GERD/IBS/UC/CD Questions Flashcards
(180 cards)
0
Q
T/F: GERD may increase the risk for development of chronic disease(s)
A
true
such as asthma
1
Q
what are some foods that can contribute to GERD?(8)
A
- Citrus fruits
- chocolate
- caffeinated beverages
- Fried and fatty food
- mint flavoring
- spicy food
- tomato-based foods/sauces
- garlic and onions
3
Q
what causes reflux?(3)
A
- natural body processes fail to prevent backflow
- pressure in the stomach causes the LES to open and leak back up
- delayed gastric emptying or transient relaxation of the LES
4
Q
what does LES stand for?
A
Lower Esophageal Sphincter
5
Q
T/F: Hiatal Hernia is always a significant risk factor for GERD
A
false
significant risk factor for GERD in persons over 50 years old
6
Q
what kind of drugs are acid suppressing drugs?(2)
A
- histamine2 receptor antagonists
- proton pump inhibitors
7
Q
T/F: infants may have GERD because their digestive system is immature
A
true
8
Q
what has been found to be linked to more severe esophagitis?
A
large hiatal hernias
8
Q
what kind of factors contribute to GERD?(6)
A
- foods
- lifestyle
- body position
- pregnancy
- obesity
- Rx and OTC medicines
10
Q
how can lifestyle be a factor contributing to GERD?(2)
A
- alcohol consumption
- cigarette smoking
11
Q
how is body position a contributing factor to GERD?
A
symptoms worsen in a prone position(lying down)
12
Q
what kind of drugs aggravate GERD?(5)
A
- impair peristalsis
- delay gastric emptying
- decrease esophageal sphincter tone
- decrease protective mucosal lining
- increase gastric acids
13
Q
what are some examples of drugs that aggravate GERD?
A
- Anticholinergics eg., hyoscyamine
- opioids eg., codeine
- calcium channel blockers eg., verapamil
- non-steroidal anti inflammatory drugs(NSAIDS) eg., naproxen
- xanthines eg.,theophylline
14
Q
T/F: naproxen is proven safe and effective in the treatment of GERD
A
false
naproxen is a NSAID, which are known to aggravate GERD.
15
Q
T/F: mint is useful in GERD relief
A
false
mint flavoring is a food factor contributing to GERD
16
Q
what is an ulcer?
A
an open wound or sore
17
Q
what kind of ulcer is located in the stomach?
A
gastric ulcer
18
Q
where would you find a peptic ulcer?
A
it is located in either the stomach or the duodenum
19
Q
what do you call an ulcer located in the upper region of the small intestine?
A
duodenal ulcer
20
Q
what are 5 risk factors for peptic ulcer disease?
A
- Helicobacter pylori (H. pylori)
- Family history of ulcers
- living with close relatives who have PUD
- age
- medicines
21
Q
does PUD stand for?
A
peptic ulcer disease
22
Q
T/F: persons over the age of 30 are at higher risk for PUD
A
false
persons older than 50
23
Q
what kind of medicines are risk factors for PUD?(3)
A
- salicylates (aspirin)
- NSAIDs (naproxen)
- corticosteroids (prednisone)
24
Q
what is the number one cause of PUD?
A
H. pylori
25
what is treatment PUD?
eliminate H. pylori
26
what are two treatment strategies for PUD, GERD and LPR?
1. reduce G.I. irritants
| 2. increase protective factors (mucus secretion by epithelial cells)
27
T/F: one treatment strategy of PUD, GERD and LPR is to increase protective factors, an example is mucus secretion by squamous cells
false
| mucus secretion by epithelial cells
28
what are acid neutralizing drugs?
antacids
29
what are you mucosal protectants?(2)
- prostaglandins
| - sucralfate
30
What are the 5 drug classifications for drugs used in the treatment of GERD and LRD?
1. acid neutralizing drugs
2. acid suppressing drugs
3. mucosal protectants
4. Anti-infectives
5. Prokinetic drugs
31
what are anti-infectives use for in the treatment of GERD and LRD?
eliminate H. pylori
32
what is an example of a prokinetic drug?
Metoclopramide®
33
what is the short name for histamine2 receptor antagonists???
H2 blockers
34
what is a common ending for H2-blockers?
-tidine
35
T/F: H2 receptor antagonists are available in by prescription only
false
| available in RX and OTC strengths
36
how do histamine2 receptor antagonists work?
they block histamine stimulated acid secretion by gastric parietal cells.
