Ch36 UPPER GI TRACT DRUGS

Question 1

What is amylase

Answer 1

A enzyme that breaks down carbs

Question 2

What are gastric secretions primarily regulated by

Answer 2

By the parasympathetic nervous system

Question 3

Where is vomiting of the GI contents controlled

Answer 3

By the vomit center in the medulla of the brain, additionally the VC can be stimulated when the chemoreceptor trigger zone is stimulated

Question 4

What is GERD

Answer 4

Allows stomach acid to back up into the esophagus

The 4 major symptoms are heartburn,regurgitation, dysphasia, and waterbrash

Question 5

What is H pylori

Answer 5

A gram negative spiral bacterium that weakens the protective mucous lining of the stomach and duodenum

Question 6

What is peptic ulcer disease

Answer 6

Is a general term that refers to ulcer formation in the stomach, esophagus, or duodenum

Question 7

What is pancreatitis

Answer 7

Occurs when digestive enzymes production is reduced or no longer occurs

Question 8

What is nausea and vomiting controlled by

Answer 8

It is caused by stimulation of the chemoreceptors in the brain and GI tract

Question 9

What are proton pump inhibitors

Answer 9

Omerprazole ( Prilosec)
It blocks the final step of gastric acid production
It is used for the treatment of heartburn and GERD

Question 10

What are adverse effects of Omerprazole ( Prilosec)

Answer 10

Headache

Diarrhea

Question 11

What is a important culture trait to remember when administering Prilosec

Answer 11

Longer duration in Asians

Question 12

When elderly clients are prescribed Omerprazole, what supplement should be suggested

Answer 12

Suggest calcium citrate supplementation for elderly patients on long term therapy

Question 13

When should Omerprazole be taken

Answer 13

One hour before meals

Question 14

What are histamine-2 receptor antagonists

Answer 14

They block the effect of histamine at the H2 receptors in the parietal cells of the stomach. This action inhibits gastric acid secretion in all phases and other secretions caused by histamine.
They also reduce the volume and concentration of gastric secretions.

Question 15

What is the prototype H-2 receptor antagonist

Answer 15

Ranitidine ( Zantac)

Question 16

What is ranitidine used for,

Answer 16

Treatment of ulcers

It inhibits both daytime and nocturnal basal gastric acid secretions

Question 17

What are adverse effects of ranitidine

Answer 17

Headache, blood count changes, GI effects, hepatocellular, cholestatic, or mixed hepatitis

Question 18

How can one minimize adverse effects of ranitidine

Answer 18

Monitor serum trough levels in patients with renal failure or hepatic impairment
Administer ranitidine IV slowly to prevent hypotension and cardiac arrhythmias

Question 19

What are antacids

Answer 19

Drugs that increase the gastric pH
They are used for various upper GI disorders, including symptoms of GERD, esophagitis, hiatal hernia, gastritis, and peptic ulcer disease.
They are composed of inorganic salts

Question 20

What is the prototype antacid drug

Answer 20

Aluminum hydroxide with magnesium hydroxide ( maaolx, mylanta)

Question 21

What is aluminum Hydroxide used for

Answer 21

It relieves symptoms assoc with GERD

It raises the gastric pH in the stomach and duodenal bulb

Question 22

Aluminum hydroxide is contraindicated in who

Answer 22

Caution In patients with recent massive GI bleed

Question 23

What are adverse effects of aluminum hydroxide

Answer 23

Osteomalacia. Encephalopathy, and rebound gastric acid production

Question 24

How can one minimize adverse effects of aluminum hydroxide

Answer 24

Administer 2 hours after other drugs to prevent drug interactions
Caution patients not to take the maximum dose for longer than 2 weeks

Question 25

What is the most serious adverse effect of aluminum hydroxide

Answer 25

Electrolyte imbalance

Question 26

What are pro kinetic agents

Answer 26

They increase the effects of acetylcholine on the GI system Acetylcholine is responsible for normal GI function Pro kinetic agents increase peristalsis and gastric emptying

Question 27

What is the prototype pro kinetic drug

Answer 27

Metoclopramide ( reglan)

Question 28

What does metoclopramide do

Answer 28

It relieves symptoms of diabetic gastroparesis

Question 29

What are contraindications of metoclopramide

Answer 29

GI hemmorrhage, perforation, or mechanical obstruction

Question 30

What are adverse effects of metoclopramide

Answer 30

Restlessness, drowsiness, depression, insomnia, headache, anxiety, dizziness, and confusion.

Question 31

What are drug interactions of metoclopramide

Answer 31

Levodopa, anticholinergics, And narcotics

Question 32

What can one do to maximize therapeutic effects of metoclopramide

Answer 32

Give oral doses 30 minutes before each meal | Do not administer metoclopramide with ANTICHOLINERGIC drugs

Question 33

What are digestive enzymes

Answer 33

They are responsible for breaking down food into forms that can be easily absorbed in the GI tract

Question 34

What is the prototype digestive enzyme

Answer 34

Pan relapse ( pancreas MT, viokase, cream, lipram,pancrecarb, panocaps)

Question 35

What is the digestive enzyme pancrelipase used for

Answer 35

Replacement therapy for patients with deficient exocrine pancreatic secretions.

Question 36

What does pancrelipase contain

Answer 36

Lipase, protease, and amylase which are responsible for the final phase of digestion

Question 37

What are adverse effects of pancrelipase

Answer 37

Nausea Abdominal cramps Diarrhea

Question 38

What are drug interactions of pancrelipase

Answer 38

Antacids calcium carbonate and magnesium hydroxide, iron preparations

Question 39

How often should pancrelipase be administered

Answer 39

Every time the person eats

Question 40

Pancrelipase is contraindicated in who

Answer 40

People allergic to pork

Question 41

What are lipase inhibitors

Answer 41

Used specifically for long term weight reduction

Question 42

What is the prototype lipase inhibitor

Answer 42

Orlistat ( Xenical)

Question 43

What does orlistat ( Xenical) do

Answer 43

Manages obesity

Question 44

How can one maximize the therapeutic effects of orlistat ( Xenical)

Answer 44

Take with all meals that contain fat

Question 45

How can one minimize adverse effects of orlistat

Answer 45

Advise to take a multivitamin that contains fat soluble vitamins to,prevent imbalances fro drug therapy