TERM 2-MY NOTES CORE CONCEPTS OF PHARMACOLOGY CH.29 "Drugs for Gastrointestinal Disorders" Flashcards Preview

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Flashcards in TERM 2-MY NOTES CORE CONCEPTS OF PHARMACOLOGY CH.29 "Drugs for Gastrointestinal Disorders" Deck (47):
1

Peptic ulcer disease is treated by a combination of lifestyle changes and pharmacotherapy.
A)true
B)false

A

2

Proton-pump inhibitors are effective at reducing gastric acid secretion.
A)true
B)false

A

3

Proton-pump inhibitors (PPis) are often the drugs of choice for the treatment of PUD and GERD. These drugs reduce acid secretion in the stomach by binding irreversibly to the enzyme H +, K +-ATPase. ln the mucosal cells of the stomach, this enzyme acts as a pump to release acid (also called H+, or protons) onto the surface of the Gl mucosa. PPis reduce acid secretion to a greater extent than do the H2-receptor blockers and have a longer duration of action.
A)true
B)false

A

4

H2-receptor blockers reduce the secretion of gastric acid.
A)true
B)false

A

5

Histamine has two types of receptors: H1 and H2

• Activation of H 1-receptors produces the classic symptoms of allergy, whereas the H 2 -receptors a re responsible for increasi ng acid secretion in the stomach. Cimetidine (Tagamet), the first H2-receptor blocker, and other drugs in this class are quite effective at suppressing the volume and acidity of stomach acid. These drugs are also used to treat the symptoms of GERD.
A)true
B)false

A

6

Mechanisms of action of antiulcer drugs:
(a) Proton-pump inhibitors act by blocking acid secretion by the HCI pump;
(b) H2-receptor blockers act by decreasing acid secretion;
(c) a ntibiotics act by removing H. pylori;
(d) antacids act by neutralizing acids.

True

7

H2-receptor blockers reduce the secretion of gastric acid.
A)true
B)false

A

8

Adverse effects of the H2-receptor blockers are minor and rarely cause discontinuation of therapy. Patients taking high doses, or those with renal or hepatic disease, may experience confusion, restlessness, hallucinations, or depression. Patients should be advised not to take antacids at the same time as H2-receptor blockers because the absorption of these drugs will be lessened.
A)true
B)false

True

9

Antacids rapidly neutralize stom ach acid and reduce the symptoms of peptic ulcer disease and GERD.
A)true
B)false

A

10

Antacids are alkaline substances that have been used to neutralize stomach acid for hundreds of years
A)true
B)false

A

11

Simethicone is classified as an antiflatulent because it reduces gas. It also is available by itself in OTC products such as Gas-X and Mylanta Gas.
A)true
B)false

A

12

Antibiotics are administered to eliminate Helicobacter pylori, the cause of many peptic ulcers.
A)true
B)false

A

13

The bacterium H. pylori i s associated with 80% of all duodenal ulcers and 70% of all gastric ulcers. This organism has adapted well as a human pathogen by devising ways to neutralize the high acidity surround ing it and by making chemical s called adhesins that allow it to stick tightly to the Gl mucosa.
A)true
B)false

A

14

The following antibiotics are commonly used for this purpose:
• Clarithromycin (Biaxin)
• Amoxicillin (Sumycin,
• Metronidazole (Fiagyl)
• Tetracycline (Achromycin, others)

True

15

Two or more antibiotics are given concurrently to increase the effectiveness of therapy and to lower the potential for bacterial resistance. Antibiotic therapy generally continues for 7 to 14 days. Bismuth compounds (Pepto-Bismol, Tritcc) are sometimes added to the antibiotic regimen. Although not antibiotics, bismuth compounds do inhibit bacterial growth and prevent H. pylori from adhering to the surface of the gastric mucosa.
A)true
B)false

A

16

Several miscellaneous drugs are also beneficial in treating peptic ulcer disease.
A)true
B)false

A

17

Three additional drugs are beneficial in treating PUD. Sucralfate (Carafate) consists of sucrose (a sugar) plus aluminum hydroxide (an antacid). The drug produces a thick, gel-like substance that coats the ulcer, protecting it against further erosion and promoting healing. Very little of the drug is absorbed from the GI tract. Other than constipation, adverse effects are minimal. A major disadvantage of sucral fate is that it must be taken four times a day.
A)true
B)false

A

18

Misoprostol (Cytotec) is a prostaglandin-like substance that inhibits gastric acid secretion and stimulates the production of protecti ve mucus. Its primary use is for the prevention of peptic ulcers in patients taking high doses of NSAIDs or glucocorticoicls. Diarrhea and abdominal cramping are relati vely common.
A)true
B)false

A

19

Difficult or infrequent bowel movements, known as constipation, is a common problem with a large number of different caues that include lack of exercise, insufficient food or fluid intake, and lack of sufficient insoluble dietary fiber.
A)true
B)false

A

20

Constipation occurs more frequently in older adults because fecal transit time through the colon slows with aging; this population a lso exercises less and has more chronic disorders that cause constipation
A)true
B)false

A

21

laxatives are used to promote defecation
A)true
B)false

A

22

Laxatives are drugs that promote emptying of the bowel , or defecation. Cathartic is a related term that implies a stronger and more complete bowel emptying. When taken in prescribed amounts, laxatives have few adverse effects.
A)true
B)false

