This document discusses drugs used to treat gastrointestinal tract conditions. It begins by introducing peptic ulcers and gastroesophageal reflux disease. It then discusses the aggressive and protective factors involved in these conditions. The document outlines how drugs like antacids, H2 blockers, and proton pump inhibitors work to neutralize or decrease stomach acid production. It provides details on the mechanisms, indications, side effects and nursing considerations for various classes of gastrointestinal drugs including antacids, H2 blockers, proton pump inhibitors, sucralfate, and misoprostol.
This document discusses various drugs used to treat gastrointestinal conditions related to acid production and regulation in the stomach. It begins by describing the anatomy and cells of the gastric gland responsible for acid and enzyme secretion. It then discusses acid-related diseases like ulcers and reflux and describes various classes of acid-controlling drugs including antacids, H2 receptor antagonists, and proton pump inhibitors. For each drug class, it provides details on mechanisms of action, indications, side effects, drug interactions and nursing implications.
This document discusses various drugs used to control acid in the gastrointestinal tract. It begins by describing the cells of the gastric gland and their roles in acid secretion. It then discusses various acid-related diseases and the pathophysiology involved. The main types of acid-controlling agents covered are antacids, H2 antagonists, and proton pump inhibitors. For each, the document outlines their mechanism of action, indications, side effects, drug interactions, and important nursing considerations. Sucralfate and misoprostol are also briefly mentioned at the end.
The document discusses acid-controlling agents and their classification. It describes how the stomach secretes hydrochloric acid and other substances. There are two main types of glands in the stomach - oxyntic and pyloric glands. The oxyntic glands contain parietal cells which produce hydrochloric acid. Acid-controlling agents are classified into five categories - antacids, anti-secretory agents, mucosal protective agents, ulcer healing agents, and anti-Helicobacter pylori agents. Common anti-secretory agents discussed are H2 receptor antagonists like ranitidine and proton pump inhibitors like omeprazole. Sucralfate and bismuth are mentioned
Gastrointestinal Medications in adult patients.pptxHaroldSuarez10
The document discusses various types of gastrointestinal medications used to treat acid-related disorders. It describes the cells of the gastric gland and their roles in acid production. Antacids work by neutralizing acid in the stomach, while H2 blockers and proton pump inhibitors reduce acid secretion by blocking histamine receptors or the proton pump enzyme. Proton pump inhibitors provide the strongest acid suppression. The document reviews the mechanisms, indications, side effects and nursing considerations for antacids, H2 blockers, proton pump inhibitors, sucralfate and misoprostol.
The document summarizes various acid-controlling agents including antacids, H2 antagonists, proton pump inhibitors, sucralfate, and misoprostol. It describes their mechanisms of action, therapeutic uses, side effects, drug interactions, and nursing implications. The stomach normally secretes acid and enzymes to digest food, but excessive acid can cause issues. Antacids neutralize stomach acid, H2 blockers reduce acid production, and proton pump inhibitors completely block acid secretion.
NurseReview.Org - Antacids And Controllers Updates (pharmacology for advanced...jben501
The document summarizes various drugs used to treat acid-related gastrointestinal disorders. It describes the mechanisms and effects of antacids, H2 blockers, proton pump inhibitors, sucralfate, and misoprostol. Antacids neutralize stomach acid but do not prevent its production, while H2 blockers and proton pump inhibitors suppress acid secretion through different mechanisms. Sucralfate forms a protective barrier over ulcers and erosions, and misoprostol protects the gastric mucosa.
The document discusses drugs used to treat peptic ulcers, gastroesophageal reflux disease, diarrhea, and constipation. It describes the causes of peptic ulcers including H. pylori infection and NSAID use. Treatment involves eradicating H. pylori, reducing gastric acid with H2 blockers or proton pump inhibitors, and protecting the gastric mucosa. Various classes of drugs are covered that act on these mechanisms including antimicrobials, H2 blockers, proton pump inhibitors, prostaglandins, and antacids.
Drugs acting on the gastro-intestinal tractElton Nyengo
The document summarizes drugs used to treat conditions of the gastrointestinal tract. It describes how drugs are categorized based on their effects in the GIT, such as antacids, laxatives, and antidiarrheals. It provides details on the anatomy and physiology of the stomach, specifically focusing on the gastric glands and cells involved in acid production. Furthermore, it discusses the different classes of acid-controlling drugs - antacids, H2 receptor antagonists, and proton pump inhibitors - and their mechanisms of action in reducing gastric acid secretion. Common uses and side effects of these drugs are also summarized.
This document discusses various drugs used to treat gastrointestinal conditions related to acid production and regulation in the stomach. It begins by describing the anatomy and cells of the gastric gland responsible for acid and enzyme secretion. It then discusses acid-related diseases like ulcers and reflux and describes various classes of acid-controlling drugs including antacids, H2 receptor antagonists, and proton pump inhibitors. For each drug class, it provides details on mechanisms of action, indications, side effects, drug interactions and nursing implications.
This document discusses various drugs used to control acid in the gastrointestinal tract. It begins by describing the cells of the gastric gland and their roles in acid secretion. It then discusses various acid-related diseases and the pathophysiology involved. The main types of acid-controlling agents covered are antacids, H2 antagonists, and proton pump inhibitors. For each, the document outlines their mechanism of action, indications, side effects, drug interactions, and important nursing considerations. Sucralfate and misoprostol are also briefly mentioned at the end.
