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WGU D116 Pharm Unit 7 GI Questions And Answers With Verified Solutions
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WGU D116 Pharm Unit 7 GI Questions And Answers With Verified Solutions
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WGU D116 Pharm Unit 7 GI Questions And AnswersWith Verified Solutions
Peptic ulcer disease (PUD) ANS Group of upper GI disorders characterized by varying degrees
of erosion of esophagus, stomach, small intestine
Patho of PUD ANS Imbalance between mucosal defensive factors and aggressive factors
Defense: mucus, bicarbonate, blood flow, prostaglandins
Aggressive: h. Pylori, nsaids, acid, pepsin, smoking
H. pylori ANS Gram negative bacillus between epithelial cells and mucus barrier, produces
urease which firms CO2 and ammonia (potentially toxic to mucosa), increases risk of CA, gastric
mucosa-assoc lymphoid tissue (MALT)
Zollinger-Ellison Syndrome (ZES) ANS disorder of excess acid secretion in the stomach
resulting in peptic ulcer disease, caused by tumor that secretes gastrin (hormone that stimulates
gastric acid production)
tx: ranitidine
Classes of anti secretory drugs ANS -H2 receptor antagonists (H2RA)
-Proton pump inhibitors (PPI)
-Mucosal protectant
-Anti secretory agent that enhances mucosal defenses
-Antiacids
Types of action: eradicate H pylori, decrease gastric acidity, enhance mucosal defenses
H2 receptor antagonists ANS -tidine
Cimetidine (Tagamet), famotidine (Pepcid), nuzatidine (axid), ranitidine (Zantac)
*suppresses acid secretion by blocking H2 receptors on parietal cells
Proton Pump Inhibitors (PPIs) ANS -prazole
, Dexlansoprazole (dexilant), esomeprazole (nexium), lansoprazole (prevacid), omeprazole (Prilosec),
pantoprazole (protonix), ralbeprozole (aciphex)
*suppress acid secretion by inhibiting H+, K+-ATPase (enzyme that makes gastric acid)
Mucosal protectant ANS Sucralfate (carafate)
Forms barrier over ulcer crater that protects against acid and pepsin
Antisecretory agent that enhances mucosal defenses ANS Misoprostol (Cytotec)
Protects against NSAID-induced ulcers by stimulating secretion of bicarbonate and mucus, maintains
blood flow, suppressing secretion of gastric acid
Antiacids ANS aluminum hydroxide, calcium carbonate, magnesium hydroxide
React with gastric acid to form neutral salts
Non drug therapy for PUD ANS Diet: change eating pattern, 5-6 meals/day can decrease
fluctuations in acid and promote healing
Others: stop smoking, avoid NSAID's, evaluate if alcohol exacerbates symptoms, if so, stop
Clarythromycin based triple therapy ANS 1-clarythromycin +amoxicillin+PPI
Or
2-clarythromycin+flagyl+PPI
Bismuth-Based Quadruple Therapy ANS PPI or H2RA, bismuth subsalicylate, tetracycline,
metronidazole
Cimetidine (Tagamet) ANS *class*: Histamine H2 antagonist, antiulcer agent
*Indication*: treatment of duodenal ulcers, GERD, heartburn, Zollinger Ellison syndrome,
prevention of GI bleeding in critical patients.
*Action*: inhibits action of histamine leading to inhibition of gastric acid secretion
*Nursing Considerations*:
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