37
what is the most potent H2 receptor agonist?
ranitidine
38
T/F: dry mouth, headache, and constipation are common adverse effects for histamine2 receptor antagonists.
false
| they are common adverse effects associated with mucosal protectant-sucralfate
39
what are the adverse reactions of histamine2 receptor antagonist?(7)
```
dizziness/drowsiness
headache
constipation/diarrhea
nausea
abdominal pain
bloating
Gynecomastia- tagamet
```
40
what are some adverse effects of misoprostol?(5)
- abdominal cramps
- diarrhea
- menstrual irregularities
- headache
- dizziness
41
T/F: GERD is a motility disorder associated with impaired peristalsis
true
41
T/F: proton pump inhibitors have the common ending -tidine
false
| have the common ending -prazole
42
in addition to metoclopramide, what other drug is approved for the treatment of heartburn in Canada?
Domperidone®
44
what do proton pump inhibitors do?(2)
- increase gastric acids
| - interfere with the final step in gastric acid production
45
what drug is approved for prevention of NSAID-induced peptic ulcers?
misoprostol
46
what is sucralfate used for?
sucralfate is a mucosal protective agent approved for treatment and maintenance of duodenal ulcers.
47
how does sucralfate work?
- binds to the ulcerated l area and forms a protective barrier
- promotes regeneration of stomach epithelial cells
48
T/F: sucralfate is a weak inhibitor of H. pylori
true
49
what are some adverse effects of sucralfate?(4)
- constipation
- gas
- dry mouth
- headache
50
T/F: misoprostol is rated category A for pregnancy use.
false
| contraindicated in pregnancy because it stimulates uterine contractions
51
is currently the only prokinetic drug approved by the US FDA?
Metoclopramide
52
in what 3 ways does misoprostol help in the treatment of GERD, LRD and PUD?
1. stimulates production of protective mucus and bicarbonate in the stomach
2. increases regeneration of gastric epithelial cells
3. enhances blood flow to the stomach
53
T/F: flatulence, vitamin B12 deficiency, and dizziness or adverse reactions to proton pump inhibitors
true
53
which drug must be dispensed in the manufacturer's original container?
misoprostol
54
what can chronic exposure to gastric acid and pepsin lead to?(3)
- inflammation
- ulceration
- stomach cancer
56
what are the adverse reactions of prokinetic drugs?(8)
- drowsiness or dizziness
- bloating
- abdominal pain
- constipation or diarrhea
- restlessness
- headache
- skin rash
- irregular heartbeat
57
irregular heartbeat and restlessness are adverse reactions to what Drug classification?
Prokinetic drugs
58
T/F: antacids are available by prescription only
false
59
what are the 2 kinds of acid suppressing drugs used in the treatment of PUD, GERD, and LPR?
1. histamine2 receptor antagonists
| 2. proton pump inhibitors
60
nausea and vomiting, skin rash, agitation or dark yellow/brown urine are adverse reactions to what Drug classification?
proton pump inhibitors
60
what Drug blocks absorption of drugs taken at the same time?
sucralfate
61
what is an example of a prostaglandin?
misoprostol
62
how do antacids work?
neutralize gastric acids and decrease pepsin secretion
63
diarrhea is an adverse effect of what kind of antacid?
magnesium containing
64
what are the four kinds of antacids?
1. magnesium containing
2. aluminum containing
3. calcium containing
4. sodium bicarbonate
65
what kind of anti-infectives are used?
antimicrobials to eradicate H. pylori infection
66
what is sodium bicarbonate?
baking soda
66
what are 2 adverse effects of aluminum containing antacids?
1. constipation
| 2. hypophosphatemia
68
constipation, hypercalcemia, and kidney stones are adverse effects to what?
calcium containing antacids
69
what is hypophosphatemia?
electrolyte disturbance, in which there is abnormally low phosphate levels in the blood
69
why are anti-infectives prescribed in the treatment of GERD, PUD, And LPR?
prescribing combination with drugs that decrease gastric acids and protect the gastric mucosa
71
T/F: a salad with oil and vinegar dressing is a safe natural alternative for the treatment of GERD
false
| creamy and oil and vinegar salad dressings should be avoided
72
what are 4 common anti-infectives prescribed in the treatment of GERD, PUD and LPR?