The document discusses acid-controlling agents and their classification. It describes how the stomach secretes hydrochloric acid and other substances. There are two main types of glands in the stomach - oxyntic and pyloric glands. The oxyntic glands contain parietal cells which produce hydrochloric acid. Acid-controlling agents are classified into five categories - antacids, anti-secretory agents, mucosal protective agents, ulcer healing agents, and anti-Helicobacter pylori agents. Common anti-secretory agents discussed are H2 receptor antagonists like ranitidine and proton pump inhibitors like omeprazole. Sucralfate and bismuth are mentioned
Gastrointestinal Medications in adult patients.pptxHaroldSuarez10
The document discusses various types of gastrointestinal medications used to treat acid-related disorders. It describes the cells of the gastric gland and their roles in acid production. Antacids work by neutralizing acid in the stomach, while H2 blockers and proton pump inhibitors reduce acid secretion by blocking histamine receptors or the proton pump enzyme. Proton pump inhibitors provide the strongest acid suppression. The document reviews the mechanisms, indications, side effects and nursing considerations for antacids, H2 blockers, proton pump inhibitors, sucralfate and misoprostol.
The document summarizes various acid-controlling agents including antacids, H2 antagonists, proton pump inhibitors, sucralfate, and misoprostol. It describes their mechanisms of action, therapeutic uses, side effects, drug interactions, and nursing implications. The stomach normally secretes acid and enzymes to digest food, but excessive acid can cause issues. Antacids neutralize stomach acid, H2 blockers reduce acid production, and proton pump inhibitors completely block acid secretion.
NurseReview.Org - Antacids And Controllers Updates (pharmacology for advanced...jben501
The document summarizes various drugs used to treat acid-related gastrointestinal disorders. It describes the mechanisms and effects of antacids, H2 blockers, proton pump inhibitors, sucralfate, and misoprostol. Antacids neutralize stomach acid but do not prevent its production, while H2 blockers and proton pump inhibitors suppress acid secretion through different mechanisms. Sucralfate forms a protective barrier over ulcers and erosions, and misoprostol protects the gastric mucosa.
The document discusses drugs used to treat peptic ulcers, gastroesophageal reflux disease, diarrhea, and constipation. It describes the causes of peptic ulcers including H. pylori infection and NSAID use. Treatment involves eradicating H. pylori, reducing gastric acid with H2 blockers or proton pump inhibitors, and protecting the gastric mucosa. Various classes of drugs are covered that act on these mechanisms including antimicrobials, H2 blockers, proton pump inhibitors, prostaglandins, and antacids.
Drugs acting on the gastro-intestinal tractElton Nyengo
The document summarizes drugs used to treat conditions of the gastrointestinal tract. It describes how drugs are categorized based on their effects in the GIT, such as antacids, laxatives, and antidiarrheals. It provides details on the anatomy and physiology of the stomach, specifically focusing on the gastric glands and cells involved in acid production. Furthermore, it discusses the different classes of acid-controlling drugs - antacids, H2 receptor antagonists, and proton pump inhibitors - and their mechanisms of action in reducing gastric acid secretion. Common uses and side effects of these drugs are also summarized.
The document discusses drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like histamine receptor blockers, proton pump inhibitors, antacids, mucosal protectants and prostaglandin analogs. It provides details on the mechanisms of action, indications, side effects and nursing considerations for various classes of drugs including H2 receptor blockers, antacids, proton pump inhibitors and the mucosal protectant sucralfate.
This document discusses various drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like antacids, H2 receptor blockers, proton pump inhibitors, mucosal protectants, and prostaglandin analogs. It also discusses laxatives, which are used to increase bowel movements, and are classified based on their mechanisms of action. Common side effects and nursing considerations are provided for each drug class.
Peptic ulcer (defination, cause, tratment)Mohd Mohd
This document summarizes peptic ulcer disease and acid peptic disorders. It discusses the anatomy of the stomach, risk factors for peptic ulcers, symptoms, physiology of acid secretion, and treatments. The main causes of peptic ulcers are Helicobacter pylori infection and NSAID use. Treatment involves acid suppression with proton pump inhibitors or H2 blockers, eradicating H. pylori infections, and mucosal protective agents.
This document discusses anti-ulcer agents and their mechanisms of action. It covers H2 receptor antagonists, which competitively block H2 receptors on parietal cells, reducing acid secretion. Common side effects are mild. It also discusses proton pump inhibitors, which irreversibly inhibit the proton pump on parietal cells, providing powerful acid suppression. Proton pump inhibitors are now the standard treatment for peptic ulcers and gastroesophageal reflux disease. Finally, it briefly discusses antacids, which neutralize gastric acid and indirectly reduce pepsin activity, but do not decrease acid production and cause acid rebound.
This document summarizes anti-ulcer drugs. It discusses the causes of ulcers including H. pylori infections and NSAID use. The main types of ulcers are described along with signs and symptoms. Treatment includes eradicating H. pylori, decreasing acid secretion through proton pump inhibitors or H2 receptor blockers, and protecting the stomach lining with drugs like misoprostol or sucralfate. Proton pump inhibitors are now the most potent way to decrease acid production and promote ulcer healing.
