Week 2: GI Tract - Drugs for PUD: Antiulcer and antibiotics Flashcards
Another antiulcer drug is sucralfate. What is the MOA? (2)
- Protects against ulcers by creating a mucosal barrier against acid and pepsin
- Undergoes chemical reaction in acidic environment of stomach to form a sticky gel
How long does sucralfate adhere to ulcers? How is it eliminated? How is it administered? (3)
- adheres to ulcers for 6 hours
- eliminated in feces
- Oral administration only
What are indications of sucralfate? (2)
- GERD
- Duodenal ulcers
What are the adverse effects of sucralfate? (2)
- Constipation (rare)
- No systemic side effects because it is not absorbed
What are nursing considerations for Sucralfate? (3)
- PO route only
- Should not be taken within 30 min of antacids
- Can alter absorption of many other meds, so should be taken 2 hours apaart
Another antiulcer drug is misoprostol. What is the MOA? (4)
- Replaces endogenous prostaglandin
- Suppresses secretion of gastric acid
- Promotes secretion of bicarb/mucus
- Increases mucosal blood flow
Note that prostaglandins are produced in the stomach and protect lining of mucosa through secretions
What are the indications of misoprostol? (2)
- Limited to prevent NSAID induced gastroduodenal ulcers
- often seen as a combination drug with NSAID
What are the adverse effects of misoprostol?
Minimal
- Diarrhea
What are nursing considerations of misoprostol? (2)
- Contraindicated in pregnancy
- will cause spontaneous abortion
Another antiulcer drug are antacids like tums. What is the MOA? (4)
- alkaline compounds that neutralize stomach acids
- raise pH of stomach (above 5)
- reduce pepsin activity
- stimulate production of prostaglandins
Are antacids systemically absorbed?
no, except sodium bicarbonate
What are the indications for antacids? (3)
- GERD
- PUD
- Gastritis
What are some examples of antacids? (4)
- Magnesium hydroxide
- Aluminum hydroxide
- Calcium carbonate (TUMS)
- Sodium bicarbonate
What are the side effects of magnesium hydroxide (Milk of Magnesia)? (3)
- Diarrhea
- often administered with aluminum hydroxide to counteract this effect - Avoid in patients with undiagnosed abd. pain
- Magnesium can accumulate in people with renal dysfunction
What are the side effects of aluminum hydroxide (almajel)? (2)
- Constipation
- High affinity for phosphate (can cause hypophosphatemia)