Test 2 - Antiulcer Meds (Josh) Flashcards
(42 cards)
Common stomach acid problems
- GERD
- Heartburn
- Erosive espophagitis
- Ulcers
What causes stomach acid problems?
- helicobactor pylori (bacteria causes 60-75% of ulcers)
- NSAIDs
- Gastric Acid
- Pepsin
- Smoking
Does alcohol cause stomach acid problems?
no
Does spicy food cause stomach acid problems?
no
Does stress/anxiety cause stomach acid problems?
no
Antiulcer Medication Classes
- Proton Pump Inhibitors (-prazole)
- Histamine 2 blockers (-tidine)
- Sucralfate
- Antacids
Major Proton Pump inhibitors
- OmePRAZOLE
- EsomePRAZOLE
- PantoPRAZOLE
- LansoPRAZOLE
- DexlansoPRAZOLE
Adverse effects of Proton Pump Inhibitors
very well tolerated
Acid rebound is a problem (can persist for several months)
How do you prevent Acid Rebound when discontinuing a proton pump inhibitor
- taper off
- take an Antacid or H2 Blocker (-tidine)
What are some controversial adverse effects of proton pump inhibitors?
- Pneumonia
- Clostridium difficile
- Nutritional deficits (vit. B12, Fe3+, Mg2+, Ca2+)
- Osteoporosis/fractures
When should a proton pump inhibitor be taken?
before breakfast
Teaching regarding Proton Pump Inhibitors?
Take before breakfast
Don’t crush (delayed release)
Major Histamine-2 Blockers.
famoTIDINE
raniTIDINE
Adverse effects of H-2 Blockers
- Tolerance
- Rebound Effect
- Confusion (if levels are too high)
Teaching regarding H-2 Blockers?
separate antacids (1 hour)
—– works by creating a protective barrier over the ulcer. (think pepto bismal commercial)
sucralfate
- requires pH
—- work by raising stomach pH and require frequent dosing.
antacids
—– lead to frequent electrolyte and pH changes.
antacids
Which receptors do antacids work on?
none, they are receptorless drugs
GERD means:
Gastro-esophogeal Reflex Disease
In GERD and Erosive Esophagitis, what is the cause?
cardiac sphincter (upper stomach sphincter) fails and stomach acid backs up into esophagus (Barrett’s Esophagus)
Which bacteria causes most ulcers?
helicobactor pylori
causes 60-75% of ulcers
Is there any difference b/t esomeprazole and omeprazole?
no, they just changed the name to lengthen the patent and make $$
MOA: Stomach Acid
Gastrin activates —— receptors and also causes —– cells to activate —— receptors. These actions cause —— to work, increasing stomach —- and decreasing stomach ——.
CCK2 ECL Cells Histamine 2 H+/K+ ATPase pump increasing H+ (acid) decreasing K+