2 - Gastrointestinal Disorders Flashcards Preview

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Flashcards in 2 - Gastrointestinal Disorders Deck (25):
1

What are some antacids?

  • Aluminum hydroxide
  • Magnesium hydroxide
  • Calcium carbonate (Tums)

These are poorly absorbed

2

What are some magnesium products of antacids?

  • Milk of Magnesia - neutralizes stomach
  • Maalox - magnesium trisilicate
    • Slow acting, coats ulcerated area, neutralizes pH

3

What are the aluminum products of antacids?

  • Amphojel - aluminum is astringent to stop bleeding
    • Coats and protects ulcers from H+
  • Aluminum glycinate + aspirin

4

How does the antacid sucralfate (Carafate) work?

  • Form complexes with albumin, fibrinogen and globulin on ulcer surface, thus creating protective barrier to acid and pepsin
    • Interferes with the absorption of many medications

5

What is the preferred histamine H2 receptor antagonist?

Zantac

6

What are indicated for use for prevention and treatment of NSAID-induced GI lesions?

Nexium - proton pump inhibitors

7

What class of drugs are Nexium, Prevacid, Prilosec, Prontonix, Aciphex?

proton pump inhibitors

8

How are antibiotics used for GI disorders? And what are the common ones?

Used in combination with other drugs to treat ulcers cause by Helicobacter pylori

  • amoxicillin
  • metronidazole
  • clarithromycin
  • tetracycline

9

What is a dental consideration of patients taking antacids?

  • They interfere with absorption of many drugs = wait 2 hours

10

While taking antacids, what additional drug can cause GI distress and diarrhea?

Macrolide antibiotics - caution in patients with Inflammatory Bowel Disease

11

What can taking antacids with antibiotics cause?

Pseudomembranous colitis

12

What should you avoid in patients with a history of stomach ulcers?

Aspirin / NSAIDS

13

H pylori is associated with cancer of gastric mucosa which is?

Lymphoma

14

Atrophic gastritis caused by chronic use of proton pump inhibitors increases risk for what?

Stomach cancer

15

Once H. pylori is found in patients with peptic ulcers, what's the normal procedure?

  1. Eradicate it
  2. Allow ulcer to heal

Triple therapy!

16

What's the triple therapy used for stomach ulcers and h pylori?

  1. amoxicillin
  2. clarithromycin (Biaxin)
  3. a proton pump inhibitor
    1. Nexium, Prevacid, Protonix, Aciphex
    2. Prilosec

17

What do you change in the triple therapy if H pylori is resistant to clarithromycin?

levofloxacin (Levaquin)

18

What are some dental considerations of pts with ulcers?

  • Avoid aspirin and NSAIDS
  • H2 receptor blockers decrease metabolism of many dental drugs

19

What are some oral manifestations of peptic ulcer disease?

  • Vascular malformations of lip
  • Enamel erosion
  • Taste alteration
  • Blood dyscrasias
  • Xerostomia

20

What are the 2 distinct conditions of IBS?

  1. Ulcerative colitis - large intestine and rectum
  2. Crohn's disease - entire wall of bowel, autoimmune

21

What are the treatments for IBS?

  1. First line - anti-inflammatories, corticosteroids
  2. Second line - immunosuppressive agents, antibiotics
  3. Third line - monoclonal antibody, surgical resection

22

What are the unique oral manifestations of Crohn's?

  • Atypical mucosal uclerations
  • Diffuse swelling of lips and cheeks
  • Cobblestone mucosal lesions

23

What are common anti-diarrheal agents?

  • Bismuth subsalicylate (Pepto-Bismol)
  • codeine and diphenoxylate (in Lomotil) = prescription drug
  • Imodium

24

What's the caution while taking pepto-bismol?

Caution with salicylate allergy

25

What are the different types of laxatives?

  • Bulk - carboxymethyl cellulose with psyllium
  • Osmotic - magnesium salts 
  • Contact - bisacodyl (Dulcolax), castor oil
  • Lubricants - mineral oil, glycerin