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antacids
neutralize stomach acid
antiflatulent
many antacids contain _____ drug simethicone
counteract the constipating effect of aluminum and calcium
what gonna happen when there is magnesium on aluminum and calcium
avoid pt with renal failure
what should be avoided when taking antacid with magnesium
sodium bicarbonate
quick onset short duration of action
highly soluble
buffer acids properties of Hydrochloric acid
cause “ METABOLIC ALLCOLOSIS
heart failure
hypertension
renal insufficiency
sodium content may cause problem with…????
do not prevent the overproduction, but help neutralize
what is the mechanism of action of antacids
mucosal defensive mechanism
what antacids promoting??? go ghurl
mucus
protective barrier from hydrochloric acid
bicarbonate
helps buffer acidic properties properties of HA ( hydrochloric acid)
Prostaglandins
prevent activation of proton pump inhibitor ( PPI)
reduction of pain and reflux associated with acid related disorder
drug effect of antacids
true
true or false
increase gastric ph 1 to nuetralize 90% of gastric acid
base mediated inhibition
increase resistance of the stomach, tone of the cardiac sphincter
decrease acidity decrease pain as result of
metabolic alkalosis
adverse effect of overuse of antacids???
constipation
adverse effect of aluminum and calcium
diarrhea
adverse effect of magnesium
kidney stone, rebound acidity
adverse effect of calcium
produce gas and blenching often combines with simethicone
adverse effect of calcium bicarbonate
relief:
peptic ulcer
gastritis
gastric hyperacidity
heartburn
indication of antacids
severe renal failure
electrolytes disturbance
GI obstruction
contraindication for antacids
aluminum hydroxide
magnesium hydroxide
simethicone
combination of aluminum hydroxide and magnesium hydroxide contain a local anaesthetic (mucaine)
types of antacids
constipating effect
what effect have the aluminum salt?
counteract constipating effect
what gonna happen when theirs magnesium on aluminum salt?
aluminum salt
often recommended pt wt renal disease
antacids plus
diovol
gelusil
maalox
multiaction
combination products : aluminum/ magnesium example:
diarrhea
what id the effect of magnesium salt
renal failure: resulting accumulation
dangerous thing can happen when using magnesium salt
carbonate
most common form of calcium salt
constipation
kidney stone
what is the cause of calcium salt
calcium salt
not recommended with renal disease
increase gastric acid secretion
what happen when their is long duration of acid action?
fluid imbalances
renal disease
gastrointestinal obstruction
heart failure
pregnancy
that may restricts the use of antacids such as:
with high sodium
pt with heart failure/ hypertention should not use antacids with????
t
t or f use caution with other medications because of many drug interaction
administer antacids with 1 to 2 hr of other medication
how to administer antacids?
malignancy
bleeding ulcer
long use of antacids ( self medication) may mask serious diseases like:
h2 antagonists
reduction of acid secretion
cimetidine
ranitidine
famotidine
most popular drug for treatment of acid- related disorder
t
t or f smoking can decreases the effectiveness of h2 blockers
Acidic gastrointestinal environment
h2 antagonists require______for absorption?
block h2 receptor producing parietal cell
mechanism of action of h2 antagonists
reduce hydrogen ion
increase ph
relief of many symptoms associated with hyperacidity related condition
whta gonna happen when producing parietal cell are blocked (3)
suppressed acid secretion in the stomach
drug effect of h2 antagonists
confusion and disorientation
adverse effect of h2 antagonists
erectile dysfunction and gynecomastia
cimetidine can cause??
thrombocytopenia
what is the thing that has been reported with ranitidine and famotidine
GERD
peptic ulcer
erosive esophagitis
zollinger- ellison syndrome
indication of h2 antagonist
LOWER DOSAGE FORM
(over the counter)OTC of h2 antagonist are available in???
1 to 2 hours before antacids and 30 mins before eating
When should h2 antagonist be administered?
