Chapter 59: Peptic Ulcer Disease & GERD

studied byStudied by 5 people
5.0(1)
get a hint
hint

What is Gastroesophageal reflux disease (GERD)?

1 / 22

Tags and Description

Nursing

23 Terms

1

What is Gastroesophageal reflux disease (GERD)?

chronic condition characterized by persistent heartburn

New cards
2

What is the process of GERD?

  1. Results when acidic stomach contents enter esophagus

  2. lower esophageal sphincter weakening or relaxation occurs

  3. decreased salivary secretions

  4. diminished esophageal motility

New cards
3

What are the etiologic risk and factors associated with peptic ulcer disease?

  1. infection w/ Helicobacter pylori

  2. close family history of PUD

  3. use of drugs

    • glucocorticoids, NSAIDs, platelet inhibitors

  4. smoking tobacco

  5. consumption of beverages and foods w/ excessive caffeine

  6. excessive psychologic stress

New cards
4

What are the goals of PUD pharmacotherapy?

  • relieve symptoms

  • promote healing of ulcer

  • prevent complications

  • prevent future recurrence

New cards
5

What are key factors to be able to achieve the goals of PUD pharmacotherapy?

  1. eradicate H. pylori

  2. discontinue NSAID/other ulcer-promoting meds when possible

New cards
6

Whare are the major drug classes in GERD & PUD pharmacotherapy?

  1. Proton pump inhibitors (PPIs)

  2. H2-receptor antagonists

  3. antacids

  4. miscellaneous drugs

New cards
7

What are risk factors for H. pylori?

  1. domestic crowding

  2. unclean water

  3. exposure to gastric content of an infected individual

New cards
8

What is the goal in the pharmacotherapy of H. pylori infection?

  1. kill bacteria while minimizing emergence of resistance

  2. PPI or histamine 2 receptor antagonist use

    *eradication rates = good w/ 10 day course AB, 14 day course AB= slightly better

New cards
9

What is the mechanism of action of PPIs?

  • reduces acid secretion in stomach by binding to H+,K+, ATPase

  • inhibits final pathway involved in acid secretion and active proton pumps

New cards
10

What are examples of PPIs?

  1. omeprazole

  2. esomeprazole (Nexium)

  3. lansoprazole (Prevacid)

  4. pantoprazole (Protonix)

    1. ^can be given IV

New cards
11

What is the therapeutic classification and use of omeprazole (Prilosec)?

  • antiulcer drug

  • OTC = relief of heartburn

    • prx = short-term (4-8 weeks) for active duodenal & gastric ulcers, GERD, or maintenance of erosive esophagitis

  • should be taken 20-30 mins BEFORE 1st major meal of day (due to it being activated by food)

New cards
12

What are the adverse effects of PPIs?

*usually minor

  1. headache

  2. nausea

  3. diarrhea

  4. rash

  5. abdominal pain

*DR Omeprazole = higher risk of C. diff in hospitalized pt’s

New cards
13

What are the drug interactions of PPI’s?

Warfarin

  • may increase likelihood of bleeding

New cards
14

What is the mechanism of action of H2-receptor antagonists?

Blocks h2 receptors of parietal cells in stomach

  • this decreases acid production

New cards
15

What are examples of H2-receptor antagonists?

  1. famotidine (PepcidAC)

  2. cimetidine (Tagamet)

New cards
16

What is the therapeutic classification and use of famotidine (PepcidAC)?

  • antiulcer drug

  • USE:

    • duodenal and gastric ulcers

    • acute stress-induced bleeding ulcers

    • hypersecretory conditions in hospitalized pt’s

    • Heartburn

    • GERD

New cards
17

What are the drug interactions of H2-receptor antagonists?

  • Antacids should NOT be given w/in 1 hour of H2-receptor antagonists

  • smoking decreases effectiveness

New cards
18

What is the mechanism of action of antacids?

  • reacts w/ gastric acid = neutral salts/salts of low acidity

  • reduces destruction of gut wall by neutralizing acid

  • Caution in use w/ renal impairment

New cards
19

What are some examples of antiacids?

  1. aluminum hydroxide (AlternaGel)

  2. calcium carbonate (Titralac, Tums)

  3. calcium carbonate w/ magnesium hydroxide (Rolaids)

  4. Sodium bicarbonate (Alka-Seltzer)

  5. magnesium trisilicate & Aluminum hydroxide (Gaviscon)

  6. magnesium hydroxide & Aluminum hydroxide w/ simethicone (Mylanta)

New cards
20

What are the different types of antacids and their disadvantages ?

  1. Sodium - fluid retention

  2. Magnesium - fatigue, hypotension, dysrhythmias, interact w/ laxatives

  3. Calcium - constipation, aggravated kidney stones, milk-alkali syndrome

  4. Aluminum - constipation, hypophosphatemia

  5. Bicarbonate - metabolic acidosis, bloating, belching

New cards
21

What are 2 miscellaneous drugs use for PUD & GERD?

  1. bismuth compounds (Kaopectate, Pepto)

  2. sucralfate (Carafate)

New cards
22

What is the mechanism of action of bismuth compounds?

  • stimulates mucosal bicarb and prostaglandin production

  • inhibits H. pylori from attaching to tissue

  • NOT used for kids if salicylate is contained

  • CAN cause black stools!

New cards
23

What is the mechanism of action of sucralfate ?

  • stimulates mucus, bicarb, and prostaglandin secretion

  • creates effective protective barrier (up to 6 hours)

  • requires 4 daily dosing @ each meal & bed time

  • CAN cause constipation

  • MAY interfere w/ sucralfate

New cards

Explore top notes

note Note
studied byStudied by 15 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 3 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 3 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 2 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 17 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 14 people
Updated ... ago
4.5 Stars(2)
note Note
studied byStudied by 13 people
Updated ... ago
5.0 Stars(1)
note Note
studied byStudied by 53325 people
Updated ... ago
4.9 Stars(282)

Explore top flashcards

flashcards Flashcard20 terms
studied byStudied by 20 people
Updated ... ago
5.0 Stars(1)
flashcards Flashcard21 terms
studied byStudied by 1 person
Updated ... ago
5.0 Stars(1)
flashcards Flashcard70 terms
studied byStudied by 28 people
Updated ... ago
5.0 Stars(1)
flashcards Flashcard54 terms
studied byStudied by 37 people
Updated ... ago
5.0 Stars(1)
flashcards Flashcard126 terms
studied byStudied by 27 people
Updated ... ago
5.0 Stars(1)
flashcards Flashcard54 terms
studied byStudied by 5 people
Updated ... ago
5.0 Stars(2)
flashcards Flashcard36 terms
studied byStudied by 14 people
Updated ... ago
5.0 Stars(1)
flashcards Flashcard246 terms
studied byStudied by 15 people
Updated ... ago
4.0 Stars(1)