32 drugs, Used To Treat Gastroesophageal Reflux And Peptic Ulcer Disease

Question 1

What are the three types of secretory cells that line portions of the stomach?

Answer 1

Chief, parietal, and mucus cells

Question 2

What inactive enzyme does the chief cell secrete?

Answer 2

Pepsinogen

Question 3

What acid does the parietal cells secrete and how?

Answer 3

Hydrochloric acid by way of a hydrogen ion pump

Question 4

What acid activates pepsinogen to pepsin, which action does this provide

Answer 4

Hydrochloric acid activates Pepsinogen to Pepsin, providing the optimal pH for pepsin to start protein digestion

Question 5

Mucus cells, secrete, the mucus that coat the stomach, is this alkaline or acidic? What does this mucus protect the stomach from?

Answer 5

Mucus cells, secrete alkaline mucus that protects the stomach wall from damage by hydrochloric acid, and the digestive enzyme pepsin

Question 6

What is prostaglandins major role regarding the stomach wall?

Answer 6

Prostaglandins protect the stomach walls from injury, caused by stomach acid and enzymes

Question 7

Where are prostaglandins produced?

Answer 7

Cell lining of the stomach

Question 8

How do prostaglandins prevent injury regarding gastric acid secretion?

Answer 8

Prostaglandins inhibit gastric acid secretion

Question 9

Do prostaglandins have a role in maintaining blood flow

Answer 9

Yes

Question 10

Prostaglandins stimulate mucus, and are responsible for an acid production or HCO3 production

Answer 10

HCO3

Question 11

Common symptoms of heartburn or GERD

Answer 11

Burning sensation, bloating, belching, regurgitation. Less frequent symptoms are a ‘lump in the throat’, hiccups, and chest pain.

Question 12

H. pylori is thought to be associated with 90% of these and 70% of these

Answer 12

Duodenal and gastric ulcers- the most common G.I. illnesses

Question 13

Risk factors that increase the likelihood of peptic ulcer disease (PUD). List what we want once thought caused ulcers.

Answer 13

Genetic predisposition, cigarette smoking (increases acid secretion altering blood flow in the stomach wall and retards prostaglandin synthesis needed for defense mechanisms), NSAIDs (inhibit prostaglandins that protect the mucosa, and directly, irritate the stomach wall). NSAIDs, will also slow the healing.
It is a belief that stress causes ulcers, but no well-controlled studies have reported this

Question 14

Goals and treatment of GERD and PUD

Answer 14

Relieve symptoms, decrease the frequency and duration of reflux, he’ll tissue injury, and prevent recurrence

Question 15

Nursing implications for agents used for stomach disorders patient education: nutrition- what dietary changes would I prescribe

Answer 15

Eat small more frequent meals to support optimal energy requirements and healing, avoid over eating. Avoid seasoning that is intolerable or aggravate the condition. Avoid caffeine and alcohol, carbonated beverages, peppermint, spearmint, citrus juices, late night snacking or meals that could result in increased gastric secretions. Increase protein foods, decrease fats to about 45 g a day or less and switch to nonfat milk

Question 16

Nursing implications for agencies for stomach disorders patient education: pain, discomfort- how would I advise patients to sit while eating, and what they should wear or not wear

Answer 16

Set up right at the table and eating, and do not lay down for at least two hours after eating, avoid tight clothing over abdomen

Question 17

Drug class: antacids- what do they all do?

Answer 17

They all act by neutralizing gastric acid

Question 18

Drug class: antacids- when a patient is taking an antacid for indigestion. How long should they take the medication before they contact a healthcare provider?

Answer 18

Two weeks

Question 19

Drug class: antacids; serious adverse effects- Gastrointestinal effect? What will alleviate the problem?

Answer 19

Diarrhea, Constipation. Alternating between calcium or aluminum coding compounds in the museum containing compounds should alleviate the problem.

