Week 2: GI Tract - Drugs for PUD Flashcards

1
Q

What is the goal of using drugs for PUD? (4)

A
  • Alleviate symptoms
  • promote healing
  • Prevent complications (hemorrhage, perforation, obstruction)
  • Prevent recurrence
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2
Q

What are the 4 types of drugs that are used for PUD?

A
  • H2 receptor antagonist
  • Proton pump inhibitors
  • Other antacids
  • antibiotics
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3
Q

Many of the medications for PUD can also be used to manage GERD. Which 3 types of drugs are those?

A
  • H2 receptor antagonist
  • Proton pump inhibitors
  • Other antacids
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4
Q

What is the goal of drug therapy for GERD? (3)

A
  1. Alleviate symptoms
  2. promote healing of esophageal mucosal injury (ulceration or bleeding)
  3. Prevent complications like esophageal strictures, Barrett’s esophagus, etc.
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5
Q

What is the goal of drug therapy for PUD? (4)

A
  • Alleviate symptoms
  • promote healing of gastric/duodenal mucosa
  • Prevent complications (hemorrhage, perforation, obstruction)
  • Prevent recurrence
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6
Q

Which medication is a histamine-2 receptor antagonist?

A
  • ranitidine
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7
Q

What is the difference between H1 receptor antagonists (antihistamines) and H2 receptor antagonists?

A
  • H1 are targeted towards allergy symptoms
  • H2 receptors are located in the parietal cells of the stomach
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8
Q

What occurs when you block the H2 receptors?

A
  • reduces the volume of gastric juice and decreases the concentration of acid
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9
Q

How long does it take to heal gastric and duodenal ulcers with ranitidine?

A
  • requires long term therapy, 6-12 weeks
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10
Q

What are the indications for using ranitidine? (2)

A
  • PUD
  • GERD
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11
Q

What are the adverse effects of ranitidine? (4)

A

CNS:
- confusion
- hallucinations
- CNS depression (cross BBB poorly so rare)

  • increased risk for pneumonia (loss of acidic buffer means increased pH)
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12
Q

What are nursing considerations for ranitidine? (3)

A
  • Assess for epigastric pain, abd pain or signs of GI bleeding (hematemesis, frank blood or occult blood in stool)
  • Assess for signs of confusion (esp. in older adults)
  • Administer antacids an hour apart from other medications
  • Monitor for signs of pneumonia
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13
Q

Which medication is an example of a proton pump inhibitor?

A

omeprazole (Losec)

most effective in suppressing gastric acid secretion

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14
Q

What is the MOA of omeprazole?

A
  • causes irreversible inhibition of H=, K+ ATPase, the enzyme that generates gastric acid
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15
Q

A single dose of omeprazole inhibits acid production by ___% in 2 hours

A

97

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16
Q

Is the effect of omeprazole reversible? (2)

A
  • Irreversible
  • no new acid until new enzyme is made, which may take days to weeks
17
Q

Why is omeprazole enteric coated? (2)

A
  • Drug is acid-labile
  • enteric coated will dissolve in duodenum
18
Q

What are the indications for omeprazole? (2)

A
  • PUD
  • GERD
19
Q

What are the minor adverse effects of omeprazole? (3)

A
  • Headache
  • Diarrhea
  • N+V
20
Q

What are the more severe adverse effects of omeprazole? (4)

A
  • Pneumonia
  • Fractures (calcium is absorbed in highly acidic environments, but there is decreased absorption)
  • Rebound acid hypersecretion DYSPEPSIA
  • Hypomagnesemia (likes acidic environments)
21
Q

What are nursing considerations for omeprazole? (4)

A
  • Administer before meals
  • Monitor serum Mg with prolonged use
  • Monitor for signs of pneumonia
  • Monitor for fractures