Chapter 39: Acid Controlling Drugs

Question 1

What do parietal cells secrete?

Answer 1

HCL

Question 2

What are the hormones that parietal cells have receptors for?

Answer 2

ACH, histamine, gastrin

Question 3

What is the pH of the stomach?

Answer 3

1-4

Question 4

What do chief cells do?

Answer 4

secrete pepsinogen

Question 5

What does pepsinogen do?

Answer 5

becomes pepsin when exposed to acid and then pepsin digests proteins

Question 6

What do mucus cells do?

Answer 6

secrete mucus

Question 7

What are the most harmful disorders related to acid production?

Answer 7

PUD, esophageal cancer

Question 8

What things can cause hyperacidity?

Answer 8

food, caffeine, alcohol, overconsumption of fatty meals, emotional stress

Question 9

What is triple therapy?

Answer 9

clarithromycin, amoxicillin/metronidazole and proton pump therapy

Question 10

What does triple therapy treat?

Answer 10

H. pylori

Question 11

What is quadruple therapy?

Answer 11

proton pump inhibitor, bismuth subsalicylate, tetracycline, and metronidazole

Question 12

Why would patients be put on proton pump inhibitors as prophylaxis?

Answer 12

to prevent ICU pts from getting ulcers. Those in ICU and traumatic states have lower blood flow to the stomach and are at risk for developing uicers

Question 13

Name the drug classes of acid controlling drugs

Answer 13

Antacids, H2 receptor antagonists, Proton pump inhibitors

Question 14

What do antacids do?

Answer 14

Buffers/neutralizes the HCL

Question 15

How do antacids buffer the HCL?

Answer 15

it prevents histamine from binding to the parietal cells which means no CAMP and then the proton pump can’t be activated

Question 16

What are the forms of antacids?

Answer 16

Aluminum, magnesium, calcium, sodium bicarb, combo format

Question 17

Does Mg cause constipation or diarrhea?

Answer 17

natural laxative that prevents constipation

Question 18

Does calcium and aluminum cause diarrhea or constipation?

Answer 18

constipation

Question 19

What can happen if a person takes a whole bottle of antacids?

Answer 19

metabolic alkalosis

Question 20

What is acid rebound?

Answer 20

when hyperacidity comes back after antacid use is discontinued

Question 21

What is another risk for continued antacid use?

Answer 21

hypercalcemia, milk-alkali syndrome, metabolic alkalosis

Question 22

What are the interactions of antacids?

Answer 22

Chelation, increased stomach pH, Increased urinary pH

Question 23

What is chelation?

Answer 23

antacid makes other drugs chemically inactive, reduces the drug absorption

Question 24

What happens when antacids increase the stomach pH?

Answer 24

Increases absorption of basic drugs and decreases absorption of acidic meds

Question 25

What happens when antacids increase urinary pH?

Answer 25

increase excretion of acidic meds, decrease in excretion of basic meds

Question 26

How should you space meds out with antacids?

Answer 26

1 hour before or after

Question 27

What med do you not want to give with antacids?

Answer 27

quinolones

Question 28

What do H2 receptors do?

Answer 28

make parietal cells less responsive to histamine

Question 29

How do h2 receptors work?

Answer 29

competitive blocking of histamine receptors so you have less hydrogen ions

Question 30

Can you use H2 receptors with antacids?

Answer 30

no, take them before or after

Question 31

What are proton pump inhibtors?

Answer 31

stop the secretion of HCL

Question 32

How do proton pump inhibitors work?

Answer 32

irreversibly bind to hydrogen, potassium, and ATPase enzyme. When bound all gastric secretion is blocked.

Question 33

What is sucralfate?

Answer 33

a pepsin inhibitor used for pud or stress ulcers. Coats the GI tract and is a protective medication

Question 34

What is a proton pump inhibitor a first line treatment for?

Answer 34

erosive esophagitis, GERD, active duodenal ulcers, gastric ulcers

Question 35

What is long term use of proton pump inhibitors associated with?

Answer 35

C diff

Question 36

What should you instruct people taking acid controlling drugs to do?

Answer 36

Drink at least 8 ounces of water to increase absorption, chew chewable tablets thoroughly and shake liquids before use. Watch for changes in BP, GI bleeds, GI irritation

Question 37

What are the adverse effects of taking acid controlling drugs?

Answer 37

constipation, diarrhea, nausea, vomiting, abdominal pain, hypotension