Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Petic Ulcers > Flashcards

Petic Ulcers Flashcards

1
Q

What is a peptic ulcer?

A

A defect in the gastric or duodenal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes a peptic ulcer to form?

A

An imbalance in factors predisposing to an ulcer (acid, pepsin, infection) and mucosal defence (mucosa, bicarbonate, PGs, NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What treatments are used to control acid secretion?

A

NSAIDs
Atropine
H2R antagonists
Proton pump inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does NSAID use lead to peptic ulcers?

A

They inhibit prostaglandin release which is important in protecting the stomach lining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What infection is most common for causing peptic ulcers?

A

Helicobacter pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What sort of drugs lead to peptic ulcers?

A

Aspirin / corticosteroids
Bisphosphonates
Nicotine
Alcohol
Caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does helicobacter pylori do?

A

Gram negative bacillus
Undermines mucosal protection system
Secretes inflammatory proteins and toxins
Contains an enzyme urease - converts urea to NH4 and CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What two ways can H Pylori be detected?

A

Carbon-13 urea breath test
Gastrointestinal endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is the urea breath test preformed?

A

Patient ingests urea containing non radioactive active carbon 13
CO2 is measured in breath pre and post
Cannot have been taking antibiotics or acid suppressing medications beforehand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What sort of biopsy is preformed for H Pylori?

A

Upper gastrointestinal endoscopy with biopsy and rapid urease test
Biopsy in placed in a medium containing urea and pH indicator
Colour change when ammonia is produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are principles of peptic ulcer treatment?

A

Reduce acid secretion
Augment protective mucosal barrier
Relieve pain
Promote ulcer healing
Prevent relapse and complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What treatment plans exist for peptic ulcers?

A

Remove irritants
Antibiotics
Acid suppressants
Mucosal protectants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What acid suppressants are used?

A

Antacid’s
Proton pump inhibitors
H2 receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What mucosal protectants can be used?

A

Sucralfate
Bismuth chelate
Misoprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do antacids do?

A

Provide symptomatic relief by raising gastric pH and reducing pepsin activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are antacids normally made up of?

A

Most are salts of aluminium and magnesium often in combination
Cancel out laxative / constipation effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe sodium bicarbonate

A

Acts rapidly
Well absorbed
Can cause metabolic alkalosis
Sodium and water retention
Renal stone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What proton pump inhibitors exist?

A

Omeprazole
Lansoprazole
Pantoprazole
Esomeprazole
Rabeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How are proton pump inhibitors absorbed?

A

Absorbed in the small intestine and then diffuse from the blood to parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are pro drug proton pump inhibitors activated?

A

By acid in parietal cells to sulfenamide, are trapped within the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do proton pump inhibitors do?

A

Inhibit basal and food stimulated acid secretion
Promote healing
Irreversible inhibitor with prolonged action
Requires synthesis of new pumps

22
Q

What are the mild side effects of proton pump inhibitors?

A

Diarrhoea
Nausea
Flatulence
Possible Headaches

23
Q

What are the more severe side effects of proton pump inhibitors?

A

Rebound effect of worsening symptoms after stopping the treatment
Can mask early cancer signs
(Bleeding, dysphagia, vomiting, weight loss)

24
Q

What are some of the drug interactions seen with proton pump inhibitors?

A

Weak cytochrome P450 (CYP) inhibitor
Reduced activation of clopidogrel
Reduced metabolism of warfarin

25
Q

Give some examples of H2 receptors antagonists

A

Cimetidine
Ranitidine
Famotidine

26
Q

How do H2 antagonist work?

A

Act as H2 receptors in gastric parietal cells
Reduce basal and stimulated acid output (90%)
Reduce volume of secretions and pepsin content

27
Q

What are the side effects of H2 antagonists?

A

Nausea
Diarrhoea
Headache
Dizziness

28
Q

What symptoms can H2 antagonists cause in the elderly?

A

Confusion
Depression

29
Q

What drug interactions are seen with H2 antagonists?

A

More than PPIs
Cimetidine inhibits CYP dependent metabolism
Potentially reacts with warfarin and phenytoin

30
Q

What is misoprostol?

A

An oral prostaglandin E2 analogue

31
Q

What does misoprostol do?

A

Stimulates mucus and bicarbonate
Inhibits acid
Prevents ulceration in long term NSAIDs users

32
Q

What are side effects seen when using misoprostol?

A

Diarrhoea
Nausea
Abdominal cramps
Flatulence
Vaginal bleeding

33
Q

Why is misoprostol more targeted to the older population?

A

Higher risk of abortion/ miscarriage
Prostaglandin is very important within the reproductive tract
Avoided in women of child bearing age

34
Q

How do mucosal protectants work?

A

Coats ulcers
Absorbs pepsin
Stimulates bicarbonate and mucus
Toxic effect on H pylori
Promotes healing

35
Q

What are the side effects of bismuth chelate?

A

Mucosal protectants can cause
Blackened tongue and teeth
Nausea
Vomiting

36
Q

What is sucralfate?

A

A complex of aluminium hydroxide and sulfated sucrose

37
Q

How does sucralfate work?

A

Activated by acid
Binds to proteins forming a protective layer on normal / damaged mucosa
Stimulates mucus and bicarbonate
Inhibits pepsin
Reduces adherence of H pylori to mucosa
Promotes healing

38
Q

What are the side effects when using sucralfate?

A

Constipation (due to aluminium)
Dry mouth

39
Q

What is the triple therapy used to eradicate H pylori?

A

PPIs / H2 antagonist - raise gastric pH
Increases H pylori’s susceptibility to antibiotics
Clarithromyocin + amoxicillin
Use metronidazole if allergic to penicillin

40
Q

What are the preventative treatments in place for ulcers?

A

High risk patients needing NSAIDS are also prescribed a PPI, misoprostol or H2 antagonist
H pylori patients needing NSAID treatment are given eradication therapy

41
Q

Why are coxibs given?

A

To reduce the risk of gastrointestinal bleeding
But increase the risk of cardiovascular event more than NSAIDs

42
Q

Which is better Cox 1 or Cox 2?

A

Cox 2 are selective inhibitors and minimise the side effects associated with Cox 1

43
Q

What are two examples of Cox 2 inhibitors?

A

Rofecoxib
Celecoxib

44
Q

How are Cox 2 different?

A

Retain analgesic, anti inflammatory and antipyretic effects
Reduce gastrointestinal toxicity but not renal toxicity

45
Q

What are the comparison points of aspirin vs coxibs?

A

Aspirin - fewer heart attacks, more bleeding events
Coxibs - more heart attacks, fewer bleeding events

46
Q

What is GERD?

A

Gastric oesophageal reflux disease
Heartburn
Acid reflux causing inflammation of the oesophageal mucosa

47
Q

What are the treatments for GERD?

A

Antacids (gaviscon)
PPIs / H2 antagonists
Metocloperamide

48
Q

What is vonoprazan?

A

First in class reversible potassium competitive acid blocker
More potent than lansoprazole

49
Q

When can vonoprazan be used?

A

GERD
NSAID ulcers
H pylori eradication with antacids

50
Q

Why would vonoprazan be favourable?

A

Prolonged duration of action
Few mild side effects - mild gastrointestinal upset

Pharmacology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions