Flashcards in Exam 2 Gastro Deck (44):
Name the condition: acid regurgitation back into the esophagus and oral cavity
Name the condition: excessive acid production
Name the condition: ulceration of the walls of the esophagus
Name the condition: lining of esophagus altered to resemble that in intestines
4 symptoms of common GI disorders
1. acidic taste
2. pain/burning sensation
3. difficulties with digestion
4. ulceration and bleeding
6 oral symptoms of common GI disorders
1. tooth erosion
2. irritation of the buccal mucosa
4,. burning mouth/tongue
5. inflammation of oropharynx
6. ulceration of pillars and pharyngeal walls
MOA for antacids
weak bases that interact with stomach acid to form water and salt, act local locally to treat excess acidity, raise gastric pH
Antacids do NOT inhibit ____ production by ____ cells
(need HCL for digestion, pepsin maximally active at pH = 2, when pH >4, pepsin activity decreases, best antactids are those that buffer to a pH of 3-4)
2 examples given in class of antacids
milk of magnesia
MOA for aluminum products
aluminum is an astringent to stop bleeding, coats and protects ulcers from H+, and interferes with absorption of tetracyclines
example of an aluminum product discussed in class
another name for buffered aspirin
What drug form complexes with albumin, fibrinogen, and globulin on ulcer surfaces, thus creating protective barrier to acid and pepsin?
Carafate - interferes with the absorption of many medications
4 examples of histamine H2 receptor antagonists discussed in class
Zantac - preferred by GI docs
Histamine H2 receptors are most know for what?
Nocturnal acid control - address multiple symptoms
Proton pump inhibitors - Bind to ______ enzyme system in parietal cells, ____ gastric secretions, ______ gastric acid after release, and protect _____ _____ from damage. Used as a long term acid suppression with ___ onset and ___ nocturnal acid control.
5 discussed PPIs
Which PPI drug is second generation and better at healing erosive lesions than Prilosec? Used in the prevention and treatment of NSAID induced GI lesions
4 antibiotics used in the treatment of H. pylori
Antibiotics plus what other 2 drugs are used in combination to treat H. pylori
2. H2 receptor blocker
When treating H. pylori, what is the standard first line therapy?
1 week triple therapy consisting of amocicillin, clarithromycin and a PPI
If treating clarithromycin resistant strain of H pylori, what drug is added as part of the therapy?
Important drug interactions with GI medications: binding of drugs in stomach = _____. Also interferes with the _____ and ____ of many drugs.
Histamine antagonists decrease _____
histamine antagonists alter ____
Tagament increases serum concentration of what 3 things?
PPIs decrease absorption of ____ ____
5 side effects of GI medications
2. taste alteration
3. aphthous stomatitis
4. candidiasis (esophageal)
5. excessive salivation (mediated by vagus nerve in response to excessive gastric acid)
Higher prevalence of stomach ulcers seen is association with these 6 things
2. heavy drinkers
4. renal dialysis patients
5. uses of NSAIDS (chronic)
6. elderly (death from disease more likely)
H. pylori lives naturally where?
resides in the oral cavity but infects at the interface between surface of gastric epithelium and overlying mucous gel - usually acquired in childhood
4 contributing factors to ulcer formation
1. acid hypersecretion
3. stress - increase acid secretion
4. Use of NSAID > 1 month
H. pylori is associated with cancer of ____ ____ = lymphoma. Peptic ulcers rarely undergo transformation to _____. Ulcers in _____ _____ of stomach more likely to become malignant. ____ ____ caused by chronic use of PPis increases risk for stomach cancer
2 oral manifestations of peptic ulcer disease
1. vascular malformation of lip
2. enamel erosion
In patients with peptic ulcer disease, what medications should be avoided? and which one is ok?
Avoid aspirin and NSAIDS
Where is the site of ulcerative colitis?
large intestines and rectum
Where does Crohn disease manifest?
entire wall of bowel - focal ulcerations along any point of alimentary canal - most common in the terminal ileum
4 oral manifestations of Crohns
1. apthous ulcerations
2. mucosal ulcerations
3. diffuse swelling of lips/cheeks
4. cobblestone mucosal lesions
In pts with IBS why is the use of corticosteroids questionable
risk for adrenal suppresssion
3 categories of antidiarrheal agents and an example of each
1. Absorbents - Pepto-Bismol (caution with salicylate allergy)
2. Opioids-paregoric - Lomotil (codeine and diphenoxylate)
3. Ioperamide - Imodium (muscle relaxant, decreases gut motility)
4 classes of laxatives
Which class of laxative uses magnesium salts? - used as prep for colonoscopy
Which class of laxative uses mineral oil/glycerin?
Lubricants, acts as emollients
Which class of laxative uses bisacodyl (dulcolax) or caster oil?
Contact - also can be used as colonoscopy prep