Chapter 50 Flashcards by Lisa Guerino

The stomach is lined with secretory cells. true or false?

true

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The stomach is very acidic, there’s Hydrochloric acid (HCl) present. This aids in digestion but what else does it do for the stomach?

it’s a barrier against infection and microorganisms

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List the 3 types of cells (highlighted) of the Gastric Gland

* Parietal Cells * Chief Cells * Mucous Cells

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Which specific cell type ( of the Gastric Gland ) produces and secretes HCl?

(hydrochloric acid)

Parietal cells

(acidic secretions)

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Which of the 3 gastric gland cells is the Primary site of action for many acid-controller drugs?

Parietal Cells

(secrete HCl)

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Which proenzyme do Chief cells secrete?

Pepsinogen

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When Pepsinogen becomes activated by being exposed to acid, what does it become?

Pepsin

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Which of the 3 types of gastric gland cells are considered surface epithelial cells because of where you find them?

Mucous cells

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What do mucous cells provide that helps protect against self-digestion by HCl?

a protective mucus coat

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What do mucous cells secrete?

(don’t overthink it)

mucus

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What does being a proenzyme mean?

(like pepsinogen)

it’s an enzyme precursor

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What is actually happening when Pepsinogen is exposed to acid?

Pepsinogen activates and becomes Pepsin (the acid breaks it down) then it’s in it’s activated form which is Pepsin

Pepsin then assits in digestion process because it breaks down proteins

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What is the commonly talked about stomach bacteria that gets in and causes infection?

H. pylori

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What stimulates Parietal cells to secrete Hydrochloric Acid?

food

large fatty meals
excessive alcohol
emotional stress
Chocolate

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What range is the pH of our stomach

1-4

very acidic

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What do PUD and GERD stand for?

PUD= Peptic Ulcer Disease

GERD= Gastroesophageal Refux Disease

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What do they find in the GI Tract of 90% of the patients that have duodenal ulcers and 70% of those with gastric ulcers?

H. pylori

(Helicobacter pylori)

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How do you detect H. pylori and how is it treated?

*detected by serum antibody tests

*treated with antibiotics

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What is the most common Acid-related Disease?

hyperacidity

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PUD, GERD, and H. pylori all have what in common?

they are all related to excessive acid in the stomach

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H. pylori caneasily be treated with antibiotics. If you don’t treat H. pylori with antibiotics, it can get out of control and eventually lead to ______.

cancer

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What are the 3 types of Acid-controlling drugs

Antacids
H₂ antagonists
Proton pump inhibitors

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Do Antacids neutralize or lessen stomac acid?

neutralize

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Do Antacids STOP THE PRODUCTION/ OVERPRODUCTION of acid in the stomach?

NO!

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What helps "buffer" the acidic properties of the HCl (hydrochloric acid)?

bicarbonate (buffers, chemicals used by the body to prevent sudden, rapid changes in the pH of a fluid)

Antacids promote gastric mucosal defense mechanisms by Secretion of : 1. \_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_\_\_\_ 3. \_\_\_\_\_\_\_\_\_\_\_\_\_\_

1. mucus 2. bicarbonate 3. prostaglandins

Takin an Antacid leads to the production of mucuc, bicarbonate, and prostaglandins. What is the function of the prostaglandins that are secreted in the stomach

prevent activation of proton pump

Drug effects expected from an antacid are overall symptomatic relief. Antacids don't do anything to remedy the cause of the problem true or false?

true

Antacids reduce the acidity (by raising pH) and this leads to relief from pain. What is causing the pain?

the acid causes the pain

Raising the Gastric pH by _ point neutralizes 90% of the gastric acid

1 point | (1.3 pH - 2.3 pH )

Raising gastric pH from ___ to ___ neutralizes 50% of the gastric acid

1.3 - 1.6

The majority of Antacids are available over- the- counter as capsules, tablets, powders, liquids and suspensions. You can buy Antacids prepared in one of two ways. What are the two options?

