Flashcards in Acid-peptic disorders Deck (27):
What are examples of sodium bicarb antacids
Unique ADE of sodium bicarb antacids
may exacerbate fluid retention in HF, HTN, and Renal insufficiency pts
Example of Calcium carbonate antacids
2 ADEs of sodium bicarb and calcium carbonate antacids
-CO2 gastric distention
If you want to advise your patient to take antacids but want to avoid the AED of belching, what kind of antacid do you prescribe?
How do H2 receptor antagonists work?
-competitive inhibition of H2 cells
-reduce acid secretion and volume
-ALSO reduce acid secretion stimulated by histamines
-do not affect H1 receptors
What 2 populations should H2 receptor antagonists be avoided in?
Pregnant/breastfeeding- crosses the placenta
elderly pts w/ renal dysfxn- can cause mental status changes
Examples of H2 receptor antagonists
Examples of PPIs
how do PPIs work?
inactivation of acid pumps, no effect on quiescent pumps
What are some ADEs of PPIs
iron, calcium, magnesium deficiency
c. diff infection
how long does it take for PPIs to wear off
takes 18 hrs for new H+ molecules to be formed
can last up to 24 hrs
when instructing a pt on when to take PPIs, what is important about the time the medication is taken
bioavailability of decreased by ~50% w/ food, so take 30-60 mins before meal (usu breakfast)
How does Sucralfate work?
forms a viscous paste that coats ulcers for 6 hrs
stimulated mucosal prostaglandin/bicarb secretion
prevents stress related bleeding
Example of Prostaglandin analog
what are the primary GI mucosal prostaglandins?
E & F
True or false:
Acid suppression is more dependent on irreversible inactivation of the proton pump than the pharmacokinetics of different agents
Decreased gastric acidity from PPI may alter absorption of what drug?
Omeprazole may inhibit metabolism of what drug?
What PPI has no significant drug interactions?
How do Prostaglandin analogs work?
inhibits acid secretion
protects the mucosa
what are the uses of Prostaglandin analogs?
reduce NSAID-induced ulcers less than 3% and the incidence of ulcer complications by 50%
What group of people should prostaglandin analogs not be used in and why?
how does bismuth work?
coats ulcers and erosions, creating a protective layer against acid and pepsin
also has direct antimicribial effects- preventing and treating traveler's diarrhea
ADEs of bismuth
darkening of tongue
AED of Sucralfate