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GI Tract Flashcards

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1
Q

Alimentary canal

A

Long continuous hollow tube

Extends from mouth to anus

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2
Q

Accessory Digestive organs

A

salivary glands
liver
gallbladder
pancreas

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3
Q

Function of GI tract

A

transport food
provide enzymes
provide surface area for chemical digestion
provide surface area for absorption

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4
Q

Control of GI system

A 
nerve plexus
a.  maintains basic electrical rhythm
b.  responds to local stimuli to increase or decrease activity
influenced by the ANS
a.   sympathetic reduces
parasympathetic increases
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5
Q

digestive enzymes of St

A

gastrin in anticipation of food
chief cells secrete pepsinogen
parietal cells secrete HCl and intrinsic factors

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6
Q

Gastrin function

A

causes St muscle to contract
causes release of HCl and Pepsinogen
Fibber decreases the concentration of acid in St.

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7
Q

Pepsinogen function

A

breaks down protein

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8
Q

Instrinsic factor function

A

essential for Vit B 12 absorption

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9
Q

Parietal Cell function

A

protect body from ingested microbes
aid in chemical digestion
secrete HCl and intrinsic factor
HCO3 and thick mucous layer protect the stomach lining from acid

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10
Q

Liver/Pancreas enzymes

A

Trypsin - protein
Amylase - sugar
Lipase - fat

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11
Q

Bile

A

breaks down fat

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12
Q

Endocrine hormones involved

A

insulin
glucagon
somatostatin

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13
Q

Where is portal system?

A

Liver

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14
Q

what is basic movement

A

peristalsis

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15
Q

how many muscle layers does St have

A

3 - produces churning action

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16
Q

Motility process of Si

A

segmentation

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17
Q

Motility process of Li

A

mass movement

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18
Q

Gastroenteric reflex

A

stimulates St by stretching causing an increase in Si activity

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19
Q

Gastrocolic reflex

A

stimulates the St causing increase colon activity

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20
Q

Duodenal - colic reflex

A

stimulates colon activity and mass movement by presence of food or stretch in duodenum

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21
Q

intestinal intestinal reflex

A

irritation in the Si in one area which can cause paralytic ileus

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22
Q

swallow reflex

A

stimulated by pressure of receptors in back of throat by a food bolus

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23
Q

vomiting reflex center

A

in medulla - 2 centers
emetic zone
CTZ zone (Chemoreceptor trigger zone)

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24
Q

How does stimulation of the CTZ zone induce vomiting

A

tactile stimulation of back of throat
excess St distention
increased intracranial pressure by direct stimulation
stimulation of vestibular receptors in inner ear
stimulation of stretch receptors in uterus and bladder
intense pain fiber stimulation
direct stimulation of various chemicals

