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Anti-ulcers Flashcards

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1
Q

Drug type for Sodium Bicarbonate

A

Systemic antacid, anti-ulcer

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2
Q

Hydrochloric acid release is influenced by what three biochemical mediators?

A

histamine
gastrin
acetylcholine

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3
Q

_____ ulcers are the result of gastric acid secretions in the esophagus as a result of a defective cardiac sphincter

A

ESOPHAGEAL

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4
Q

_____ ulcers occur TEN times more frequently than gastric or esophageal ulcers and are due to the hypersecretion of acid from the stomach.

A

DUODENAL

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5
Q

What are three causes of duodenal ulcers?

A

insufficient buffers.
defective pyloric sphincter.
hypermotile stomach.

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6
Q

With a _____ ulcer, pain will occur 2-3 hours after eating

A

duodenal

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7
Q

If pain occurs 30 min to 1.5 hours after eating, this suggests WHAT type of ulcer?

A

GASTRIC

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8
Q

____ ____ is released by the parietal cells of the stomach.

A

hydrochloric acid

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9
Q

What is the goal pH of the stomach?

A

2-5

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10
Q

Which digestive enzyme is activated at a pH of 2?

A

pepsin

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11
Q

At what pH will pepsin activity decline?

A

5

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12
Q

What are some predisposing factors in Peptic Ulcer Disease?

A

mechanical disturbances
environmental factors
drugs

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13
Q

Which GRAM-NEG bacillus is a cause of many peptic ulcers?

A

Helicobacter pylori

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14
Q

Treatment for peptic ulcers caused by H. pylori will usually include…

A

dual, triple, or quadruple drug therapy for 7-14 days.

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15
Q

WHICH medication type is usually added to peptic ulcer treatment to suppress acid secretion, continuing for up to 6 weeks following antibiotic therapy?

A

PPI

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16
Q

What is the main cause of GERD?

A

incompetent Lower Esophageal Sphincter

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17
Q

Anti-ulcer drugs to neutralize gastric contents and reduce acid secretion in GERD therapy include WHICH DRUG TYPES?

A

H2 blockers such as ranitidine.
and
Proton Pump Inhibitors such as Omeprazole, Lansoprazole, Pantoprazole.

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18
Q

Does GERD resolve completely after treatment?

A

No, it is a chronic disorder requiring continuous management.

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19
Q

What are some NONpharmacologic methods for PUD and GERD?

A 
avoid smoking and alcohol. 
Weight loss.
Avoid spicy foods. 
Avoid NSAIDs
Take glucocorticoids with food--- they can cause ulceration. 
Raise head of bed. 
Do not eat before bed. 
Loose fitting clothing.
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20
Q

THIS DRUG TYPE is no longer commonly used in PUD treatment. It has minimal effect, but it dies reduce vagal stimulation and decrease anxiety.

A

TRANQUILIZERS

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21
Q

The usage of THIS DRUG TYPE for PUD treatment has declined since the introduction of H2 blockers. It decreases GI motility and secretion, inhibits ACh, Blocks histamine and HCl, and is usually used in combination.

A

Anticholinergics

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22
Q

Since antacids slow the absorption of anticholinergics (among other drugs), when should antacids be taken?

A

At least 2 hours after taking anticholinergic.

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23
Q

THIS anti-ulcer DRUG TYPE has numerous SE including dry mouth, decreased secretions, headache, blurred vision, urinary retention, and drowsiness.

A

ANTI-CHOLINERGICS

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24
Q

THIS DRUG TYPE promotes ulcer healing by neutralizing HCl Acid, thereby reducing pepsin activity.