A

23

These drugs are often classified into four primary groups and a miscellaneous category:

,

24

Bulk-Forming laxative-absorb water, thus adding size to the fecal mass. These are agents of choice for the prevention and treatment o f chronic constipation. They have a slow onset of action and arc not used when a rapid and complete bowel evacuation is necessary.
A)true
B)false

A

25

Stimulants promote peristalsis by irritating the bowel. A lthough drugs in thi s class are effective and act rapidly, they are more likely to cause diarrhea and cramping than the other types of laxatives. They shou ld only be used occasionally because they may cause laxative dependence and depletion of fluid and electrolytes.
A)true
B)false

A

26

Saline/osmotic cause water to be retained in the fecal mass. causing a more liquid stool. These drugs produce a bowel movement in 1-6 hours, and they should not be used on a regular basis because of the possibility of fluid and electrolyte depletion.
A)true
B)false

A

27

Stool softener/surfactants cause more water and fat to be absorbed into the stools. They are most o ften used to p revellt constipation, especially in patients who have undergone recent surgery.
A)true
B)false

A

28

Miscellaneous act by mechanisms other than those just described.
A)true
B)false

A

29

Laxatives are contraindicated in any patient with a suspected bowel obstruction because their use could cause the bowel to perforate. If acute abdominal cramping or diarrhea occurs, laxatives should be di scontinued. Patients should be advised not to over-use laxatives because the smooth muscle in the colon can lose its tone. Chronic constipation is the result.
A)true
B)false

A

30

Occasionally, the colon does not reabsorb enough water from the fecal mass, and stools become watery. Diarrhea is an increase in the frequency and nuidity of bowel movements. Like contipation. occasional diarrhea is a common. self- limiting disorder that does not require drug therapy. When prolonged or severe, especially in children, diarrhea can result in significant loss of body flu ids, and medications may be indicated. Prolonged diarrhea may lead to acid-base or electrolyte disorders,
A)true
B)false

A

31

Opioids are the most effective drugs for controlling severe diarrhea
A)true
B)false

A

32

Drug therapy of diarrhea depends on the severity of the condition and whether or not a spec ific cause can be identified. If the cause is an infectious disease, then an antibiotic or antiparasitic drug such as metronidazole (Flagyl) is indicated. If the cause is inflammatory in nature , antiinflammatory drugs are needed. If the cause appears to be drug induced , the medication should be discontinued and another substituted.
A)true
B)false

A

33

Antidiarrheals act by relaxing the colon's smooth muscle , thus relieving cramping. Slower transit through the large intestine allows for better-formed stools
A)true
B)false

A

34

Antiemetics are prescribed to treat nausea, vomiting, and motion sickness
A)true
B)false

A

35

Antiemetic drugs be long to a number of different classes, including the following:
• Antihistamines
• Antipsychotics
• Serotonin-receptor blockers
• Glucocorticoids (corticosteroids)
• Benzodiazepines

True

36

Anorexiants and lipase inhibitors are used for the short-term management of obesity.
A)true
B)false

A

37

anorcxiants to reduce appetite.
A)true
B)false

A

38

The pancreas is responsible for the secretion of essential digestive enzymes. Lack of secretion, or pancreatic insufficiency, will result in malabsorption disorders. Replacement therapy with pancreatic enzymes is sometimes necessary.
A)true
B)false

A

39

Pancreatic enzymes are administered as replacement therapy for patients with pancreatitis or malabsorption syndromes.
A)true
B)false

A

40

Steatorrhea, the pass ing of bulky, foul-smelling fatty stools, occurs because dietary fats are passing through the Gl tract without being broken down.
A)true
B)false

A

41

Ginger is used for nausea
A)true
B)false

A

42

Regarding Antiulcer Medications

1. Do not smoke tobacco when taking H2-receptor blockers because this interferes w ith the drug action.

2. Because drowsiness may occur when starting therapy with H2-receptor blockers or proton-pump inhibitors, monitor operating equipment and the use of alcohol or other CNS drugs ca refully.

3. When taking medications for peptic ulcer, avoid drugs that may cause stomach irritation such as aspirin or NSAIDs.

4. Shake liquid antacids well before pouring. Chewable tablets should be thoroughly chewed before swallowing.

True

43

Regarding laxatives

5. Because bulk-forming laxatives and stool softeners may take several days for results, be patient and do not take more than prescribed.

6. Take bulk-forming laxatives with at least two full glasses of water because this aids in forming larger stools.

7. If constipation is a frequent problem, try drinking more fluids and adding fiber t o the diet rather than taking laxatives on a continual basis. Foods rich in fiber include all fruits and vegetables, bran cereals, and whole grain breads.

True

44

Regarding Antiemetics

8. Before taking antiemetic medications, try other methods of relieving nausea, such as drinking flat carbonated beverages or weak tea or eating small amounts of crackers or dry toast.

9. When taking phenothiazines or antihistamines as antiemetics, use sugarless candy, gum, or ice chips to minimize dry mouth.

10. Recall that medications taken to suppress hunger produce only modest weight loss and are not effective without a reduced-calorie diet.

True, sustained weight loss can only be achieved by modification of dietary habits.

True

45

H.plyri can cause antiviral antibodies
A)true
B)false

A

46

Antibiotics are used for H.plyri
A)true
B)false

A

47

Drugs for Gastrointestinal Disorders

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