptor blockers
Term
this H2 receptor blocker inhibits the metabolism of estrogen- problem for men
Definition
cimetidine (tagment)
Term
cimetidine
famotidine
ranitidine
nizatidine
Definition
H2 receptor blockers
Term
strong inhibitors of gastric acid secretion by irreversibly bloking the proton pump of parietal cells. decreases acid secretion by 95% for 48 hrs
Definition
proton pump inhibitors
Term
omeprazole (prilosec)
esomeprazole (nexium)
rebeprazole
lansoprazole
pantoprazole
Definition
proton pump inhibitors
Term
older med from before H2 blockers- this is a PGE1 analog and stimulates the GI pathway leading to a decrease in gastric acid release
Definition
Misoprostol
Term
these should not be given to women of childbearing age unless they are on birth control
Definition
prostaglandins- Misoprostol
Term
muscarinic M1 acteylcholine receptor antagonist that blocks gastric acid secretions. rarely used today
Definition
Pirenzipine
Term
side effects of Pirenzipine
Definition
anorexia, blurry vision, constipation, dry mouth, sedation
Term
this mucosal protective agents requires an acid pH in the stomach for activation and then coats the stomach. must be give 2 hrs between drugs and meals
Definition
Sucralfate
Term
this mucosal protective agent protects the ulcer crater and allows healing. should not be used repeatedly or longer than 2 months
Definition
Chelated Bismuth
Term
triple therapy for h.pylori
Definition
proton pump inhibitor+ amoxicillin/tetracycline (moderate antibiotic)+metronidazone/ clarithomycin(stong antibiotic)
Term
how long is the triple therapy?
Definition
7 days
Term
quadruple therapy for h.pylori:
Definition
3 day treatment as efficacious as triple therapy (85%) the same, but add pepto bismol
Term
for this, all therapies are anti-inflammatory and strength depends on the severity
Definition
inflammatory bowel disease
Term
# 1 cause of constipation
Definition
laxative abuse
Term
treatments of constipation
Definition
bulking agents, osmotic laxatives, stimulant drugs, stool softeners
Term
increase in bowel content volume triggers stretch recsptors in the intestinal wall
Definition
bulk laxatives
Term
psyllum, bran, methylcellulose
Definition
bulk laxatives
Term
effective in 1-3 hrs, used to purge the intestine, fluid is drawn into the bowel by osmotic force, increasing volume and triggering peristalsis
Definition
saline and osmotic laxatives
Term
non-digestible sugar and alcohol
Definition
lactulose
Term
milk of magnesia
epsom salt
glauber's salt
sodium phosphate
sodium citrate
Definition
salts
Term
docusate sodium (surfactant and stimulant)
liquid paraffin (oral solution)
glycerin suppositories
Definition
stool softeners- emollients
Term
increases intestinal motility, irritate the GI mucosa and pull water into the lumen, indicated for severe constipation where more rapid effect is required (6-8) hours
Definition
irritant/ stimulant laxatives
Term
castor oil, senna, bisacodyl, lubiprostone
Definition
irritant/stimulant laxatives
Term
stimulant laxative PGE-1 derivative that stimulates chloride channels, producing chloride-rich secretions
Definition
Lubiprostone
Term
you shouldn't administer anti-diarrheal agents unless_______
Definition
you know the cause
Term
anti-diarrheal agents all reduce perisalsis by stimulating ______ receptors in the bowel.
Definition
opioid
Term
This anti-diarrheal is OTC and 40-50x more potent than morphine but does not cross the BBB
Definition
Loperamide (Imodium)
Term
primary cause of diarrhea in pts exposed to antibiotics. seen in hospitals
Definition
c. diff
Term
treatment of c. diff
Definition
discontinue offending antibiotic
- metronidazole
- vancomycin
Term
used to relieve the painful symptoms associated with gas by altering the elasticity of mucus-coated bubbles, causing them to break
limited data regarding effectiveness
Definition
simethicone (gas-x)
Term
this is prepared from the root of the ipechacuanha plant and induces emesis
Definition
syrup of ipecac
Term
Ipecac syrup should only be given if there is a delay of _____ between the time the toxin is ingested and the time arriving at the hospital
Definition
1 hour
Term
antiemetic therapy for motion sickness that is a M1 receptor antagonist
Definition
scopolamine
Term
antiemetic H1/ D2 receptor antagonists
Definition
Phenothiazines: Promethazine (phenergan) Prochlorperazine (compazine)
Term
these anti emetics may have the side effect of tardive diskensia when used long term
Definition
Phenothiazines
Term
these are good from chemotherapy-induced nausea and vomiting
Definition
serotonin 5-HT3 receptor antagonists
Term
ondansetron (sofran)
granisetron
Definition
Serotonin 5-HT3 receptor antagonists
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