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NUR 2060 (Pharmacology) - GI lect - EXAM 1 CONTENT (2)
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NUR 2060 (Pharmacology) - GI lect - EXAM 1 CONTENT (2)
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NUR 2060 (Pharmacology) - GI lect - EXAM 1CONTENT
What are the defense factors for GI protection? - ANS-1. mucus secretion (barrier)
2. bicarbonate (neutralizes H+ ions)
3. blood flow (sufficient for cells, maintains 1st 2 defenses)
4. prostaglandins (stimulate all of above, and suppress secretion of gastric acid)
What are the aggressive factors that affect the GI protection? - ANS-1. Helicobactor pylori
(carcinogen bacteria, degrades mucous barrier promoting ulcers)
2. NSAID's (inhibits prostaglandins)
3. gastric acid (ulcer production)
4. Pepsin (natural enzyme that can injure unprotected cells)
5. smoking (weakens the sphincter and accelerates gastric emptying---increase acid in
duodenum)
What is the primary carcinogen for stomach cancer? - ANS-Heliobactor pylori
What are risk factors for ulcers? - ANS--H. pylori
-smoking
-NSAID usage
-ETOH (alcohol)
-more acid
-less bicarb
-stress/anxiety
What is Zollinger-Ellison syndrome? - ANS-condition where there is hyper secretion of gastric
acid; increased ulcer probability
What are prevention/treatments for ulcers? - ANS--eliminate H. pylori
-avoid (irritating drugs) NSAID's and corticosteroids
-avoid smoking and ETOH
-eat 6 small meals/day
-bland diet
-decrease stress
What are the classes of antiulcer drugs? - ANS--antibiotics
-antisecretory agents to decrease acid production (proton pump inhibitor and H2 receptor
antagonists)
-mucosal protectants
-antisecretory agents that enhance mucosal defenses
, -antiacids
Why do we give antibiotics in the cocktail for treatment of ulcers? - ANS-to treat H.pylori
How many antibiotics are usually prescribed to treat H. pylori and why? - ANS-2-3 antibiotics; to
decrease resistance
What is the regime for treatment of H. pylori infection? - ANS--2-3 antibiotics
-antisecretory agent (i.e. H2 antagonist or proton pump inhibitor)-decreases stomach acid
-14 day course is best (long enough to eradicate infection)
What are some antibiotics that are useful for eradication of H. pylori? - ANS--*amoxicillin
-*bismuth (pepto; has antibacterial properties)
-clarithromycin (Baxin)
-*metronidazole (Flagyl)
-tetracycline (Achromycin)
What is the action of Histamine 2 receptor antagonists? - ANS-inhibit gastric acid secretion
(targets H2, H2 "Blockers")
What are the uses of Histamine 2 receptor antagonists? - ANS--H. pylori regime
-decrease painful symptoms & prevent complications of PUD (ulcers)
-prevent NSAID induced ulcers
-decrease heartburn
-GERD
-Zollinger-Ellison syndrome (hypersecretory)
What are some cautions when giving Histamine 2 antagonists? - ANS--avoid antacids 1 hour
before giving H2 antagonists
-increased bleeding abnormalities
-some risk of pneumonia with decreased acid in GI
Give medication examples of Histamine 2 Antagonists. - ANS-**((End in -dine))**
i.e.
-cimetidine (Tagamet)**: inhibits cyp 450 - decreases clearance of many drugs, causes
confusion in elderly
-ranitidine (Zantac)**
-famotidine (Pepcid)**
-nizatidine (Axid)
What is the action of a Proton Pump Inhibitor? - ANS-suppress gastric acid secretion (block the
enzyme needed for acid formation)
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