GI Flashcards
(34 cards)
PUD/GERD: how to prevent and treat it?
*avoid NSAIDS
*infection by H. pylori
*lifestyle changes
*pharmacotherapy (PPIs, H2 receptor blockers, antacids, antibiotics (NOT GERD)
*eliminate infection
*ulcer healing
GERD: What is it?
This is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining.
Lifestyle changes
*watch what you’re eating (spicy foods)
*lose weight
*quit smoking
*elevate head of the bed
*eat slowly
omeprazole
*Proton pump inhibitors (PPI)
*all end in -prazole
*MOA: reduces acid secretion in stomach by binding to enzyme
*Short-term, 4-8 week therapy for peptic ulcers and GERD
*administer before meals
*Adverse: HA, nausea, diarrhea, rash, ab pain
*Long-term use = high risk of gastric cancer/kidney injury
aluminum hydroxide (simethicone)
*antacid
*MOA: neutralizes stomach acid by raising pH of stomach contents
*Adverse: minor constipation
*give antacids 2 hours before or after other drugs because they affect absorption
Antibiotics (not GERD)
*Administered to treat H. pylori infections
*2+ antibiotics given concurrently for increased effectiveness, less potential for resistance
*amoxicillin
*clarithromycin
* tetracycline
*Metronidazole
Sucralfate
*misc. med to treat PUD
*sucrose + aluminum hydroxide produces a gel-like substance that coats the ulcer
Misoprostol
*misc. med to treat PUD
*Prostaglandin-like substance
*inhibits gastric acid secretion and stimulates production of protective mucus
Metoclopramide
*misc. med to treat PUD
*used short term in patients who fail to respond to first-line agents
**Stimulates motility of the upper GI tract and accelerates gastric emptying
Constipation Laxatives
*Not to be used in fecal impaction, bowel obstruction and acute abdominal surgery
*Monitor chronic laxative use/abuse
*Provide fluids to prevent obstructions
Bulk forming laxative
*Psyllium mucilloid
*Absorb water, add to the size of the fecal mass
*Prevention and treatment of chronic constipation
*Slow onset of action
Saline osmotic laxative
*magnesium hydroxide (Milk of magnesia)
*Polyethylene glycol (Miralax)
*Cause water to be retained in the fecal mass
*Produce a bowel movement in 1–6 hours
*FDA warning: May cause severe dehydration and electrolyte depletion
Stimulant laxative
*bisacodly & senna
*Promote peristalsis by irritating the bowel mucosa
*Rapid-acting
*More likely to cause diarrhea and cramping
*Only to be used occasionally
*may cause dependence
*may cause depletion of fluid and electrolytes
Stool softener laxative
*docusate (Colace)
*Cause more water and fat to be absorbed into the stools (fluffy floaties)
*prevents constipation
Herbal agent: aloe
*laxative
Diarrhea
*Increase in frequency and fluidity of bowel movements
*Occurs when colon fails to reabsorb enough water
*Is a type of body defense
*Eliminates toxins/pathogens/meds
*If prolonged, can lead to fluid, electrolyte, and acid–base imbalance
*Monitor frequently
*May be related to pseudomembranous colitis
Diphenoxylate with atropine
*Antidiarrheals, Opioids
*Schedule V no risk for dependence
*MOA: slows peristalsis
*Use: for moderate to severe diarrhea
*Adverse: dizziness and drowsiness
Loperamide
*Imodium
*Antidiarrheals
*adverse: CARDIAC ARREST, QT INTERVAL PROLONGATION, TORSADES DE POINTES
Crohns
ulcerations most common in the small intestine, but can occur anywhere in the GI tract
IBS
*irritable bowel syndrome
*AKA spastic colon or mucous colitis
*Symptoms: abdominal pain, cramping, bloating, gas, constipation alternating with diarrhea, mucus in stool
*Impaired function of lower GI with no detectable disease
*Stress and dietary factors precipitate symptoms
*treatment with 5-aminosalicylic acid (5-ASA) agents, glucocorticoids and immunosuppressant drugs
Ulcerative colitis
erosions in the large intestine
sulfasalazine
*IBD med
* MOA: inhibits mediators of inflammation in the colon such as prostaglandins and leukotrienes.
*Adverse: N/V, diarrhea, dyspepsia (upper abdomen discomfort), photosensitivity
Glucocorticoids that treat IBS
*Prednisone
*methylprednisolone
*hydrocortisone
Immunosuppressant
drugs that treat IBS
*methotrexate
*infliximab (Remicade)