1. amoxicillin-omeprazole-clarithromycin
2. amoxicillin-metronidazole-ranitidine
3. Clarithromycin-omeprazole
4. amoxicillin-omeprazole
73
_______ is approved for the prevention of NSAID-induced peptic ulcers.
misoprostol
74
rebound hyperacidity, metabolic alkalosis, edema and hypertension are adverse effects of what?
sodium bicarbonate antacids
75
T/F: fennel tea or chamomile tea have a soothing effect and are a good natural alternative to GERD
true
| sip slowly
76
T/F: juices are food to avoid
true
77
T/F: organic apple cider is a natural alternative in the treatment of GERD
true
| shake well; pulp contains enzymes to reduce acid
78
T/F: stress and spicy foods can cause ulcers
false
| however, some foods can aggravate existing GERD
79
what histamine2 receptor antagonists are used in the treatment of GERD?(4)
- cimetidine
- famotidine
- nizatidine
- ranitidine
80
Pepcid Complete belongs to what Drug classification?
H2 receptor antagonist combinations
81
T/F: Pepcid Complete is available as an OTC product
true
82
what are some unique symptoms of PUD?(3)
- Burning pain in the gut 2-3 hours after a meal
- weight loss
- loss of appetite
83
T/F: ranitidine capsules are prescription only
true
| only 75mg and 150mg tablets are OTC
84
Is nizatidine an OTC product?
yes, 75mg tablets (Axid AR) only
85
T/F: ranitidine is up to 10 times more effective than cimetidine
true
86
T/F: proton pump inhibitor drugs are more potent than H2 receptor antagonists
true
87
what are OTC proton pump inhibitors marketed for the treatment of?
heartburn
88
T/F: ant acids are the oldest drugs used for the treatment of GERD and LPR
false
| GERD and PUD
89
T/F: persons of any age can develop GERD
true
90
what is LPR?
laryngopharyngeal reflux
91
T/F: GERD, PUD, and LPR are known at chronic state to cause discomfort
false
although these diseases initially produce minor discomfort, they may progress into life-threatening hemorrhage or stomach cancer
92
unique symptoms of GERD(8)
- difficulty swallowing
- dry cough
- bad breath
- bloated
- rumbling noise in stomach
- belching or burping
- respiratory problems
- hoarseness
93
what are some common symptoms of GERD?(5)
- heartburn
- stomach ache
- Hunger pains
- nausea or vomiting
- chest pain
94
what are some unique symptoms of LPR?(9)
- hoarseness
- voice fatigue or breaks
- sore throat
- excessive phlegm or saliva
- chronic cough
- bad breath
- middle ear infection
- wheezing
- chronic sinusitis
95
T/F: red licorice can aggravates GERD
false
| Red licorice and jellybeans are safe natural alternatives
96
T/F: many prescription and OTC medicines can worsen GERD
true
97
what OTC products irritate the esophagus and may cause heartburn?
OTC iron and potassium supplements, and NSAIDs
98
what are some less common adverse effects of H2 receptor antagonists?
- skin rash
- agitation
- depression
- hepatitis
- decreased libido
- Gynecomastia
99
what drug binds to the ulcerated area and forms a protective barrier, much like a bandage protects a sore?
sucralfate
100
name 2 proton pump inhibitor drugs(6)
1. dexlansoprazole
2. esomeprazole
3. lansoprazole
4. omeprazole
5. pantoprazole sodium, pantoprazole magnesium
6. rabeprazole
101
_____-containing antacids cause diarrhea; _____-containing antacids cause constipation
magnesium ; aluminum or calcium
102
proton pump inhibitors are effective in treating GE already, LPR, and PUD because they ______
decrease gastric acid levels
103
which sphincter in the digestive system is affected by GERD?
lower esophageal sphincter
104
what is inflammatory bowel disease?
chronic disorder of the gastrointestinal tract characterized by inflammation of the intestine and resulting in abdominal cramping and persistent diarrhea
105
what is diarrhea?
abnormally frequent passage of loose and watery stools
106
what is irritable bowel syndrome?
condition that causes abdominal distress and erratic movement of the contents of the large bowel resulting in diarrhea and/or constipation
107
T/F: inflammatory bowel disease and irritable bowel syndrome are interchangeable terms
false
108
what is constipation?
abnormally delayed or infrequent passage of dry hardened feces
109
what is a laxative?
medicine induces evacuation of the bowel
110
what are some symptoms of Crohn's disease?