A

ANTACIDS

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25
What are the two types of Antacids?
Systemic & non-systemic
26
What is one example of a SYSTEMIC antacid?
Sodium Bicarbonate, e.g. alka-seltzer.
27
THIS SYSTEMIC ANTACID is seldom used because it has serious SE, including HYPERnatremia, water retention, metabolic ALKALosis, and rebound acid secretion.
Sodium Bicarbonate
28
What is one example of a NON-SYTEMIC ANTACID?
Aluminum Hydroxide
29
THIS DRUG TYPE is composed of alkaline salts such as aluminum or magnesium. A very small amount of aluminum is absorbed systemically.
NON-SYSTEMIC ANTACIDS
30
Aluminum antacids are most likely to cause which SE?
CONSTIPATION
31
Magnesium antacids are most likely to cause which SE?
DIARRHEA
32
THIS NON-SYSTEMIC ANTACID can also help to treat hyperphosphatemia.
Aluminum Hydroxide
33
Adverse Reactions to THIS DRUG include *Hypophosphatemia*, hypercalcemia, hypomagnesemia, osteoporosis, *nephrolithiasis*, and long-term GI obstruction
Aluminum Hydroxide (a non-sytemic antacid)
34
Impaired cognition can be a side effect of this antacid.
Aluminum Hydroxide
35
Which baseline assessments are especially important before Aluminum Hydroxide treatment for peptic ulcer?
renal, electrolytes - especially phosphate and calcium.
36
What is important to remember about antacids if you are also taking other medications?
Antacids will delay absorption of other drugs, so they should be given 1-3 hours before or after other medications.
37
Should antacids be taken with Vitamin D or milk?
NO
38
Should water be consumed after taking an antacid?
YES
39
What is a common side effect seen in stools during antacid therapy?
whitish color stools
40
THIS DRUG TYPE blocks the Histamine-2 receptors of the parietal cells in the stomach, reducing gastric acid secretion and concentration.
H2 Blockers/ H2 Receptor Antagonists
41
In patients with renal insufficiency, the dosage of H2 Blockers may need to be...
REDUCED
42
What is one example of an H2 Blocker?
Famotidine
43
What are the pharmacodynamics of Famotidine?
Inhibits gastric acid secretion by blocking the H2 receptors of parietal cells in the stomach.
44
THIS H2 BLOCKER is used to prevent and treat peptic ulcers, pyrosis, dyspepsia, esophagitis, GERD, and Zollinger-Ellison Syndrome
Famotidine
45
Famotidine can cause decreased absorption of what essential mineral? And for this reason, it should be used with caution in Vitamin B12 deficiency, as anemia may result.
Iron
46
Although drugs that reduce stomach acid usually decrease effects of many drugs, mainly by slowing their absorption, FAMOTIDINE increases the action of THIS antidiabetic biguanide.
METFORMIN
47
Famotidine is likely to increase WHICH lab result?
Serum alkaline phosphatase
48
Palpitations and gynecomastia are adverse reactions of THIS H2 blocker
famotidine
49
Blood dyscrasias, HEPATOTOXICITY, and cardiac dysrhythmias are serious adverse reactions to which anti-ulcer drug?
Famotidine
50
Confusion, agitation, and depression may be side effects of THIS anti-ulcer
Famotidine
51
Before administering Famotidine, the nurse should assess WHICH baseline labs?
Liver function, GI status
52
When should H2 Blockers be administered?
Just before meals and at bedtime.
53
THIS DRUG TYPE suppresses gastric acid by inhibiting the hydrogen/potassium ATPase pump located in parietal cells.
Proton Pump Inhibitors
54
THIS DRUG TYPE inhbits gastric acid secretion 90% more than H2 blockers.
Proton Pump Inhibitors
55
THIS DRUG TYPE blocks the final step of gastric acid production
Proton Pump Inhibitors
56
Long term usage of PPIs can lead to...
osteoporosis and hypomagnesemia
57
What is one example of Proton Pump Inhibitors>
PANTOPRAZOLE
58
What is the mechanism of action of Pantoprazole?
Inhibits gastric acid secretion by inhibiting the hydrogen/potassium ATPase pump in parietal cells.
59
One use of THIS DRUG is to prevent NSAID-induced ulcers
PANTOPRAZOLE
60
Adverse reactions of PANTOPRAZOLE include hypertriglyceridemia and hyperbilirubinemia, so it should be used with extreme caution in ...
hepatic impairment
61
This PPI may cause dry mouth, blurred vision, and itchy rash.
PANTOPRAZOLE
62
Older adults may need to ________ dosing of Pantoprazole due to their lower production of gastric acid.
REDUCE
63
One serious adverse reaction Pantoprazole is...
GI Bleeding
64
Because GI bleeding is one serious adverse reaction of Pantoprazole, it is important for the patient to report WHICH conditions?
Coughing or vomiting blood, blood in sputum or stools, GI pain
65
Smoking has WHAT effect on Pantoprazole?
Decreases efectiveness
66
True/False It is important to take Pantoprazole EXACTLY as prescribed?
TRUE
67
THIS DRUG TYPE forms a protective coating on the ulcer surface
PEPSIN INHIBITORS
68
What is one example of Pepsin Inhibitors?
Sucralfate
69
This drug is most likely to be used to prevent gastric mucosal injury from drug-induced ulcers, but it can be used to manage existing ulcers.
SUCRALFATE
70
HYPERGLYCEMIA is an adverse reaction in SUCRALFATE use, so it should be used with caution in patients with ____ _____.
Diabetes Mellitus
71
______ (a pepsin inhibitor) should be used with caution in Renal Impairment.
SUCRALFATE
72
HYPOphosphatemia is an adverse reaction of THIS pepsin inhibitor.
SUCRALFATE
73
WHICH baseline labs would be important to assess before SUCRALFATE therapy?
Renal Function, Electrolytes
74
If a patient is using SUCRALFATE with other medications, how does this affect their drug schedule?
Allow 1-2 hours between sucralfate and other drugs
75
Approximately how long does Sucralfate take to achieve optimal ulcer healing?
4-8 weeks
76
This pepsin inhibitor is likely to cause _____, which can be mitigated by increased fluids, fiber, and exercise.
Constipation
77
THIS DRUG is a Prostaglandin Analogue Antiulcer Drug
MISOPROSTOL
78
This drug suppresses gastric acid and increases production of protective mucus, but it can also cause menstrual spotting AND may induce labor and harm a fetus.
MISOPROSTOL
79
This anti-ulcer must be avoided in pregnancy and in women of child-bearing capacity.
MISOPROSTOL
80
Aluminum Hydroxide drug type
non-systemic antacid, antiulcer
81
Famotidine drug type
H2 blocker, antiulcer
82
pantoprazole drug type
proton pump inhibitor, antiulcer
83
sucralfate drug type
pepsin inhibitor/mucosal protective agent, antiulcer
84
misoprostol drug type
prostaglandin analogue antiulcer

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