Peptic Ulcer Disease, Laxatives and Other Gastrointestinal Drugs Flashcards

Flashcards for Peptic Ulcer Disease, Laxatives and Other Gastrointestinal Drugs

Peptic Ulcer Disease

Group of upper gastrointestinal (GI) disorders with varying degrees of erosion of the gut wall.

Mucus

Secreted cells of the GI mucosa that form a barrier to protect underlying cells from acid and pepsin.

Bicarbonate

Secreted by epithelial cells of stomach and duodenum to neutralize hydrogen ions.

Prostaglandins

Stimulate the secretion of mucus and bicarbonate in the stomach.

Helicobacter pylori (H. pylori)

Gram-negative bacillus that can colonize the stomach and duodenum, contributing to peptic ulcer disease.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Inhibit the biosynthesis of prostaglandins, reducing blood flow, mucus, and bicarbonate, increasing the risk of ulcers.

Pepsin

Proteolytic enzyme in gastric juice that can contribute to ulcer development.

Goals of Peptic Ulcer Disease Drug Therapy

Alleviate symptoms, promote healing, prevent complications, and prevent recurrence.

Antibiotics for H. pylori

Should be given to all patients with gastric/duodenal ulcers and documented H. pylori infection.

Proton pump inhibitors (PPIs)

Preferred drugs for prophylaxis against NSAID-induced ulcers.

Histamine2 Receptor Antagonists

Class of drugs that are first-choice for treating gastric and duodenal ulcers and promote healing by suppressing secretion of gastric acid.

Proton Pump Inhibitors (PPIs)

Most effective drugs for suppressing secretion of gastric acid, used for short-term therapy of gastric/duodenal ulcers and GERD.

Sucralfate [Carafate]

Creates a protective barrier for up to 6 hours and is used for acute ulcers and maintenance therapy.

Antacids

React with gastric acid to produce neutral salts or salts of low acidity, reducing destruction of the gut wall.

Laxatives

Used to ease or stimulate defecation.

Group I Laxatives

Act rapidly (within 2 to 6 hours) and give stool a watery consistency; useful for preparing the bowel for diagnostic procedures or surgery.

Psyllium [Metamucil]

Bulk-forming laxative that functions similarly to dietary fiber, swelling with water to form a gel that softens and increases fecal mass.

Docusate sodium [Colace]

Laxative that alters stool consistency by lowering surface tension, which facilitates penetration of water into feces.

Bisacodyl [Dulcolax]

Laxative that stimulates intestinal motility and increases the amounts of water and electrolytes in the intestinal lumen.

Osmotic Laxatives

Laxatives that are poorly absorbed salts that draw water into the intestinal lumen, softening fecal mass and stimulating peristalsis.

Lubiprostone

Selective chloride channel activator that promotes secretion of chloride-rich fluid into the intestine and enhances motility.

Antiemetics

Antiemetics given to suppress nausea and vomiting.

Ondansetron [Zofran]

Antiemetic that blocks type 3 serotonin receptors on afferent vagal nerves.

Aprepitant

Antiemetic that blocks neurokinin1-type receptors (for substance P) in the chemoreceptor trigger zone (CTZ).

Prochlorperazine

Antiemetic that blocks dopamine2 receptors in CTZ.

Diarrhea

Causes stools of excessive volume and fluidity and increased frequency of defecation.

Opioids

Most effective antidiarrheal agents that activate opioid receptors in the GI tract, reducing intestinal motility.

Loperamide

Structural analog of meperidine used to treat diarrhea and reduce the volume of discharge from ileostomies.

Irritable Bowel Syndrome (IBS)

Most common disorder of the GI tract, characterized by symptoms present for 12 weeks over the past year.

Inflammatory Bowel Disease (IBD)

Caused by exaggerated immune response to normal bowel flora; includes Crohn’s disease and ulcerative colitis.

Sulfasalazine

Aminosalicylate that reduces inflammation and suppresses prostaglandin synthesis.

Infliximab

Monoclonal antibody designed to neutralize tumor necrosis factor (TNF), used for moderate to severe Crohn’s disease and ulcerative colitis.

Prokinetic Agents

Increase tone and motility of the GI tract.

Metoclopramide

Blocks receptors for dopamine and serotonin in the CTZ and increases upper GI motility and suppresses emesis.

Pancrelipase

Pancreatic enzyme for clinical use, a mixture of lipases, amylases, and proteases prepared from hog pancreas.

Regulation of Gastric Acid Secretion

Gastric acid secretion is increased by histamine, gastrin, and acetylcholine.

Complications of Peptic Ulcer Disease

Ulcers are a common cause of upper GI bleeding, characterized by hematemesis (vomiting blood) or melena (black, tarry stools).

Role of Acid-Suppressing Agents in H. pylori Treatment

Administered with antibiotics to treat H. pylori infections, reducing gastric acid secretion and promoting ulcer healing.

Therapeutic Uses of Proton Pump Inhibitors (PPIs)

Used primarily for acid suppression, promoting healing of ulcers, and managing GERD symptoms.

Administration Guidelines for Sucralfate

Promotes ulcer healing by creating a protective barrier against acid and pepsin; administer on an empty stomach to maximize effectiveness.

Clinical Use of Laxatives

Primarily used for constipation, but some are used to cleanse the bowel before procedures or surgery.

Benefits of Psyllium [Metamucil] as a Fiber Supplement

Useful in patients with difficulty increasing fiber intake from whole foods alone.

Considerations for Use of Osmotic Laxatives

Avoid prolonged use due to potential for electrolyte imbalances and dehydration.

Clinical Uses of Ondansetron [Zofran]

Used for chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV).

Combination Therapy with Aprepitant

Often used in combination with other antiemetics for enhanced control of chemotherapy-induced nausea and vomiting.

Use of Opioids in Diarrhea Management

Can be used to reduce fluid loss in severe diarrhea.

Subtypes of Irritable Bowel Syndrome

Categorized mainly as diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), mixed (IBS-M), and unsubtyped (IBS-U).

Etiology of Inflammatory Bowel Disease (IBD)

May involve genetic predisposition, immune dysregulation, and environmental factors.

Mechanism of Action of Sulfasalazine

Used to treat inflammatory bowel disease by reducing inflammation and suppressing prostaglandin synthesis.

Effects of Metoclopramide on Gastrointestinal Motility

Facilitates gastric emptying and reduces acid reflux into the esophagus.

Purpose of Pancrelipase in Pancreatic Insufficiency

Used to supplement pancreatic secretions in patients with pancreatic insufficiency, aiding in digestion.