- rectal bleeding
- skin lesions
- decreased growth (children)
- fever
- arthritis(joint pain)
- anemia
- weight loss, loss of appetite
111
define: fistula
ulcer that tunnels from the site of origin to surrounding tissues
112
what are the two main types of IBS?
1. ulcerative colitis (UC)
| 2. Crohn's disease(CD)
113
T/F: an estimated 20% of people in North America have IBS
false
| 10% to 15%
115
what is Crohn's disease?
irritable bowel disease that produces inflammation and damage anywhere along the G.I. tract
116
what are the four inflammatory diseases of the bowel?
1. ulcerative colitis
2. Crohn's disease
3. ulcerative proctitis
4. pouchitis
117
T/F: UC only affects the colon and CD can involve any segment of the G.I. tract
true
| CD may also cause inflammation in the eye, mouth, or some joints
118
how do bulk forming laxatives work?
swells in the presence of liquid. Bacteria normally live in the colon and digest cellulose and polysaccharide fibers. As the bacteria colony grows, colonic bulk increases. This causes the bowel to feel full and stimulates evacuation
119
what is the only bulk forming laxative the FDA has approved for treatment of IBS? can it be obtained without a prescription?
Polycarbophil; yes
120
what kind of drugs are used in the treatment of IBS?(4)
1. anticholinergic
2. Fiber supplement
3. antidiarrheal
4. laxative
121
what are some adverse reactions of polycarbophil?(6)
- bloating
- gas
- abdominal cramps
- nausea
- diarrhea or constipation
122
in what dosage form(s) and strength(s) does polycarbophil come in?
tablet: 500 mg, 625 mg, 1250 mg chewable
123
why are opioid antidiarrheals administered?
to control watery and frequent stools
124
what opioid antidiarrheals are prescribed for the treatment of diarrhea?(3)
1. Difenoxin
2. diphenoxylate
3. loperamide
125
T/F: Difenoxin and diphenoxylate are more potent than loperamide
false
| Difenoxin and loperamide are more potent than diphenoxylate
126
T/F: Difenoxin and diphenoxylate are controlled substances and may produce dependence at high doses
true
127
_____ & _____ are the most common side effects of opioid antidiarrheals. they may also cause _____.
sedation and dizziness
| constipation
128
T/F: loperamide is habit-forming and therefore only available with prescription
false
| not habit-forming and is available without a prescription
129
what is toxic megacolon?
life-threatening condition characterized by a very inflated colon, abdominal distention, and sometimes fever, abdominal pain, or shock
129
why should antidiarrheals be used cautiously for patients with UC?
because they can cause toxic megacolon
130
T/F: IBS is sometimes called colitis
true
131
when are anticholinergic drugs used in the treatment of IBS?
when diarrhea is the primary symptom
132
T/F: anticholinergic agent dicyclomine, may cause hallucinations at high doses
true
133
name 3 bowel movement disorders
1. constipation
2. diarrhea
3. irritable bowel syndrome (IBS)
134
what is the main complication of diarrhea?
dehydration
135
what kind of drugs are used for the treatment of UC and CD?
aminosalicylates
136
what are the 3 aminosalicylate anti-inflammatory agents used in the treatment of UC and CD?
1. sulfasalazine
2. olsalazine
3. mesalazine
137
what 2 types of drugs are used for the treatment of UC?
1. aminosalicylates
| 2. corticosteroids
138
what 3 types of drugs are used for the treatment of Crohn's disease?
1. immunosuppressants
2. immunomodulators
3. anti-infectives
- -corticosteroids and aminosalicylates are also used
139
what are the two routes of administration of corticosteroids in the treatment of UC and CD?
by mouth or rectally in the form of an enema or suppository
140
_______is a time-release formulation (of aminosalicylates in treating UC and CD)
Pentasa
141
what are the five most common adverse effects of aminosalicylates?
- nausea
- vomiting
- heartburn
- headache
- watery diarrhea
142
what drug may cause sunburn, impaired folic acids absorption, crystalluria area, and damage to white blood cells (cytopenias)? what classification does it belong to?
Sulfasalazine , aminosalicylates
144
what is a common ending for aminosalicylates ?