Antacids alone or Antacids in combination with * aluminum salts * magnesium salts * calcium salts * sodium bicarbonate

What effects do Aluminum salts have?

constipation

Doctors recommend Aluminum salts (antacids) to patients that have _____ disease, as long as _________ is not included, because they are easiest to excrete.

renal disease magnesium not included

Why might they include magnesium in an aluminum salt antacid?

to counteract constipation

Aluminum and _______ cause patients to be constipated

aluminum and calcium

\_\_\_\_\_\_\_\_ salts are "safer" than calcium or magnesium would be for renal disease patients

aluminum salts | (safer, but still not completely safe)

What is the common side effect of Magnesium salts?

commonly cause diarrhea (they are normally used with other drugs to counteract the effect)

Which of the antacid "salts" is the **_most_** dangerous for patients with renal disease because of the failing kidney not being able to excrete it which leads to accumulation?

Magnesium Salts

Which form of antacid (salt) is the oldest and most common

Calcium salts

Name the most common form of Calcium salt (antacid)

Carbonate

Give two common side effects of Calcium Salts (antacids)

* constipation * kidney stones

Calcium salts are not recommended for patients with Renal failure because just like magnesium, it is difficult for the kidneys to excrete it so then the calcium accumulates in the system.. It accumulates to extremely toxic levels and having too much Calcium accumulate in your system can cause major issues with which two main areas of the body?

Cardiac issues Muscular issues

Give a few descriptive factors about Sodium bicarbonate (a common antacid)

highly soluble, quick onset short duration, **buffers the acidic properties of HCl**, may cause metabolic alkalosis

What would be the cause of metabolic alkalosis?

too much bicarbonate in the blood

What part of sodium bicarbonate might cause problems with patients that have HF (heart failure), hypertension, or renal insufficiency? (people with these conditiond should not take sodium bicarbonate)

the Sodium content

Lots of H+ means a ____ pH Lots of -OH means a ____ pH

low (very acidic) high (very alkaline)

What are Antiflatulants used for?

used to relieve the painful symptoms associated with gas

often times, antiacid combination products are combined with what?

antiflatulants

What does Mylicon (Simethicone) do for infants ?

relieves gas by altering the elasticity of the gas pockets causing them to break so that the gas does not build up

What are the drug interactions that we need to worry about when taking antacids?

taking antacids will.... \*reduce the ability of other drugs to be absorbed into the body \* Chelation (can render a drug you're taking completely inactive because it's been chelated) \*increased stomach pH (increase absorption of basic drugs, decrease absorption of acidic drugs) \*increase urinary pH (increase excretion of acidic drugs, decrease excretion of basic drugs)

H₂Antagonists are used for people who have what diseases and issues?

* GERD * PUD * erosive esophagitis * Adjunct therapy to control upper GI Bleeding * Pathologic gastric hypersecretory conditions

When you need to administer another medication as well as an antacid, make sure to give the other medication _ hour before or _ hours after the antacid

1 hour before 2 hours after

Antacids may cause premature dissolving of what type of medication that will ultimately result in stomach upset?

Enteric-coated medications

With Antacids, chewable tablets must be chewed thoroughly and liquid forms must be shaken well. true or false?

true

How many ounces of water should you drink along with your antacid to enhance absorption? (except for "rapid-dissolve forms")

at least 8 ounces

Longterm self-medicating with antacids could be masking symptoms of serious underlying diseases such as ______ or ________ \_\_\_\_\_

cancer bleeding ulcers

What specific type of Antagonist is Pepcid (famotidine) or Zantac (ranitidine)?

H₂Antagonist (Histamine type 2) (used to be Rx only but now most available over-the-counter in lower dosage forms)

How do H₂Antagonists work?

these drugs work by blocking histamine at the histamine type 2 (H₂) receptors in acid producing parietal cells

Name a drug effect of an H₂Antagonist

suppressed acid-secretion in the stomach

When H₂Antagonists block the H₂ receptors in the acid-producing parietal cells, the production of ________ ions is reduced, resulting in decreased production of HCl in the stomach

Hydrogen Ions reduced

There are very few adverse effects to taking an H₂ Antagonist true or false?

true

H₂Antagonist Cimetidine, may cause _________ and gynecomastia. in elderly patients it mayalso cause headaches, lethargy, confusion, diarrhea, urticaria, sweating, and flushing

impotence

Chapter 50 Flashcards

(66 cards)