Term
| Antibiotics employed most often in the treatment of H. pylori infection |
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Definition
| amoxicillin, clarithromycin, bismuth, metronidazole, and tetracycline (NONE IS EFFECTIVE ALONE) |
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Term
| Risk of using antibacterials alone |
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Definition
| developing resistance to the drug |
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Term
| Amount of antibiotics to use at the same time according to guidelines? |
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Definition
| at least 2 antibiotics and preferably three |
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Term
| What should also be administered with antibiotics? |
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Definition
| An anti-secretory agent (histamine receptor blocker or proton pump inhibitor) |
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Term
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Definition
| H. pylori is highly sensitive to amoxicillin. Amoxicillin kills bacteria by disrupting bacterial cell wall. Most common side effect is diarrhea. |
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Term
| clarithromycin (Biaxin) (macrolides group) |
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Definition
| Suppresses growth of H. pylori by inhibiting protein synthesis. Treatment is highly effective. Most common side effects are nausea, diarrhea, and distortion of taste. |
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Term
|
Definition
| Bismuth compounds act topically to disrupt cell walls of H. pylori, causing lysis and death. Bismuth can impart harmless black discoloration to tongue and stool. |
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Term
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Definition
| Inhibits bacterial protein synthesis and is highly effective against H. pylori. Should not be used by pregnant Inhibits bacterial protein synthesis and is highly effective against H. pylori. Should not be used by pregnant women or young children because can stain the teeth.(do not take with dairy - causes malabsorbtion) |
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Term
| Which antibiotic should not be taken with dairy? |
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Definition
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Term
| metronidazole (Flagyl) (anti-fungal group) |
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Definition
| Very effective against sensitive strains of H. pylori. Most common side effects are headache and nausea. |
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Term
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Definition
| DO NOT GIVE WITH ALCOHOL!!! Person can have antabuse-like reaction when taking Metronidazole and drinking alcohol. (chest pain, N/V, hypertension) |
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Term
| Do not use alcohol with which medication? |
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Definition
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Term
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Definition
| Should not be taken during pregnancy. |
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Term
|
Definition
| triggers the production of HCl |
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Term
| Which medication ends in "tidine" |
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Definition
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Term
|
Definition
| H2 receptor antagonists are first-choice drugs for treating gastric and duodenal ulcers |
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Term
| H2 receptor antagonists (H2RAs) promote ulcer healing by? |
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Definition
| suppressing secretion of gastric acid. |
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Term
| H2-RA - cimetidine (Tagamet) |
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Definition
| Blockage of H2 receptors on parietal cells of stomach reduces the volume of gastric juice and its hydrogen ion concentration |
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Term
| H2-RA - cimetidine (Tagamet) |
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Definition
| May be given orally or IV |
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Term
| H2-RA - cimetidine (Tagamet) |
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Definition
for Gastric and duodenal ulcers
To heal duodenal ulcers, 4 – 6 weeks of therapy is often needed. To heal gastric ulcers, therapy of up to 12 weeks may be necessary |
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Term
| H2-RA - cimetidine (Tagamet) |
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Definition
| Tagamet is drug of choice for relieving symptoms of GERD, but does little to promote healing. |
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Term
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Definition
| inflammatory condition caused by reflux of gastric contents back into esophagus |
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Term
| H2-RA - cimetidine (Tagamet)- "Adverse Effects" |
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Definition
| o CNS effects: most likely seen in elderly with renal or hepatic impairment. May see confusion, hallucinations, lethargy, somnolence, restlessness, seizures. |
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Term
| H2-RA - cimetidine (Tagamet)- "Adverse Effects" |
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Definition
| o Hypotension and arrhythmias when administered by IV bolus. |
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Term
| H2-RA - cimetidine (Tagamet)- "Adverse Effects" |
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Definition
| o Can cause increased levels of Coumadin, Dilantin, Theophyllin, and Lidocaine. |
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Term