This document discusses the pharmacotherapy of peptic ulcers. It begins by classifying the main drugs used: 1) those that inhibit gastric acid secretion like H2 blockers and proton pump inhibitors, 2) antacids that neutralize acid, 3) ulcer protectives like sucralfate, and 4) anti-H. pylori drugs for eradication. It then goes into detail about the mechanisms, uses, and side effects of the major drug classes. H2 blockers competitively block H2 receptors to suppress acid secretion. Proton pump inhibitors irreversibly inactivate the H+/K+ ATPase pump for prolonged acid inhibition. Antacids chemically neutralize acid. Sucralfate
Group 5_ Year 3 Pharmacology 2023.pptxssuser504dda
This document discusses acid secretion disorder drugs and anti-emetic drugs. It begins by explaining the physiology of gastric acid secretion, which is regulated by gastrin, histamine, and acetylcholine. It then discusses acid secretion disorders like GERD, gastritis, and ulcers. The main drugs used for acid secretion disorders are outlined, including antacids, H2 receptor antagonists like ranitidine, and proton pump inhibitors like omeprazole. It provides details on their mechanisms of action, pharmacokinetics, uses and side effects. The document also briefly discusses anti-emetic drugs and the physiology of vomiting before concluding.
This document summarizes drugs used to treat gastrointestinal disorders including peptic ulcers, gastroesophageal reflux disease, chemotherapy-induced nausea and vomiting, and diarrhea or constipation. It describes classes of drugs like H2 receptor antagonists, proton pump inhibitors, antacids, cytoprotective agents, antiemetics, antimotility agents, and laxatives. It provides details on specific drugs, their mechanisms of action, indications, and side effects for treating various GI conditions.
This document discusses various drugs used to treat gastric acid-related disorders. It describes antacids that neutralize acid in the stomach, including aluminum and magnesium compounds, calcium carbonate, and sodium bicarbonate. It also discusses H2 receptor antagonists, proton pump inhibitors, and other drugs that reduce acid secretion. The document provides details on the mechanisms of action, pharmacokinetics, therapeutic uses and potential side effects of these different drug classes.
Pharmacology of Gastrointestinal Disorders dineshmeena53
This power point presentation will be helpful for Pharmacy, Medical and paramedical students. it consists of" what are the common GIT disorders and their pharmacological management "
The document discusses drugs used to treat peptic ulcers. It explains that peptic ulcers result from an imbalance between acid-pepsin secretion and mucosal defenses in the gastrointestinal tract. Various classes of drugs are described that work by neutralizing acid, reducing acid secretion, or protecting the mucosa. Antacids neutralize acid but do not reduce secretion. H2 receptor blockers and proton pump inhibitors competitively inhibit acid secretion through different mechanisms. Protective drugs like sucralfate coat the mucosa to prevent damage from acid.
The document summarizes drugs used to treat peptic ulcers. It discusses how gastric acid secretion is regulated and the roles of histamine, acetylcholine, and gastrin. It outlines approaches to treatment including eradicating Helicobacter pylori infections, reducing acid with H2 receptor antagonists or proton pump inhibitors, and protecting the mucosa. Specific drugs mentioned include omeprazole, lansoprazole, ranitidine, famotidine, misoprostol, and antacids. Adverse effects and pharmacokinetics of the various drug classes are also summarized.
This document provides an overview of drugs that affect the digestive system. It discusses how the digestive system and drug therapy have a reciprocal relationship, with some drugs causing GI symptoms and some GI disorders altering drug absorption. Several classes of drugs are described, including laxatives, antacids, H2 receptor antagonists, proton pump inhibitors, antiemetics, and others. The mechanisms of action, indications, and side effects of these drugs are summarized. Nursing considerations for administering some of these medications are also reviewed.
This document provides an overview of drugs that affect the digestive system. It discusses how the digestive system and drug therapy interact, and classes of drugs that impact the GI tract, including laxatives, antacids, H2 receptor antagonists, and proton pump inhibitors. Specific drugs are explained, along with their mechanisms of action, indications, and side effects. The document also reviews causes of nausea and vomiting and classes of antiemetic drugs.
This document discusses drugs used to treat peptic ulcer disease. It begins by defining peptic ulcers and noting the major causes include H. pylori infection, NSAIDs, smoking, and stress. The pathophysiology involves a imbalance between aggressive factors like acid and protective factors. Treatment involves eradicating H. pylori, reducing acid secretion using proton pump inhibitors or H2 receptor blockers, and cytoprotective agents. Proton pump inhibitors are the most potent acid reducers and are now the first choice treatment. Common side effects of treatment include headaches and diarrhea.
The document discusses various drugs that affect the gastrointestinal system, including those used to treat peptic ulcer disease, constipation, diarrhea, and vomiting. It describes factors that increase or decrease acid secretion in the stomach, and drugs that inhibit acid production such as H2 receptor antagonists and proton pump inhibitors. It also discusses treatments for Helicobacter pylori infection, as well as laxatives, antidiarrheal agents, and antiemetic drugs.
This document discusses peptic ulcers, including their causes, symptoms, and treatments. It notes that peptic ulcers are open sores in the upper digestive tract that can form in the stomach (gastric ulcer) or small intestine (duodenal ulcer). Common causes include H. pylori infection, NSAIDs, and stress. Symptoms may include abdominal pain, nausea, black stools, or weight loss. Treatments discussed include antibiotics to kill H. pylori, antacids to neutralize stomach acid, drugs that decrease acid secretion, ulcer protective drugs to coat the ulcer, and ulcer healing drugs.
This slide consists of details related to Peptic ulcers and what can be the possible drugs to be used with their overview. I hope this will be helpful for all readers.
The document discusses drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like histamine receptor blockers, proton pump inhibitors, antacids, mucosal protectants and prostaglandin analogs. It provides details on the mechanisms of action, indications, side effects and nursing considerations for various classes of drugs including H2 receptor blockers, antacids, proton pump inhibitors and the mucosal protectant sucralfate.
This document discusses various drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like antacids, H2 receptor blockers, proton pump inhibitors, mucosal protectants, and prostaglandin analogs. It also discusses laxatives, which are used to increase bowel movements, and are classified based on their mechanisms of action. Common side effects and nursing considerations are provided for each drug class.
