NR565 wk 7-8 Final Exam Study Guide
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NR 565 Exam Final Study Guide
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➢ Antacids: weak bases that react with hydrochloric acid to form salt & water.
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o Used in the treatment of Hyperacidity, GERD, PUD, hyperphosphatemia, and calcium
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deficiency
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o Contain combinations of v v
▪ metallic cation (aluminum, calcium, magnesium, and sodium)
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▪ and basic anion (hydroxide, bicarbonate, carbonate, citrate, and trisilicate)
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➢ Pharmacodynamics, Pharmacokinetics, Pharmacotherapeutics v v
o Neutralize Gastric Acidity (causes ^pH of the stomach and duodenal bulb)
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o Inhibit proteolytic activity of pepsin
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o Increase lower esophageal sphincter tone
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o Acid-neutralizing capacity ANC varies between products expressed in mEqs v v v v v v v v
o If ingested in a fasting state, antacids reduce acidity for approximately 20 to 40 minutes
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o If taken 1 hr after a meal, acidity is reduced for 2 to 3 hrs
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o A second dose taken after a meal maintains reduced acidity for more than 4 hrs after the
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meal
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o The action of antacids occurs locally in the GI tract with minimal absorption, minimal
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metabolism
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o ALL antacids are contraindicated in the presence of severe abdominal pain of
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, unknown cause, especially ifaccompanied by fever
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-HIGH SODIUM content: pts w/ HTN, CHF, marked renal failure, or on low-sodium diets
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need to use low sodiumpreparation
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-Concurrent administration with enteric-coated drugs, destroys the coating= alters
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absorption, ^ the risk foradverse effects
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-Administrations should be separated by at least 2 hours to decrease drug/drug interactions
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1. Calcium based antacids: TUMS, Caltrate, Calcarb
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• Prescribed to treat calcium deficient states, i.e. chronic renal failure, post-menopause,
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and osteoporosis
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• Used to bind phosphates in CRF
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• Require Vitamin D for absorption from the GI tract
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• Excreted mainly in feces, 20% in urine v v v v v v
• ADR: Contraindicated in the presence of hypercalcemia and renal calculi
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• Can cause constipation- increase bulk, fluids and mobility, stool softener
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• Administered 30min- 1hr on empty stomach or 3hr after meals v v v v v v v v v
• Should not be administered with food containing large amounts of oxalic acid
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(spinach, rhubarb), orphytic acid (bran, cereals), they decrease the absorption
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v of calcium
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• Taking w/ foods containing phosphorus (milk, dairy) can lead to milk-alkali
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syndrome (N/V, confusion,headache).
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• Taking with acidic fruit juice improve absorption
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2. Aluminum based: AlternaGEL, Amphojel, Mylanta
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• Inhibit smooth muscle contraction and slow gastric emptying
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• Used to bind phosphates in CRF
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Aluminum dialysis b/cit is bound to albumin & transferrin = do not cross dialysis membrane
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is not easily
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removed by v
,• Not alacia
absorba
v o Aluminum deposits in bone and osteomalacia occurs
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ble with v • Elevated aluminum tissue levels contribute to the development of dialysis
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routine
v encephalopathy
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use
v • Used to treat hyperphosphatemia in pts w/ renal failure & phosphate renal stone
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• Aluminu prevention
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m • Can cause constipation- increase bulk, fluids and mobility, stool softener
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concent
v
rated in v
the CNS
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• Bind
with
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phospha
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te and v
excrete
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d inv
feces
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• Prolong
ed use in v v
patients
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with
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renal
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failure
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may
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result in
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dialysis
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osteom
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, 3. Magnesium based: Milk of mag, Maalox, Mylanta
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• Can be used to treat magnesium deficiencies from malnutrition, alcoholism, or mag-
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depleting drugs v
• Contraindicated in patients with renal failure & used with caution in pts with renal
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insufficiency
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The • Not absorbable with routine use
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v malfuncti • Excreted in the urine v v v
oning • Contraindicated in patients with renal failure, use with caution for patients with
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kidney any degree of renalinsufficiency
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v cannot o Malfunctioning kidney is unable to excrete magnesium and hypermagnesemia ma v v v v v v v v v
v excrete result
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v magnesiu • Can cause diarrhea- increase fiber intake (Alkalosis may occur in renal impairment)
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m=
Clinical Use and Dosing
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vhypermag
nesemia