| H2-RA - cimetidine (Tagamet)- "Adverse Effects" |
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Definition
| o Antacids can decrease absorption of Tagamet; tagamet and antacids should be administered at least 1 hour apart |
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Term
| H2-RA - ranitidine (Zantac) |
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Definition
| More potent than Tagamet and produces fewer adverse effects and causes fewer drug interactions |
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Term
| H2-RA - ranitidine (Zantac) |
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Definition
| Like Tagamet, Zantac blocks H2 receptors on the parietal cells and thereby suppresses secretion of gastric acid |
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Term
| H2-RA - ranitidine (Zantac) |
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Definition
| Can be given PO, IV, or IM. Used in short-term treatment of gastric and duodenal ulcers and for prophylaxis of recurrent duodenal ulcers |
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Term
| Difference between cimetidine (Tagamet) and ranitidine (Zantac)? |
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Definition
| Zantac is more potent than Tagamet and produces fewer adverse effects and causes fewer drug interactions. |
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Term
| H2-RA - ranitidine (Zantac) |
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Definition
| Used in treatment of GERD |
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Term
| H2-RA - famotidine (Pepcid) |
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Definition
| Used to treat GERD and PUD |
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Term
| H2-RA - nizatidine (Axid) |
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Definition
| Similar to Famotidine and Ranitidine. Used in treatment and prevention of gastric and duodenal ulcers, treatment of GERD. |
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Term
| What is a respiratory risk of the increase in production of HCl? |
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Definition
| pneumonia due to aspiration |
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Term
| PROTON PUMP INHIBITORS (PPIs) |
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Definition
|
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Term
| Difference between H2-RAs and PPI's? |
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Definition
| H2-receptor antagonists suppress production of HCl and PPI's completely block production |
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Term
| PROTON PUMP INHIBITORS (PPIs) |
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Definition
| These are the most effective drugs for suppressing gastric acid secretion.(completely blocks production) |
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Term
| PROTON PUMP INHIBITORS (PPIs) |
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Definition
| Used in the treatment of gastric and duodenal ulcers and GERD. |
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Term
| PROTON PUMP INHIBITORS (PPIs) |
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Definition
| Cause inhibition of H+-K+-ATPase (enzyme that generates gastric acid) |
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Term
|
Definition
| enzyme that generates gastric acid |
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Term
| PPI- Omeprazole (Prilosec) |
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Definition
| Powerful acid suppressant with effects superior to those of H2 receptor antagonists |
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Term
PPI- Omeprazole (Prilosec)
"Adverse Effects" |
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Definition
•Short-term therapy: headache, nausea and vomiting
•Long-term therapy: risk of gastric cancer |
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Term
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Definition
| Nearly identical to Omeprazole. Given for GERD, erosive esophagitis and duodenal ulcers |
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Term
| esomeprazole (Nexium) "Adverse Effects" |
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Definition
|
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Term
| Proton Pump Inhibitors (PPIs) |
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Definition
|
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Term
|
Definition
| Causes prolonged inhibition of H+,K+-ATPase |
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Term
| lansoprazole (Prevacid) "Adverse Effects" |
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Definition
| Diarrhea, abdominal pain, and nausea |
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Term
|
Definition
| Given for duodenal ulcers, gastric ulcers, GERD May be given PO or IV |
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Term
|
Definition
| increase the risk of osteoporosis |
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Term
| MUCOSAL PROTECTIVE AGENTS |
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Definition
| Sucralfate (Carafate), Misoprostol (Cytotec), Creates a protective barrier against acid and pepsin over the ulcer crater. |
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Term
| MUCOSAL PROTECTIVE AGENTS |
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Definition
| Sucralfate (Carafate), Misoprostol (Cytotec), Creates a protective barrier against acid and pepsin over the ulcer crater. |
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Term
| MPA - Sucralfate (Carafate) |
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Definition
| Creates a protective barrier against acid and pepsin over the ulcer crater |
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Term
| MPA - Sucralfate (Carafate) |
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Definition
Administered PO (take 30 minutes b/4 meals)Used for acute and maintenance therapy of duodenal ulcers.