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25
head injury causes what physiological changes
increasing intracranial pressure
26
stimulation of vestibular receptors can cause what physiology response
motion sickness, nausea, vomiting
27
physical response before vomiting
increased saliva, mucus production in upper GI, sweating, HR, deeper breathing, nausea decreased gastric acid production
28
TPN and ingredients
total parenteral nutrition hypertonic solution contains AA, lipid emulsions, carbs (dextrose), electrolytes, vitamins, minerals
29
vitamins
organic substances needed to promote growth and maintain health
30
indications for vitamins
alcoholics pregnancy, breast feeding chronic Kd/Lv disease therapy with certain meds that affect vitamin metabolism
31
water soluble vitamins
B & C | easily dissolved and excreted in urine - required daily
32
thiamine B1
promotes muscle and nervous system | found in enriched whole grains
33
Riboflavin B2
RBC production and body growth | found in milk, yeast, liver
34
Niacin B3
helps form coenzymes | found in meat
35
Pyroxidine B6
RBC synthesis, CHO and lipid metabolism, neurotransmitter synthesis found in grains, egg yolk
36
Folic Acid B9
DNA snthesis, homocysteine metabolism, neurotransmitter formation, helps complete formation of spine green leafy
37
B12
found in meat, seafood, eggs
38
Vit C
found in citrus fruits | deficiency leads to scurvy
39
Lipid soluble vitamins
``` ADEK can be toxic in excess amounts must be ingested with other lipids stored in Liver and fat tissue absorbed in Si ```
40
Vit A
eye health, skin, skeletal health | excess leads to orange skin, loss of hair, peeling skin
41
Vit D
absorption of Ca
42
Vit E
antioxidant
43
Vit K
clotting factors
44
Minerals
inorganic substances that are needed to maintain body metabolism ingested
45
drugs that affect mineral metabolism
thiazides or loop diuretics - lose K corticosteroids, oral contraceptives - retain Na; lowers plasma zinc, increases copper oral hypoglycemics, lithium carbonate - impairs uptake of iodine by thyroid
46
what is a hemoglobin molecule composed of
4 heme molecules
47
role of sodium
fluid and electrolyte balance maintenance of extracellular fluid balance acid/base balance muscle contraction - enters the fast channels during depolarization - nerve transmission
48
K role
fluid, electrolyte balance, cell integrity, maintain Ht beat (Ca/Na in, K out) found in banana, potato
49
Cl role
follows Na part of HCl acid/base, eletrolyte balance
50
Ca
for nerve conduction, musc contraction, hemostasis, prep: Ca Carbonate, citrate, gluconate, lactate hypocalcemia
51
PO
phosphorus bone formation part of ATP
52
Mg
nueromusc function - uterine contractions | salts for laxatives
53
Trace minerals
``` only less than 20 mg required Fe iodine fluorine zinc ```
54
Fe excess
hemochromatosis
55
fe deficiency
anemia
56
Iodine
for thyroid hormone from iodized salt deficiency - goiter excess - suppresses thyroid function temporarily
57
Lugol's solution
iodine mixture | administered prior to thyroidectomy
58
sodium iodine
for acute thyroid crisis
59
fluorine
excess - toxic | for bones and teeth
60
zinc
``` helps with immunity wound healing male fertility bone formation excess destroys sense of taste and smell ```
61
peptic ulcer disease risk
``` family hx type O smoking alcohol caffeine meds - corticosteroids, aspirin, nsaids stress h pylori ```
62
types of ulcer
duodenal | gastric
63
duodenal ulcer
burn upper abd 1-3 hrs after eating disappears after ingesting bleeding
64
gastric ulcer
``` more serious less commmon requires longer tx relieved by food, but continues after meal anorexia, vomit, weight loss ```
65
drugs that affect GI secretions
``` Histamine 2 antagonist protein pump inhibitor antacid antipeptic agent prostaglandin digestive enzymes ```
66
Cimetidine (Tagamet)
``` H2 receptor antagonist suppresses volume and acidity of ST acid treats GERD 800 mg @ bedtime or QID weaker than proton pump inhibitors ```
67
c/i of Tagamet
concurrent antacid therapy - NO! breast feeding Kd Lv dysfunciton elderly
68
interactions of tagamet
antacids inhibit absorption | smoking increases HCL secretion
69
A/R of Tagamet
h/a, dizziness, confusion, decrease libido. | watch for abd pain, FRANK AND OCCULT BLEEDING, avoid irritants
70
Other H2 receptor drugs
Pepcid | Zantac
71
Omeprazole (Prilosec)
``` Proton Pump Inhibitor for PUD and GERD blocks enzymes that secrete HCl works better and longer than H2 receptors for erosive esophagitis associated with C Diff & Hip Fx can administer with antacid ```
72
A/R of Prilosec
``` h/a diarrhea abd pain n/v dizziness rash constipation dry mouth flatulence ```
73
Prilosec interactions
interfere with metabolism of valium, dilantin, coumadin. | interfere with absorption of drugs that need gastric pH
74
other protein pump inhibitors
Prevacid | Protonix
75
Sodium Bicarbonate (Bell/Ans)
antacid was for GERD and PUD alkaline, inorganic compounds of Al, Mg, Ca neutralizes st acid Al compounds may interfere with phosphate metabolism and cause constipation
76
which compounds cause constipation
Al | Ca
77
which compounds may cause diarrhea
Mg
78
Common antacids
Mylanta Maalox Amphojel
79
nursing consideration for antacids
monitor for systemic alkalosis administer 1-2 hours before other oral meds assess for OTC, Rx, KD insufficiency
80
Antibiotic therapy used with antacids
``` for H Pylori Amoxicillin (Amoxil) Clarithromycin (Biaxin) Metronidazole (Flagyl) - antifungal Tetracycline (Achromycin) ```
81
Sucalfate (carafate)
Antipeptic agent coats ulcer crater for short term and prevention
82
cautions, with antipeptics
``` c/i hypersensitivity caution - breast feeding, chronic renal failure a/r -constipation interaction - binds with other drugs NOT WITH OTHER AL BASED PRODUCTS frank/occult bleeding ```
83
Misoprostol (Cytolec)
Prostaglandin inhibits HCl secretion and increases HCO3 and Mucus prevents NSAID induced gastric ulcer treats duodenal ulcer
84
c/i of prostaglandin | cautions, A/R
Pregnancy lactation n/v, diarr, abd pain, flatulence, dyspepsia, constip. miscarriage, excess bleeding, spotting, cramps, hypermenorrhea, dysmenorrhea.
85
Pancrelipase (Pancrease)
Digestive Enzyme need artificial saliva with elecrolytes help digest and absorb fat, protein, carbs replacement therapy
86
digestive enzyme cautions and a/r
c/i - enzymes -> gastric irritation pregnancy and lactation contact dermatitis, N, abd cramps, diarr, skin irritation
87
saliva allergy
cautions: CHF, hypertension, Kd fail | a/r - complications from abn electrolytes, increased levels of Mg, Na, K
88
vomiting center
medulla | senses toxins and triggers reflex
89
n/v drug classes
``` phenothiazine - compazine antihistamines - benadryl cannabinoids - marinol glucocorticoids - decadron benzodiazepine - ativan serotonin receptor antagonists - zofran ```
90
Prochloroperazine (compazine)
phenothiazine - antiemetic helps nausea used for kids as suppository
91
Metoclopramide (Reglan)
NON Phenothiazine - antiemetic improves emptying gastric area, for diabetic paralytic ileus for n/v motion sickness, diabetic gastroparesis, tube feeding to promote emptying NOT WITH DIGOXIN
92
ONdansetron - Zofran
serotonin 5-HT3 receptor blocker blocks receptors assoc with n/v in CTZ used for chemo and post op c/i -preg/lact, myalgia, urin retent
93
C/I & A/R of antiemetic
``` GI obstruction angle closure glaucoma bone marrow depression Lv Ht dz watch for anticholinergic effects - hyptension, constip, blurred vision, dryness of eyes, mouth, rectal irritation, drowsy, photosens, urin retent. ```
94
Meclizine (Antivert)
ANtichol/antihistamine block impulse to CTZ for n/v, motion sickness
95
Aprepitant (Emend)
substance P neurokinin 1 receptor antagonist in CNS block receptors assoc with n/v combo with other agents - for chemo encourage fluids! a/r - anorexia, fatigue, constip, diarr, LV enzyme elevation, dehydration
96
Ipecac syrup
emetics induce vomit 2003 warning - not recommended anymore c/i semicomatose, unconscious - risk for aspiration a/r - arryth, diarr, drowsy, cardiotoxicity follow with 1-2 glasses of water

Pharmacology (8 decks)

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