Term
| 3x more likely to have H. Pylori colonization |
|
Definition
|
|
Term
| Concomitant disease (PUD risk factor) |
|
Definition
| COPD(smoking), Cystic Fibrosis, Cirrhosis |
|
|
Term
|
Definition
| decreased gastric motility, diet, genetics, stress/psychological (not proven), concomitant diseases |
|
|
Term
| Age > 64 yrs, previous PUD, corticosteroids, high dose NSAIDs, Multiple NSAIDs, anticoagulants, SSRIs |
|
Definition
| Established risk factors for NSAID-induced ulcers |
|
|
Term
| cigarettes, alcohol, poor general health, asymptomatic, H2RA users, antacid users, HP |
|
Definition
| Possible risk factors for NSAID-induced ulcers |
|
|
Term
| Proteolytic (digestive) enzyme |
|
Definition
|
|
Term
| stimulates release of Pepsinogen from chief cells in stomach lining |
|
Definition
|
|
Term
| Pepsin is reversibly inactivated at ___ and destroyed at _____ |
|
Definition
|
|
Term
| Mucus, sodium bicarbonate, prostaglandins |
|
Definition
| mucosal defense mechanism |
|
|
Term
| secreted by gastric cells to provide a protective layer from noxious substances |
|
Definition
|
|
Term
| secreted by gastric and duodenal mucosa- makes mucus viscous and near-neutral pH |
|
Definition
|
|
Term
| plays a role in mucosal integrity, maintenance and repair; increases mucus and HCO3 secretion, blood flow, and cellular repair |
|
Definition
|
|
Term
| causatives roles as well as risk of ulcer recurrence |
|
Definition
| H. Pylori, NSAIDs/Aspirin, Zollinger-Ellison syndrome, stress related mucosal bleeding (SRMB) |
|
|
Term
| tumors in duodenum that produce gastrin that stimulates acid secretion |
|
Definition
| Zollinger-Ellison syndrome |
|
|
Term
| Mobility via flagella to move from lumen of stomach to muscos; produces urease which hydrolyzes urea in gastric juice and converts it to ammonia and carbon dioxide |
|
Definition
|
|
Term
| Alteration of Mucosal Defense (theoretical mechanisms) |
|
Definition
| Direct Mucosal Damage; Inflammatory Resposne; Hypergastrinemia |
|
|
Term
| direct irritation of gastric epithelium and prostaglandin suppression |
|
Definition
|
|
Term
|
Definition
| Upper GI bleeding, Perforation into peritoneal cavity, Gastric outlet obstruction |
|
|
Term
|
Definition
| Serology, Urea Breath Test |
|
|
Term
| Proton Pump inhibitors, Histamine 2 Receptor Antagonists, Sucralfate, Antacids, Mucosal protective agent (misoprostol) |
|
Definition
|
|
Term
| Antibiotics, Bismuth subsalicylate, acid suppressive therapy (PPI) |
|
Definition
|
|
Term
| HP eradication 1st line (Triple therapy) |
|
Definition
| PPI BID, Clarithromycin 500 mg BID, amoxicillin 1g BID |
|
|
Term
| HP Eradication Quadruple therapy |
|
Definition
| Bismuth 525 mg QID, Tetracycline 500 mg QID, Metronidazole 250 mg-500 mg QID, H2RA or PPI Qday-BID |
|
|
Term
|
Definition
| PPI, Misoprostol, use of COX-2 inhibitor |
|
|
Term
| MOA: prodrugs, absorbed systemically in the duodenum; under acidic conditions they are protonated to active metabolites with IRREVERSIBLY bind to the proton pump |
|
Definition
|
|
Term
| Inhibition of hydrogen, potassium, and ATPase pump of gastric parietal cells |
|
Definition
| Inhibition of gastric acid secretion |
|
|
Term
|
Definition
| duodenal and gastric ulcer treatment, h. pylori, GERD, erosive esophagitis, QD or BID for active ulcer treatment |
|
|
Term
| PPIs heal and relieve abdominal pain faster than |
|
Definition
|
|
Term
|
Definition
| headache, nausea, abdominal pain most common; acid reflux rebound |
|
|
Term
|
Definition
| substrate, inhibitor, and inducer of several CYP450 enzymes; may increase half life of diazepam, warfarin, digoxin, phenytoin |
|
|