Peptic ulcer (defination, cause, tratment)Mohd Mohd
This document summarizes peptic ulcer disease and acid peptic disorders. It discusses the anatomy of the stomach, risk factors for peptic ulcers, symptoms, physiology of acid secretion, and treatments. The main causes of peptic ulcers are Helicobacter pylori infection and NSAID use. Treatment involves acid suppression with proton pump inhibitors or H2 blockers, eradicating H. pylori infections, and mucosal protective agents.
This document discusses anti-ulcer agents and their mechanisms of action. It covers H2 receptor antagonists, which competitively block H2 receptors on parietal cells, reducing acid secretion. Common side effects are mild. It also discusses proton pump inhibitors, which irreversibly inhibit the proton pump on parietal cells, providing powerful acid suppression. Proton pump inhibitors are now the standard treatment for peptic ulcers and gastroesophageal reflux disease. Finally, it briefly discusses antacids, which neutralize gastric acid and indirectly reduce pepsin activity, but do not decrease acid production and cause acid rebound.
This document summarizes anti-ulcer drugs. It discusses the causes of ulcers including H. pylori infections and NSAID use. The main types of ulcers are described along with signs and symptoms. Treatment includes eradicating H. pylori, decreasing acid secretion through proton pump inhibitors or H2 receptor blockers, and protecting the stomach lining with drugs like misoprostol or sucralfate. Proton pump inhibitors are now the most potent way to decrease acid production and promote ulcer healing.
This document discusses the pharmacotherapy of peptic ulcers. It begins by classifying the main drugs used: 1) those that inhibit gastric acid secretion like H2 blockers and proton pump inhibitors, 2) antacids that neutralize acid, 3) ulcer protectives like sucralfate, and 4) anti-H. pylori drugs for eradication. It then goes into detail about the mechanisms, uses, and side effects of the major drug classes. H2 blockers competitively block H2 receptors to suppress acid secretion. Proton pump inhibitors irreversibly inactivate the H+/K+ ATPase pump for prolonged acid inhibition. Antacids chemically neutralize acid. Sucralfate
Group 5_ Year 3 Pharmacology 2023.pptxssuser504dda
This document discusses acid secretion disorder drugs and anti-emetic drugs. It begins by explaining the physiology of gastric acid secretion, which is regulated by gastrin, histamine, and acetylcholine. It then discusses acid secretion disorders like GERD, gastritis, and ulcers. The main drugs used for acid secretion disorders are outlined, including antacids, H2 receptor antagonists like ranitidine, and proton pump inhibitors like omeprazole. It provides details on their mechanisms of action, pharmacokinetics, uses and side effects. The document also briefly discusses anti-emetic drugs and the physiology of vomiting before concluding.
This document summarizes drugs used to treat gastrointestinal disorders including peptic ulcers, gastroesophageal reflux disease, chemotherapy-induced nausea and vomiting, and diarrhea or constipation. It describes classes of drugs like H2 receptor antagonists, proton pump inhibitors, antacids, cytoprotective agents, antiemetics, antimotility agents, and laxatives. It provides details on specific drugs, their mechanisms of action, indications, and side effects for treating various GI conditions.
This document discusses various drugs used to treat gastric acid-related disorders. It describes antacids that neutralize acid in the stomach, including aluminum and magnesium compounds, calcium carbonate, and sodium bicarbonate. It also discusses H2 receptor antagonists, proton pump inhibitors, and other drugs that reduce acid secretion. The document provides details on the mechanisms of action, pharmacokinetics, therapeutic uses and potential side effects of these different drug classes.
Pharmacology of Gastrointestinal Disorders dineshmeena53
This power point presentation will be helpful for Pharmacy, Medical and paramedical students. it consists of" what are the common GIT disorders and their pharmacological management "
The document discusses drugs used to treat peptic ulcers. It explains that peptic ulcers result from an imbalance between acid-pepsin secretion and mucosal defenses in the gastrointestinal tract. Various classes of drugs are described that work by neutralizing acid, reducing acid secretion, or protecting the mucosa. Antacids neutralize acid but do not reduce secretion. H2 receptor blockers and proton pump inhibitors competitively inhibit acid secretion through different mechanisms. Protective drugs like sucralfate coat the mucosa to prevent damage from acid.
The document summarizes drugs used to treat peptic ulcers. It discusses how gastric acid secretion is regulated and the roles of histamine, acetylcholine, and gastrin. It outlines approaches to treatment including eradicating Helicobacter pylori infections, reducing acid with H2 receptor antagonists or proton pump inhibitors, and protecting the mucosa. Specific drugs mentioned include omeprazole, lansoprazole, ranitidine, famotidine, misoprostol, and antacids. Adverse effects and pharmacokinetics of the various drug classes are also summarized.
This document provides an overview of drugs that affect the digestive system. It discusses how the digestive system and drug therapy have a reciprocal relationship, with some drugs causing GI symptoms and some GI disorders altering drug absorption. Several classes of drugs are described, including laxatives, antacids, H2 receptor antagonists, proton pump inhibitors, antiemetics, and others. The mechanisms of action, indications, and side effects of these drugs are summarized. Nursing considerations for administering some of these medications are also reviewed.
This document provides an overview of drugs that affect the digestive system. It discusses how the digestive system and drug therapy interact, and classes of drugs that impact the GI tract, including laxatives, antacids, H2 receptor antagonists, and proton pump inhibitors. Specific drugs are explained, along with their mechanisms of action, indications, and side effects. The document also reviews causes of nausea and vomiting and classes of antiemetic drugs.