Question 20

Calcium or aluminum base antacids such as tums can cause this

Answer 20

Constipation

Question 21

Magnesium compound antacids, such as milk of magnesia can cause this

Answer 21

Diarrhea

Question 22

Drug class: histamine-2 receptor antagonists; actions- how is this product used after surgery

Answer 22

Used after surgery to reduce post op nausea, and acid secretion

Question 23

Drug class: histamine-2 receptor antagonists; actions- what receptors do these antagonists block? What is the result? What does this do to the stomach contents pH?

Answer 23

Blocks the H2 receptors, result in a decrease of acid volume secreted, pH of the stomach contents rises as a consequence of a reduction in acid

Question 24

Drug class: histamine-2 receptor antagonist; availability, dosage, and administration- due to an acid therapy being continued during early therapy of PUD, When should antacid be administered before and/or after the H2 antagonist dose

Answer 24

One hour before or two hours after

Question 25

What is the drug class of Tagamet?

Answer 25

Histamine-2 receptor antagonist

Question 26

Drug class: Gastrointestinal prostaglandin; actions- what is an example of a synthetic prostaglandin E-series drug

Answer 26

Misoprostol

Question 27

Misoprostol is used to prevent what

Answer 27

Used to prevent gastric ulcers caused by prostaglandin inhibitors

Question 28

What is an example of a prostaglandin inhibitor?

Answer 28

NSAIDs, including aspirin

Question 29

Prostaglandin inhibition in the stomach caused by NSAIDs makes a patient more predisposed to this

Answer 29

Gastric ulcers

Question 30

Drug class: gastrointestinal prostaglandin; common adverse effects- gastrointestinal: what is a common adverse effects associated with misoprostol therapy that takes affect after approximately two weeks that resolves in about eight days

Answer 30

Diarrhea

Question 31

What can minimize the Gastrointestinal common adverse effects of Misoprostol

Answer 31

Take medication with meals and at bedtime and avoid using magnesium containing an acid such as Maalox liquid and Mylanta

Question 32

Drug class: proton pump inhibitors; actions- what is the action of PPIs in relation to gastric secretion of hydrochloric acid

Answer 32

PPIs inhibit gastric secretion of hydrochloric acid by inhibiting the gastric acid (adenosine triphosphate {ATP} pump) of the stomach‘s parietal cells

Question 33

Drug class: coating agent; dosage and administration- how many tablets a day one hour before each meal, and a bedtime on an empty stomach or full stomach?

Answer 33

One tablet, four times a day, one hour before each meal, and at bedtime, all on an empty stomach

Question 34

Drug class: prokinetic agent; actions- how do drugs in this class reduce reflux (by increasing the pressure of what)

Answer 34

Increasing the lower, esophageal sphincter pressure which reduces reflux

Question 35

Drug class: prokinetic agent; metoclopramide is what kind of agent? motility or inmotility

Answer 35

Motility

Question 36

metoclopramide relaxes the pyloric valve and increases peristalsis in the G.I. tract resulting in what

Answer 36

Resulting in an increased rate of gastric emptying an intestinal transit

Question 37

Drug class: prokinetic agent- Metoclopramide; what are the common uses?

Answer 37

Metoclopramide used to relieve the symptoms of gastric reflux, esophagitis, and diabetic gastroparesis, as an aid in small bowel, intubation and stimulate gastric, emptying and intestinal transit of barium after radiologic examination of the upper G.I. tract.

Question 38

Drug class: prokinetic agent- metoclopramide- how is this used after surgery?

Answer 38

Used after surgery to wake up bowels

Question 39

Drug class: prokinetic agent; metoclopramide - when would this be used to treat GERD

Answer 39

when lifestyle and diet changes are ineffective

Question 40

SAE of metoclopramide

Answer 40

extrapyramidal symptoms- risk of seizures

Question 41

CAE of metoclopramide

Answer 41

neurologic: drowsiness, fatigue, lethargy, dizziness
gi: nausea and diarrhea

Question 42

Drug classes used to treat Gastroesophageal reflux and peptic ulcer disease

Answer 42

antacids, histamine-2 receptor antagonists, gastrointestinal prostaglandin, proton pump inhibitors, coating agents,