GI Medication: Class & Types Inflo

Question 1

What are the 6 types of acid controlling agents?

Answer 1

• Antacids
• H2 Receptor blockers
• Proton Pump Inhibitors
• Mucous barrier
• Prostaglandin like substances
• Prokinetic agents

Question 2

What is the function of antacids?

Answer 2

• Antacids help to treat heartburn/indigestion/acid reflux/GERD
• They work by neutralizing the stomach acid that causes heartburn

Question 3

Patients with renal failure should avoid what kind of antacids?

Answer 3

• Magnesium based

Question 4

Patients w/ heart failure or HTN should be advised to avoid what kind of antacids?

Answer 4

• Sodium based

Question 5

How long before other oral medications should you take antacids?

Answer 5

• 2hrs

Question 6

When taking an antacid, what is the guidance for food?

Answer 6

• Take with food or w/in 1hr (or <3hrs)

Question 7

When taking an antacid, what is the guidance regarding before sleep?

Answer 7

• Take w/in 1hr of bedtime (or <3hrs)

Question 8

What is better, a liquid or solid antacid and why?

Answer 8

• Liquid, as it absorbs faster

Question 9

When taking antacids, it will decrease the absorption rate of what drugs?

Answer 9

• Digoxin
• Tetracycline
• Aspirin
• Iron
• Inderol

Question 10

How do H2 Receptor (H2) Blockers work?

Answer 10

• They bind to histamine type 2 receptors on the basolateral (antiluminal) surface of gastric parietal cells, interfering with pathways of gastric acid production and secretion.

Question 11

When should H2 blockers and other meds be taken in relation to antacids?

Answer 11

• Take 1hr before or after antacids

Question 12

Should H2 blockers be taken before or after meals?

Answer 12

• Before

Question 13

True or False
The HCP should be notified of significant diarrhea when taking H2 receptors.

Answer 13

• True

Question 14

True or False
It is permitted to crush, break or chew H2 receptors

Answer 14

• False

Question 15

When taking H2 receptors, what should be avoided as to not cause gastric discomfort?

Answer 15

• Smoking
• Alcohol
• Spicy/acidic foods

Question 16

When should a once-a-day dose of H2 blockers be taken and why?

Answer 16

• At bedtime
• It is likely to enhance nocturnal gastric pH control and decrease nocturnal gastric acid breakthrough.

Question 17

What side effects may be experienced with the use of H2 blockers?

Answer 17

• HA/Dizziness
• N/V, abdominal discomfort
• Constipation

Question 18

What is the function of Proton Pump Inhibitors?

Answer 18

• Deactivates the enzyme system that pumps H+ ions from the parietal cells, thus inhibiting gastric acid secretion

Question 19

Should PPIs be taken before, with or after meals?

Answer 19

• Before

Question 20

True or False
It is ok to chew, divide or crush PPI’s

Answer 20

• False

Question 21

True or False
PPI’s may be administered with antacids

Answer 21

• True

Question 22

If ordered twice a day, when should PPIs be given?

Answer 22

• Before breakfast and at bedtime

Question 23

How do PPIs interact with digoxin?

Answer 23

• PPIs can increase blood levels by changing gastric pH resulting in increased absorption of digoxin
• This can potentially lead to digoxin toxicity which can trigger fatal arrhythmias

Question 24

How do PPIs interact with iron?

Answer 24

• Supresses iron absorption through the inhibition of duodenal ferroportin (transport protein that allows for cellular passage in/out of the cell
• Puts pt @ risk for iron deficiency

Question 25

How do PPIs interact with Warfarin?

Answer 25

• Increase the effect of warfarin
• Will require careful monitoring of international normalized ratio (INR) when initiating PPI among warfarin users

Question 26

What are the side effects of PPIs?

Answer 26

• HA, Dizziness
• N/V/D/C

Question 27

Prokinetic agents are known as GI _____.

Answer 27

• Stimulants

Question 28

What is the function of Prokinetic agents?

Answer 28

• Rather than neutralizing acid, prokinetic agents increase both gastric emptying and lower esophageal sphincter pressure

Question 29

When should prokinetic agents be administered?

Answer 29

• 30 mins before meals and bedtime

Question 30

What is the function of Anticholinergics (antispasmatics)?

Answer 30

• Inhibits secretion of gastric acid in large doses.

Question 31

We do NOT give anticholinergics to patients with…

Answer 31

• Paralytic ileus
• Hiatal hernia
• GERD

Question 32

How do laxatives work?

Answer 32

• Laxatives ease the passage of softened, fully formed fecal matter from the rectum

Question 33

How does mineral oil help with bowel movements?

Answer 33

• Mineral oil is used to treat constipation.
• It is a lubricant laxative and works by keeping water in the stool and intestines.