This document discusses drugs used to treat peptic ulcer disease. It begins by defining peptic ulcers and noting the major causes include H. pylori infection, NSAIDs, smoking, and stress. The pathophysiology involves a imbalance between aggressive factors like acid and protective factors. Treatment involves eradicating H. pylori, reducing acid secretion using proton pump inhibitors or H2 receptor blockers, and cytoprotective agents. Proton pump inhibitors are the most potent acid reducers and are now the first choice treatment. Common side effects of treatment include headaches and diarrhea.
The document discusses various drugs that affect the gastrointestinal system, including those used to treat peptic ulcer disease, constipation, diarrhea, and vomiting. It describes factors that increase or decrease acid secretion in the stomach, and drugs that inhibit acid production such as H2 receptor antagonists and proton pump inhibitors. It also discusses treatments for Helicobacter pylori infection, as well as laxatives, antidiarrheal agents, and antiemetic drugs.
This document discusses peptic ulcers, including their causes, symptoms, and treatments. It notes that peptic ulcers are open sores in the upper digestive tract that can form in the stomach (gastric ulcer) or small intestine (duodenal ulcer). Common causes include H. pylori infection, NSAIDs, and stress. Symptoms may include abdominal pain, nausea, black stools, or weight loss. Treatments discussed include antibiotics to kill H. pylori, antacids to neutralize stomach acid, drugs that decrease acid secretion, ulcer protective drugs to coat the ulcer, and ulcer healing drugs.
This slide consists of details related to Peptic ulcers and what can be the possible drugs to be used with their overview. I hope this will be helpful for all readers.
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Vectors have both magnitude and direction, while scalars only have magnitude. Examples of vectors include velocity and force, while examples of scalars include speed and temperature. Addition and subtraction of vectors can be done by using their components in x and y directions or by using geometric methods like the parallelogram rule.
This document discusses drugs used to treat gastrointestinal tract conditions. It begins by introducing peptic ulcers and gastroesophageal reflux disease. It then discusses the aggressive and protective factors involved in these conditions. The document outlines how drugs work to neutralize hydrochloric acid through various mechanisms, including antacids, H2 blockers, and proton pump inhibitors. It provides details on the mechanisms, indications, side effects and nursing implications of different drug classes used to treat gastrointestinal conditions like ulcers.
How to Setup Default Value for a Field in Odoo 17Celine George
In Odoo, we can set a default value for a field during the creation of a record for a model. We have many methods in odoo for setting a default value to the field.
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2. Introduction:
Peptic ulcer : is a damage of the mucosal lining of the stomach (gastric ulce
r) or the duodenum (duodenal ulcer) due to imbalance between aggressive f
actors and protectivefactors
Gastroesophageal Reflux Disease (GERD): ulceration of esophageal mucosa by
regurgitation of gastric HCL to esophagus through incompetent lower esophage
al
sphincter) - Reflux symptoms (e.g. heart burn.)
▪Gastritis: Diffuse inflammation of gastric or duodenal mucosa
Aggressive factors : Protectiv
e factors:
1
. Gastric HCl.
2
. Pepsin ( protein digestive enzyme)
3
. Infection with Helicobacter Pylori. Bacteria.
1
. Mucous
2
. Bicarbonate
3
. Prostaglandins E2
3. Regulation of HCL secretion
Histamine binds to H2 increase HCL
ACh binds gastric M1increase HCL
Gastrin binds to G receptor increase HCL
PG E2 & Somatostatin decreases HCL
4. Treatment includ :
Non- Drug therapy: Rest and Sedation , stop smokin
g,spices food , avoid stress and ulcergenic drugs as NSAIDs
Drug therapy:
1) Drugs that neutralize HCL : antacids
2) Drugs that decrease HCL secretion: selective M1blockers, H2 blocke
rs , PPIs .
3) Drugs that increase mucosal defense : sucralfate , PGE1 analogoues
, bismuth .
4) antimicrobial drugs for H.pylori : e.g. amoxicillin .
5. 1) Antacids
M.O.A:
1) Weak bases that react with HCL ------ > salt + H2O.
2) pH activity of pepsin. (Pepsin is not active in pH > 4)
Agents:
1) Al(OH)3 & 2) Mg(OH)2
Used together (Al constipation & Mg diarrhea).
Most commonly used.
3) NaHCO3
The only antacid absorbed may cause systemic alkalosis.
liberates CO2 flatulence.
Hypernatremia contraindicated in heart failure & ↑ BP.
4) CaCO3
Liberate CO2 flatulence.
Ca Constipation.
5) Mg trisilicate
Mg trisilicate + HCL MgCL2 + H2O + Silicone dioxide gel.
EFFECTIVE because it acts both:
Chemically.
Physically due to formation of demulcent Silicone dioxide gel
Mg ----> diarrhea.
6. Hydrochloric Acid
Secreted by the parietal cells when sti
mulated by food
Maintains stomach at pH of 1 to 4
Secretion also stimulated by:
Large fatty meals
Excessive amounts of alcohol
Emotional stress
7. Cells of the Gastric Gland (cont'
d)
Chief cells
Secrete pepsinogen, a proenzyme
Pepsinogen becomes pepsin when activated by e
xposure to acid
Pepsin breaks down proteins (proteolytic)
8. Cells of the Gastric Gland (cont'
d)
Mucoid cells
Mucus-secreting cells (surface epithelial cells)
Provide a protective mucous coat
Protect against self-digestion by HCl
9.