Term
| Cimetidine, Ranitidine, Famotidine, Nizatidine |
|
Definition
| Histamine 2 Receptor Antagonists |
|
|
Term
|
Definition
| OTC formulations- relief of heartburn, acid indigestion, and dyspepsida; prescription- txt of duodenal uler, gastric ulcer, symptomatic relief in gastritis, GERD< active benign ulcer, and hypersecretory conditions |
|
|
Term
|
Definition
| Headache, GI symptoms (diarrhea, constipation); increased pH can adversely affect absorption of some other drugs (e.g., azole antifungals) |
|
|
Term
| Cimetidine Adverse effects |
|
Definition
| gynecomastia, impotence; CYP450 inhibitor: interactions! |
|
|
Term
| MOA: forms a paste-like barrier that adheres to the base of ulcer; requires separation from other medications and can cause constipation |
|
Definition
|
|
Term
| synthetic prostaglandin E2 analog that replaces protective prostaglandins |
|
Definition
|
|
Term
| used for adjunctive pain control in PUD; effective for 30 min on empty stomach (with food 3 hours) |
|
Definition
|
|
Term
| gastritis or multiple superficial erosions (more superficial than PUD) |
|
Definition
|
|
Term
| well documented efficacy for stress ulcers; available IV; Renally eliminated |
|
Definition
|
|
Term
| Chronic symptoms or mucosal damage produced by the reflux of gastric contents into esophagus |
|
Definition
|
|
Term
| Medications that may worsen GERD: Decrease LES tone |
|
Definition
| anticholinergics, estrogen/progesterone, narcotic analgesics, benzodiazepines, nitrates, CCs, nicotine/alcohol |
|
|
Term
| Medications that may worsen GERD: Direct irritant |
|
Definition
| bisphosphonates, aspirin/NSAIDs, iron, quinidine, potassium chloride |
|
|
Term
| Foods that may worsen GERD: Decrease LES tone |
|
Definition
| peppermint, spearmint, chocolate, coffee, cola, tea, fatty meal, garlic, onions |
|
|
Term
| Foods that may worsen GERD: Direct Irritant |
|
Definition
| tomato juice, coffee, orange juice, spicy foods |
|
|
Term
| Spontaneous transient LES relaxation, increased intra-abdominal pressure, weak or incompetent resting LES |
|
Definition
| Defective Lower Esophageal Sphincter (LES) |
|
|
Term
| Responsible for 65% of reflux episodes |
|
Definition
| spontaneous transient LES relaxation |
|
|
Term
| Pregnancy, obesity, chronic: constipation, straining, coughing, bending, eating |
|
Definition
| increased intra-abdominal pressure |
|
|
Term
|
Definition
| heartburn, regurgitation, hypersalivation |
|
|
Term
|
Definition
| non-coronary chest pain, chronic cough, hoarseness, non-allergic asthma, dental erosions |
|
|
Term
|
Definition
| Esophageal stricture, Bleeding esophagitis, Esophageal adenocarcinoma |
|
|
Term
| can occur in GERD patients when the epithelial cells in the lower esophagus become damaged as a result of chronic exposure to the stomach chemistry |
|
Definition
|
|
Term
| pathways to GERD treatment |
|
Definition
| Neutralize the acid, Slow down acid production, Increase protective barrier, Speed up stomach emptying |
|
|
Term
| mild, infrequent heartburn or dyspepsia (treatment) |
|
Definition
|
|
Term
| mild, infrequent heartburn or dyspepsia, GERD (treatment) |
|
Definition
|
|
Term
| moderate-severe GERD or complications |
|
Definition
|
|
Term
|
Definition
| quick relief, but short lasting; May increase LES pressure |
|
|
Term
|
Definition
| longer duration of action than antacids |
|
|
Term
| floats on surface of gastric contents and is refluxed instead of acid; tablets must be chewed and followed by a glass of water; works only in upright position |
|
Definition
| Sodium Alginate (Gaviscon) |
|
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