NSAIDs Because it decreases effectiveness
smoking
stress
overeating
what should be avoided when taking h2 antagonists and why
tot treat certain allergic reaction
cimetidine still used for today for
ranitidine hydrochloride (zantac)
what is the most widely used h2 antagonists
follow administration guideline
h2 antagonists: for intravenous doses what should the nurse do
inhibited oxidation of many drug
increased drug level
cimetidine binds with p450 microsmal oxidose in liver resulting ?? (2)
release positive hydrogen ( protons ) during hydrochloric acid production
How does the proton pump work?
h2 blocksers
antihistamine
what are the 2 things that cant stop the action of proton pump
Binds to h+/ k+ adenosine triphosphatase (ATPASE) enzymes
mechanism of action of PPI
it prevent the movement of the parietal cell to the stomach resulting : ACHLORHYDRIA:
what gonna happen when they Binds to ATPase enzymes
temporary blocked
what gonna happen to the gastric acid secretion when there is ACHLORHYDRIA:
the parietal cell must synthesize new H+ / K+ ATPase
what to do to unblock the gastric acid secretion ?
true
t or f: PPI are generally well tolerated
osteoporosis
long term use of PPI can develop WHATT??????????!!?!?!?!
clostridium difficile infection risk of fracture ( hip , wrist , spine) and pneumonia
long term use of PPI with HIGH DOSE associated with
acute kidney injury
interstitial nephritis ( in older people)
if PPI are taken the health care providers to be alert to the possibility of an increased risk of
erosive esophagitis
symptomatic GERD
PPI are currently indicated as first line therapy for (2)
duodenal
benign gastric ulcer
zollinger ellison syndrome
NSAIDs
using PPI for short term treatment for
stress ulcer prohylaxis
PPI also used for
H. bylori infection
All PPI can be used in combination with antibiotics to treat what?
lansoprazole , a combo with amoxicillin and clarithromycin
taken 30 to 60 min before meals
when should omeprazole (locsec) be administered
used in combination to treat H. pylori
what is the usage of lansoprazole
true
t or f the pill of lansoprazole can be opened and mixed with apple sauce or something to be given through a tube feed
Increase serum level of DIAZEPAM AND PHENYTOIN
contraindication for PPI
bleeding
taking both PPI and warfarin sodium the pt risk for ?
sucralfate
what is the thing that can delay the absorption of PPI
T
t or f FOOD may decrease absorption of PPI
take with a empty stomach
How to take PPI
sucralfate
misoprostol
simethicone
what are the miscellaneous acid controlling drug
mucosal protectant; active stress ulceration and long term therapy for Peptic ulcer disease
sucralfate used as_______ and treat
FALSE GHURL
SUCRALFATE act locally
t or f sucralfate act systemically
begins to dissociate into aluminum hydroxide ( antacids) and sulphate anions
once sucralfate comes contact with acid of the stomach what happen next
protective barrier
sucralfate attached and binds to the base of ulcer and erosion to form what?
t
t or f sucralfate limit the access of pepsin
ulcer healing
sucralfate bind and concentrates epidermal growth factor in the gastric tissue which promote what??!?!?!?
chronic renal failure to reduce phosphate level
sucralfate binds with phosphate may be used in
nausea
constipation
dry mouth
sucralfate adverse effect are uncommon but include what???
misprostol
prostaglandins E analoque
effectively reduce the incidence ofgastric ulcers in the pt taking NSAIDs
protect gastric mucosa from injury
promote local cell regeneration
help to maintain mucosal blood flow
protaglandins have cytoprotective activity
drug allergy
pregnant or trying to be pregnant
use of misoprostol contraindicated in pat w/
headache
GI distress
Vaginal bleeding
adverse effect of misoprostol
abdominal cramps, diarrhea
synthetic of analoques of prostaglandins promote healing of duodenal ulcer; to accomplish this the drugs must be used in dosages that have adverse effect of
simethicone
used to reduced the discomfort of gastric intestinal gas via mouth and rectum; classified as antiflatulents drug
swallowed air; largely of nitrogen
gas in the upper gi tract composed of? (2)
legumens ( beans)
cruciferous vegetables
cauliflower/ brocoli
gas producing properties (3)
diverculitis
dyspepsia
peptic ulcer
spatic/ irritable colon
gas also result from disorder(4)
decreased gas pain/ increased expulsion via mouth and rectum
simethicone: alter elasticity of mucus coated gas bubbles breaking them into smaller ones result as????
Note 
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