10. Acid-Related Diseases
Caused by imbalance of the three cell
s of the gastric gland and their secreti
ons
Most common: hyperacidity
Clients report symptoms of overprodu
ction of HCl by the parietal cells as in
digestion, sour stomach, heartburn, a
cid stomach
11. Acid-Related Diseases (cont'd)
PUD: peptic ulcer disease
GERD: gastroesophageal reflux dise
ase
Helicobacter pylori (H. pylori)
Bacterium found in GI tract of 90% of
patients with duodenal ulcers, and 70%
of those with gastric ulcers
Combination therapy is used most ofte
n to eradicate H. pylori
12. Treatment for H. pylori
Eight regimens approved by the FDA
H. pylori is not associated with acute
perforating ulcers
It is suggested that factors other than
the presence of H. pylori lead to ulcer
ation
14. Antacids: Mechanism of Action
Promote gastric mucosal defense mechanism
s
Secretion of:
Mucus: protective barrier against HCl
Bicarbonate: helps buffer acidic propertie
s of HCl
Prostaglandins: prevent activation of pro
ton pump which results in HCl producti
on
15. Antacids: Mechanism of Action
(cont'd)
Antacids DO NOT prevent the over-pr
oduction of acid
Antacids DO neutralize the acid once i
t’s in the stomach
16. Antacids: Drug Effects
Reduction of pain associated with acid
-related disorders
Raising gastric pH from 1.3 to 1.6 neutralizes 50
% of the gastric acid
Raising gastric pH 1 point (1.3 to 2.3) neutralize
s 90% of the gastric acid
Reducing acidity reduces pain
18. Antacids: Aluminum Salts
Forms: carbonate, hydroxide
Have constipating effects
Often used with magnesium to counteract c
onstipation
Examples
Aluminum carbonate: Basaljel
Hydroxide salt: AlternaGEL
Combination products (aluminum and magnesiu
m): Gaviscon, Maalox, Mylanta, Di-Gel
19. Antacids: Magnesium Salts
Forms: carbonate, hydroxide, oxide, trisilic
ate
Commonly cause diarrhea; usually used wit
h other agents to counteract this effect
Dangerous when used with renal failure —t
he failing kidney cannot excrete extra magn
esium, resulting in hypermagnesemia
20. Antacids: Magnesium
Salts (cont'd)
Examples
Hydroxide salt: magnesium hydroxide (M
OM)
Carbonate salt: Gaviscon (also a combin
ation product)
Combination products such as Maalox, M
ylanta (aluminum and magnesium)
21. Antacids: Calcium Salts
Forms: many, but carbonate is most common
May cause constipation
Their use may result in kidney stones
Long duration of acid action may cause incr
eased gastric acid secretion (hyperacidity r
ebound)
Often advertised as an extra source of dieta
ry calcium
Example: Tums (calcium carbonate)
22. Antacids: Sodium Bicarbonate
Highly soluble
Buffers the acidic properties of HCl
Quick onset, but short duration
May cause metabolic alkalosis
Sodium content may cause problems i
n patients with HF, hypertension, or r
enal insufficiency (fluid retention)
23. Antacids and Antiflatulents
Antiflatulents: used to relieve the pai
nful symptoms associated with gas
Several agents are used to bind or alt
er intestinal gas and are often added
to antacid combination products
24. Antacids and
Antiflatulents (cont'd)
OTC antiflatulents
Activated charcoal
Simethicone
Alters elasticity of mucus-coated bubbles
, causing them to break
Used often, but there are limited data to
support effectiveness
25. Antacids: Side Effects
Minimal, and depend on the compound
used
Aluminum and calcium
Constipation
Magnesium
Diarrhea
Calcium carbonate
Produces gas and belching; often combined with
simethicone
26. Antacids: Drug Interactions
Adsorption of other drugs to antacids
Reduces the ability of the other drug to b
e absorbed into the body
Chelation
Chemical binding, or inactivation, of anot
her drug
Produces insoluble complexes
Result: reduced drug absorption
27. Antacids: Nursing Implications
Assess for allergies and preexisting conditio
ns that may restrict the use of antacids, suc
h as:
Fluid imbalances – Renal disease – HF
Pregnancy – GI obstruction
Patients with HF or hypertension should use
low-sodium antacids such as Riopan, Maalo
x, or Mylanta II
28. Antacids: Nursing Implications
Use with caution with other medicatio
ns due to the many drug interactions
Most medications should be given 1 t
o 2 hours after giving an antacid
Antacids may cause premature dissol
ving of enteric-coated medications, re
sulting in stomach upset
29. Antacids: Nursing Implications
Be sure that chewable tablets are chewed t
horoughly, and liquid forms are shaken well
before giving
Administer with at least 8 ounces of water t
o enhance absorption (except for the “rapid
dissolve” forms)
Caffeine, alcohol, harsh spices, and black p
epper may aggravate the underlying GI con
dition
30. Antacids: Nursing Implications
Monitor for side effects
Nausea, vomiting, abdominal pain, diarrh
ea
With calcium-containing products: consti
pation, acid rebound
Monitor for therapeutic response
Notify heath care provider if symptoms a
re not relieved
32. H2 Antagonists
Reduce acid secretion
All available OTC in lower dosage for
ms
Most popular drugs for treatment of a
cid-related disorders
cimetidine (Tagamet)
famotidine (Pepcid)
ranitidine (Zantac)
33. H2 Antagonists:
Mechanism of Action
Block histamine (H2) at the receptors
of acid-producing parietal cells
Production of hydrogen ions is reduce