-salazine
145
T/F: common endings for corticosteroids are -sone & -one
true
146
oral administration of corticosteroids in the treatment of CD and UC produces _______ effects. common adverse reactions are_______(
systemic effect;
| osteoporosis, acne, cataracts, poor wound healing, increased risk of infection, and ulceration in the G.I. tract
147
how do glucocorticosteroids work in the treatment of UC and CD?
they decrease the synthesis of pro-inflammatory substances such as prostaglandins.
148
T/F: glucocorticosteroids may initially produce muscle weakness.
true
| this is a serious problem for people with myasthenia gravis given that muscle weakness is a symptom of the disease
149
are there any long-term effects of glucocorticosteroids?
May increase the need for potassium; vitamins A, B6, C, D; folate; calcium; zinc; and phosphorus supplementation
150
what is an autoantibody?
an abnormal antibody that attacks healthy cells and tissue
151
what 2 Drugs from the drug classification immunomodulators are used for the treatment of CD?
1. infliximab
| 2. natalizumab
152
what 3 drugs from the drug classification immunosuppressants are used for the treatment of CD?
1. azathioprine
2. 6-mercaptopurine
3. methotrexate
153
the immunosuppressants azathioprine, 6-mercaptopurine and methotrexate and classified as _______.
antimetabolites
154
what are some adverse reactions of anticholinergics?
May produce constipation, difficulty sleeping, dry mouth, change in taste, headache, photophobia, nausea, sexual difficulty, fast or slow heartbeat, urinary retention, dizziness or drowsiness.
154
how are hepatitis B and C commonly transmitted?
parenteral contact with infected body fluids
155
why are antimetabolites used in the treatment of CD?
to induce remission
156
T/F: TNF levels are increased in Crohn's disease
true
157
Anti-infectives prescribed to treat fistulas include:(5)
1. ampicillin
2. sulfonamides
3. cephalosporins
4. tetracycline
5. metronidazole
158
what immunomodulator drug package contains FDA required warning that teenage or young adult males with CD or UC may develop a rare form of fatal lymphoma??
Infliximab
159
what is a common ending for immunomodulators?
-mab
160
what tests may be performed to diagnose UC and CD?(2)
1. colonoscopy
| 2. sigmoidoscopy
161
name three common symptoms of IBS, UC and CD
1. abdominal pain
2. diarrhea
3. cramping
162
which types of hepatitis have a vaccine available for prevention?
hepatitis a and hepatitis B
163
an Alster that is located in the upper portion of the small intestine or duodenum is called a(n) _______
Duodenal ulcer
164
what is the generic name for the rectally administered corticosteroid?
hydrocortisone
165
what food should be avoided so that it does not worsen symptoms of IBS, UC and CD?(5)
- wheat
- rye
- barley
- diary
- chocolate
166
```
The following labels should be applied to prescription vials for which class of drugs used to treat IBS:
"May cause dizziness or drowsiness; avoid driving, avoid alcohol, drink lots of fluids, take on an empty stomach"
```
anticholinergics
166
_______ (drug classification) increase peristalsis, speed gastric emptying, and improve LES tone
Prokinetic drugs
167
________ are commonly prescribed to suppress inflammation, reduce flare-ups, and treat pain associated with UC(and CD).
Glucocorticosteroids
169
following what kind of diet may reduce symptoms of irritable bowel syndrome??
a diet for celiac disease
169
how is hepatitis A usually transmitted?
ingestion of contaminated food or water
170
T/F: an infected persons feces are always infectious to other people when they are infected with hepatitis
true
172
in how long do symptoms appear after person has been infected with hepatitis?
15-180 days
173
what is the volume of acid normally present between meals?
1-2 ounces of HCl
174
what lifestyle modifications can be made to lessen the symptoms of IBS?(7)
- eat small meals
- drink at least 6-8 glasses of water/day
- avoid alcohol
- avoid caffeinated beverages
- limit carbonated beverages
- avoid foods that worsen symptoms
- engage in stress reduction activities
179
T/F: delayed release tablets of lansoprazole disintegrate in less than 1 minute
true
180
what is a standard used to evaluate the potency of antacids?
The acid neutralizing capacity (ANC)
181
what drug is approved for the treatment and maintenance therapy of duodenal ulcers
sucralfate
182
_____ is a term used to describe ulcers that are located in either the duodenum or stomach
Peptic Ulcer Disease (PUD)
183
what is an ANC?
A measure of the ability of an antacid to do the following:
1. neutralize approx. 1-2 oz hydrochloric acid
2. raise the pH of the stomach to 3.5 within 10 minutes
