pharm chapter 39

antacids

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????