d, resulting in decreased production o
f HCl
34. H2 Antagonists: Indications
GERD
PUD
Erosive esophagitis
Adjunct therapy in control of upper GI
bleeding
Pathologic gastric hypersecretory con
ditions (Zollinger-Ellison syndrome)
35. H2 Antagonists: Side Effects
Overall, less than 3% incidence of sid
e effects
Cimetidine may induce impotence and
gynecomastia
May see:
Headaches, lethargy, confusion, diarrhea
, urticaria, sweating, flushing, other effec
ts
36. H2 Antagonists:
Drug Interactions
Cimetidine (Tagamet)
Binds with P-450 microsomal oxidase sys
tem in the liver, resulting in inhibited oxi
dation of many drugs and increased drug
levels
All H2 antagonists may inhibit the absorp
tion of drugs that require an acidic GI en
vironment for absorption
37. H2 Antagonists: Drug Interactio
ns (cont'd)
SMOKING has been shown to decrease
the effectiveness of H2 blockers (increas
es gastric acid production)
38. H2 Antagonists:
Nursing Implications
Assess for allergies and impaired rena
l or liver function
Use with caution in patients who are c
onfused, disoriented, or elderly (high
er incidence of CNS side effects)
Take 1 hour before or after antacids
For intravenous doses, follow adminis
tration guidelines
40. Proton Pump
The parietal cells release positive hyd
rogen ions (protons) during HCl produ
ction
This process is called the “proton pum
p”
H2 blockers and antihistamines do not
stop the action of this pump
41. Proton Pump Inhibitors:
Mechanism of Action
Irreversibly bind to H+/K+ ATPase enz
yme
Result: achlorhydria—ALL gastric acid
secretion is blocked
42.
43. Proton Pump Inhibitors:
Drug Effect
Total inhibition of gastric acid secretio
n
lansoprazole (Prevacid)
omeprazole (Prilosec)*
rabeprazole (AcipHex)
pantoprazole (Protonix)
esomeprazole (Nexium)
*The first in this new class of drugs
44. Proton Pump Inhibitors:
Indications
GERD maintenance therapy
Erosive esophagitis
Short-term treatment of active duode
nal and benign gastric ulcers
Zollinger-Ellison syndrome
Treatment of H. pylori–induced ulcers
46. Proton Pump Inhibitors:
Nursing Implications
Assess for allergies and history of liver dise
ase
pantoprazole (Protonix) is the only proton p
ump inhibitor available for parenteral admin
istration, and can be used for patients who
are unable to take oral medications
May increase serum levels of diazepam, ph
enytoin, and cause increased chance for ble
eding with warfarin
47. Proton Pump Inhibitors:
Nursing Implications
Instruct the patient taking omeprazole (
Prilosec):
It should be taken before meals
The capsule should be swallowed whole, no
t crushed, opened, or chewed
It may be given with antacids
Emphasize that the treatment will be short
term
49. sucralfate (Carafate)
Cytoprotective agent
Used for stress ulcers, erosions, PUD
Attracted to and binds to the base of ulcers
and erosions, forming a protective barrier o
ver these areas
Protects these areas from pepsin, which nor
mally breaks down proteins (making ulcers
worse)
50. sucralfate (Carafate) (cont'd)
Little absorption from the gut
May cause constipation, nausea, and dry m
outh
May impair absorption of other drugs, espe
cially tetracycline
Binds with phosphate; may be used in chro
nic renal failure to reduce phosphate levels
Do not administer with other medications
51. misoprostol (Cytotec)
Synthetic prostaglandin analog
Prostaglandins have cytoprotective ac
tivity
Protect gastric mucosa from injury by en
hancing local production of mucus or bic
arbonate
Promote local cell regeneration
Help to maintain mucosal blood flow
52. misoprostol (Cytotec) (cont'd)
Used for prevention of NSAID-induced
gastric ulcers
Doses that are therapeutic enough to
treat duodenal ulcers often produce a
bdominal cramps, diarrhea
54. Diarrhea
Abnormal frequent passage of loose s
tool or
Abnormal passage of stools with incre
ased frequency, fluidity, and weight,
or with increased stool water excretio
n
55. Diarrhea (cont'd)
Acute diarrhea
Sudden onset in a previously healthy
person
Lasts from 3 days to 2 weeks
Self-limiting
Resolves without sequelae
56. Diarrhea (cont'd)
Chronic diarrhea
Lasts for more than 3 weeks
Associated with recurring passage of
diarrheal stools, fever, loss of appetit
e, nausea, vomiting, weight loss, and
chronic weakness
58. Antidiarrheals:
Mechanism of Action
Adsorbents
Coat the walls of the GI tract
Bind to the causative bacteria or toxin
, which is then eliminated through the
stool
Examples: bismuth subsalicylate (Pep
to-Bismol), kaolin-pectin, activated ch
arcoal, attapulgite (Kaopectate)
59. Antidiarrheals:
Mechanism of Action (cont'd)
Anticholinergics
Decrease intestinal muscle tone and p
eristalsis of GI tract
Result: slowing the movement of feca
l matter through the GI tract
Examples: belladonna alkaloids (Donn
atal), atropine
60. Antidiarrheals:
Mechanism of Action (cont'd)
Intestinal flora modifiers
Bacterial cultures of Lactobacillus organism
s work by:
Supplying missing bacteria to the GI trac
t
Suppressing the growth of diarrhea-causi
ng bacteria
Example: L. acidophilus (Lactinex)
61. Antidiarrheals:
Mechanism of Action (cont'd)
Opiates
Decrease bowel motility and relieve r
ectal spasms
Decrease transit time through the bo
wel, allowing more time for water and