Side Effects: constipation |
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Term
|
Definition
| lowers surface tension – H2O in feces |
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Term
| MPA - Misoprostol (Cytotec) |
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Definition
| Analog of Prostaglandin E1. Used to prevent gastric ulcers in patients taking NSAIDs |
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Term
| MPA - Misoprostol (Cytotec) "Adverse Effects" |
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Definition
|
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Term
| MPA - Misoprostol (Cytotec) "Adverse Effects" |
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Definition
| Contraindicated during pregnancy because prostaglandins stimulate uterine contractions. |
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Term
| Which med is contraindicated during pregnancy because of the increased production of prostaglandins? |
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Definition
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Term
|
Definition
| Minimum of 2 antibiotics and a PPI – for combination therapy |
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Term
|
Definition
Alkaline components that neutralize stomach acid.
Principle indications include GERD and PUD |
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Term
| Antacid - magnesium hydroxide (Milk of Mag) |
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Definition
| Rapid action with long duration Most common adverse effect is diarrhea. Used as a laxative frequently.Often given in combination with aluminum hydroxide (Gaviscon, Maalox). |
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Term
| Antacid -Milk of Magnesia "Adverse Effects" - |
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Definition
| kidneys excrete magnesium. Too much may cause kidney failure and a build up of Mg (hypermagnesia). Symptoms of hypermagnesia are CNS depression, weakening of the muscles, arrhythmia, low blood pressure |
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Term
| Which medication should be avoided by renal patients? |
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Definition
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Term
| Antacids - Aluminum Hydroxide (Alternagel, Amphogel, Basogel) |
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Definition
Slow-acting with long duration
Side Effect: constipation |
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Term
| Antacids - Aluminum Hydroxide (Alternagel, Amphogel, Basogel) |
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Definition
| Has high affinity for phosphorus; binds phosphorus and is used in renal patients who cannot excrete phosphorus in urine |
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Term
| Which medication is useful to renal patients and why? |
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Definition
| Aluminum Hydroxide (Alternagel, Amphogel, Basogel)Has high affinity for phosphorus; binds phosphorus and is used in renal patients who cannot excrete phosphorus in urine |
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Term
|
Definition
| Alka-Seltzer and baking soda |
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Term
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Definition
| Prokinetic drugs that increase tone and motility of GI tract. |
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Term
|
Definition
| Indications: GERD, Chemotherapy induced nausea and vomiting (CINV), diabetic gastroparesis |
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Term
| Motility Agent - metoclopramide (Reglan) |
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Definition
1.Suppresses emesis by blocking dopamine and serotonin receptors in chemoreceptor trigger zone (CTZ)
2.Increases upper GI motility by enhancing action of acetylcholine |
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Term
| Motility Agent - metoclopramide (Reglan) "Adverse Effects" |
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Definition
• Sedation and diarrhea in high dose therapy
Administered PO or IV |
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Term
| Motility Agent - metoclopramide (Reglan) "Adverse Effects" in elderly |
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Definition
| EPS side effects from blocking dopamine |
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Term
| Extrapyramidal side effects (EPS) |
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Definition
| These symptoms include tremor, slurred speech, akathesia, dystonia, anxiety, distress, paranoia, and bradyphrenia |
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Term
|
Definition
| reduces certain side effects of opioid medications without reducing pain relieving effects |
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Term
|
Definition
| used to speed recovery of stomach and intestinal functions after GI surgery and to prevent side effects caused by narcotic medications |
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Term
|
Definition
-only given in hospital
-has bad cardiac side effects
-hypokalemia
-given PO
-no more than 15 doses to one pt.
-cannot be discharged on it |
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Term
|
Definition
-increases upper GI motility
-to restore GI motility to prevent ileuses
-look for the return of bowel sounds |
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Term
|
Definition
| drink lots of fluids to bulk stool |
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Term
|
Definition
| pulls water across bowel and retains it in stool |
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Term
| Adverse Effects of Laxatives |
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Definition
| With continued use, your body becomes accustomed to the effects of the laxative, and if you stop taking it, the colon slows down and its contractions become very weak |
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