NURS 366- Exam 1 Pharm content Questions & Answers Rated 100% Correct

Antacid families - - Aluminum compounds - Magnesium compounds - Calcium compounds - Sodium compounds Diphenoxylate (Lomotil) - - Formulated with atropine to discourage abuse - Opioid used only for diarrhea - High doses can elicit typical morphine-like subjective responses Do antacids alter systemic pH? - Except for sodium bicarbonate, *antacids do not alter systemic pH* Evaluation of therapy - - Monitor for relief of pain - Radiologic or endoscopic examination of ulcer site - H. pylori tests For what reason, other than an antacid, is Magnesium Hydroxide commonly used for? - As a laxative For which patients is ulcer prophylaxis indicated for? - Ulcer prophylaxis is indicated only for patients in *intensive care units, and then only if they have an additional risk factor*, such as multiple trauma, spinal cord injury, or prolonged mechanical ventilation (longer then 48 hours) How can constipation caused by calcium carbonate be relieved? - By combining calcium carbonate with a magnesium-containing antacid (for example, magnesium hydroxide) How can you avoid activation of pepsin? - Drugs that reduce acidity should be administered in doses sufficient to raise the gastric pH above 5How do antacids work? - - React with gastric acid to produce neutral salts or salts of low acidity - Reduce destruction of gut wall by neutralizing acid - May also enhance mucosal protection by stimulating production of prostaglandins How do NSAIDs act as aggressive factors for peptic ulcers? - - Inhibit the biosynthesis of prostaglandins - Reduce blood flow, mucus, and bicarbonate How do prostaglandins defend against peptic ulcers? - Stimulate the secretion of mucus and bicarbonate How do you treat NSAID induced ulcers? - - *Histamine blockers and PPIs are preferred* (Ex. omeprazole) - Antacids, sucralfate, and histamine2 receptor blockers are NOT recommended - Discontinue NSAIDs if possible How does bicarbonate defend against peptic ulcers? - - Secreted by epithelial cells of stomach and duodenum - Most remains trapped in mucus layer to neutralize hydrogen ions that penetrate the mucus How does blood flow defend against peptic ulcers? - Poor blood flow can lead to ischemia, cell injury, and vulnerability to attack How does gastric acid act as an aggressive factor for peptic ulcers? - - Causes ulcers directly by injuring cells of the GI mucosa and indirectly by activating pepsin - Increased acid alone does not increase ulcers but is a definite factor in PUD - Zollinger-Ellison syndrome How does mucus defend against peptic ulcers? - - Secreted cells of the GI mucosa- Forms a barrier to protect underlying cells from acid and pepsin How does pepsin acid act as an aggressive factor for peptic ulcers? - Proteolytic enzyme in gastric juice How does smoking act as an aggressive factor for peptic ulcers? - Delays ulcer healing and increases risk for recurrence How is diarrhea managed? - - Diagnosis and treatment of underlying disease - Replacement of lost water and salts - Relief of cramping - Reducing passage of unformed stools