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Pharmacology Chapter 48
FSCJ Nursing program
30
Nursing
Undergraduate 3
09/29/2011

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Term
Peptic ulcer
Definition
broad term for an ulcer occurring in the esophagus, stomach, or duodenum within the upper gastrointestinal (GI) tract
Term
The release of __________ from the parietal cells of the stomach is influenced by histamine, gastrin, and acetylcholine.
Definition
hydrochloric acid (HCl)
Term
Peptic ulcers occur when there is a hypersecretion of ________ and _________, which erode the GI mucosal lining.
Definition
hydrochloric acid, pepsin
Term
The gastric secretions in the stomach strive to maintain a pH of ___ to __.
Definition
2,5
Term
Pepsin is a
Definition
digestive enzyme
Term
The ___________ is a thick, viscous, mucous material that provides a barrier between the mucosal lining and acidic gastric secretions.
Definition
gastric mucosal barrier (GMB)
Term
. The two sphincter muscles—the _____, located at the upper portion of the stomach, and the _____, located at the lower portion of the stomach—act as barriers to prevent reflux of acid into the esophagus and duodenum.
Definition
cardiac, pyloric
Term
symptom of peptic ulcers is
Definition
gnawing, aching pain
Term
With a gastric ulcer, pain occurs ___ minutes to___ hours after eating,
Definition
30, 1.5
Term
With a duodenal ulcer, pain occurs ___ to ____ hours after eating
Definition
2, 3
Term
In the United States, 40% to 44% of adults have heartburn, which in many cases is caused by ______
Definition
Gastroesophageal reflux disease (GERD),
Term
Drugs used in treatment include ______ such as ranitidine (Zantac),and ______such as omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), or esomeprazole (Nexium).
Definition
H2 blocker, PPI's
Term
With GERD, _______ relaxes the lower esophageal sphincter, permitting gastric acid reflux.
Definition
nicotine
Term
what are seven groups of antiulcer agents
Definition
(1) tranquilizers, which decrease vagal activity; (2) anticholinergics, which decrease acetylcholine by blocking the cholinergic receptors; (3) antacids, which neutralize gastric acid; (4) H2 blockers, which block the H2 receptor; (5) PPIs, which inhibit gastric acid secretion, regardless of acetylcholine or histamine release; (6) the pepsin inhibitor sucralfate; and (7) the prostaglandin E1 analogue misoprostol, which inhibits gastric acid secretion and protects the mucosa.
Term
Tranquilizers have _______ effect in preventing and treating ulcers; however, they reduce vagal stimulation and decrease anxiety
Definition
minimal
Term
Anticholinergics relieve pain by decreasing _______ and ____________.
Definition
GI Motility, secretion
Term
Antacids promote ulcer healing by _________ and reducing ______activity;
Definition
neutralizing hydrochloric acid, pepsin
Term
what do histamine2 (H2) blockers do?
Definition
Histamine2 blockers prevent acid reflux in the esophagus (reflux esophagitis). These drugs block the H2 receptors of the parietal cells in the stomach, thus reducing gastric acid secretion and concentration.
Term
An antacid should definitely not be given with ____, _____, or _____ because it binds with and inactivates most of the drug
Definition
tetracycline, digoxin, or quinidine,
Term
An antacid should definitely not be given with ____, _____, or _____ because it binds with and inactivates most of the drug
Definition
tetracycline, digoxin, or quinidine,
Term
When administering antacids to a patient you need to monitor ____, _____, ____, and ______ levels.
Definition
electrolytes and urinary pH, calcium, and phosphate
Term
Tell client to avoid taking antacids within______ of other oral medications, because there may be interference with absorption.
Definition
1-2 hours
Term
Side effects and adverse reactions of H2 blockers include
Definition
headaches, dizziness, constipation, pruritus, skin rash, gynecomastia, decreased libido, and impotence.
Term
Proton Pump Inhibitors suppress gastric acid secretion by
Definition
inhibiting the hydrogen/potassium adenosine triphosphatase (ATPase) enzyme system located in the gastric parietal cells.
Term
Pepsin Inhibitor (Mucosal Protective Drug) is nonabsorbable and combines with protein to form a viscous substance that __________
Definition
that covers the ulcer and protects it from acid and pepsin. This drug does not neutralize acid or decrease acid secretions.
Term
1. A client is diagnosed with peptic ulcer disease. The nurse realizes that which factor is a predisposing factor for this condition?

a. Helicobacter pylori

b. hyposecretion of pepsin

c. decreased hydrochloric acid

d. decreased number of parietal cells
Definition
A
Term
When a client is given sucralfate (Carafate), the nurse knows that its mode of action is what?

a. To neutralize gastric acidity

b. To inhibit gastric acid secretion by inhibiting histamine at H2 receptors in parietal cells

c. To suppress gastric acid secretion by inhibiting the hydrogen/potassium ATPase enzyme

d. To combine with protein to form a viscous substance that forms a protective covering of ulcer
Definition
D
Term
3. A client is taking ranitidine (Zantac). The nurse who is teaching the client about this drug should include which information? (Select all that apply.)

a. Drug-induced impotence is irreversible

b. The drug must be administered 30 minutes before meals

c. The drug must be administered separate from an antacid by at least 1 hour

d. The drug must always be administered with magnesium hydroxide

e. Smoking should be avoided while taking this drug

f. Foods high in vitamin B12 should be increased in diet
Definition
C, E, F
Term
4. When a client complains of pain accompanying a peptic ulcer, why should an antacid be given?

a. Antacids decrease GI motility.

b. Antacids decrease gastric acid secretion.

c. Aluminum hydroxide is a systemic antacid.

d. Antacids neutralize HCl and reduce pepsin activity.
Definition
D
Term
5. A client is taking famotidine (Pepcid) to inhibit gastric secretions. What are the side effects of famotidine? (Select all that apply.)

a. Diarrhea

b. Dizziness

c. Dry mouth

d. Headaches

e. Blurred vision

f. Decreased libido
Definition
B, D, F
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