electrolytes to be absorbed
Examples: paregoric, opium tincture,
codeine, loperamide (Imodium), diph
enoxylate (Lomotil)
65. Antidiarrheal Agents: Interacti
ons
Adsorbents decrease the absorption o
f many agents, including digoxin, clin
damycin, quinidine, and hypoglycemic
agents
Adsorbents cause increased bleeding
time when given with anticoagulants
Antacids can decrease effects of antic
holinergic antidiarrheal agents
66. Antidiarrheal Agents:
Nursing Implications
Obtain thorough history of bowel patt
erns, general state of health, and rec
ent history of illness or dietary chang
es, and assess for allergies
DO NOT give bismuth subsalicylate to
children younger than age 16 or teen
agers with chickenpox because of the
risk of Reye’s syndrome
67. Antidiarrheal Agents:
Nursing Implications
Use adsorbents carefully in geriatric patient
s or those with decreased bleeding time, clo
tting disorders, recent bowel surgery, confu
sion
Anticholinergics should not be administered
to patients with a history of glaucoma, BPH,
urinary retention, recent bladder surgery, c
ardiac problems, myasthenia gravis
68. Antidiarrheal Agents:
Nursing Implications
Teach patients to take medications ex
actly as prescribed and to be aware of
their fluid intake and dietary changes
Assess fluid volume status, I&O, and
mucous membranes before, during, a
nd after initiation of treatment
71. Constipation
Abnormally infrequent and difficult pa
ssage of feces through the lower GI tr
act
Symptom, not a disease
Disorder of movement through the co
lon and/or rectum
Can be caused by a variety of disease
s or drugs
72. Laxatives: Mechanism of Action
Bulk forming
High fiber
Absorbs water to increase bulk
Distends bowel to initiate reflex bowel activi
ty
Examples:
psyllium (Metamucil)
methylcellulose (Citrucel)
Polycarbophil (FiberCon)
73. Laxatives:
Mechanism of Action (cont'd)
Emollient
Stool softeners and lubricants
Promote more water and fat in the stools
Lubricate the fecal material and intestinal w
alls
Examples:
Stool softeners: docusate salts (Colace, Surfak)
Lubricants: mineral oil
74. Laxatives:
Mechanism of Action (cont'd)
Hyperosmotic
Increase fecal water content
Result: bowel distention, increased peristals
is, and evacuation
Examples:
polyethylene glycol (GoLYTELY)
sorbitol (increases fluid movement into intestine
)
glycerin
lactulose (Chronulac)
75. Laxatives:
Mechanism of Action (cont'd)
Saline
Increase osmotic pressure within the i
ntestinal tract, causing more water to
enter the intestines
Result: bowel distention, increased pe
ristalsis, and evacuation
77. Laxatives:
Mechanism of Action (cont'd)
Stimulant
Increases peristalsis via intestinal nerve sti
mulation
Examples:
castor oil (Granulex)
senna (Senokot)
cascara
78. Laxatives: Indications
Laxative Group
Bulk forming
Emollient
Use
Acute and chronic constipation
Irritable bowel syndrome
Diverticulosis
Acute and chronic constipation
Softening of fecal impaction; fac
ilitation of BMs in anorectal
conditions
79. Laxatives: Indications (cont'd)
Laxative Group
Hyperosmotic
Saline
Use
Chronic constipation
Diagnostic and surgical pre
ps
Constipation
Diagnostic and surgical pre
ps
Removal of helminths and
parasites
84. Laxatives: Nursing Implications
Obtain a thorough history of presenting sy
mptoms, elimination patterns, and allergies
Assess fluid and electrolytes before
initiating therapy
Patients should not take a laxative or catha
rtic if they are experiencing nausea, vomiti
ng, and/or abdominal pain
85. Laxatives: Nursing Implications
A healthy, high-fiber diet and increased
fluid intake should be encouraged as an alt
ernative to laxative use
Long-term use of laxatives often results in
decreased bowel tone and may lead to dep
endency
All laxative tablets should be swallowed wh
ole, not crushed or chewed, especially
if enteric coated
86. Laxatives: Nursing Implications
Patients should take all laxative tablet
s with 6 to 8 ounces of water
Patients should take bulk-forming lax
atives as directed by the manufacture
r with at least 240 mL (8 ounces) of
water
87. Laxatives: Nursing Implications
Bisacodyl and cascara sagrada should
be given with water due to interaction
s with milk, antacids, and H2 blockers
Patients should contact their provider
if they experience severe abdominal p
ain, muscle weakness, cramps, and/
or dizziness, which may indicate fluid
or electrolyte loss
90. Definitions
Nausea
Unpleasant feeling that often precedes v
omiting
Emesis (vomiting)
Forcible emptying of gastric, and occasio
nally, intestinal contents
Antiemetic agents
Used to relieve nausea and vomiting
91. VC and CTZ
Vomiting center (VC)
Chemoreceptor trigger zone (CTZ)
Both located in the brain
Once stimulated, cause the vomiting refl
ex
92. Mechanism of Action
Many different mechanisms of action
Most work by blocking one of the vom
iting pathways, thus blocking the stim
ulus that induces vomiting
94. Mechanism of Action and Indication
s
Anticholinergic agents (ACh blockers)
Bind to and block acetylcholine (ACh) receptors i
n the inner ear labyrinth
Block transmission of nauseating stimuli to CTZ
Also block transmission of nauseating stimuli fro
m the reticular formation to the VC
Scopolamine
Also used for motion sickness
95. Mechanism of Action
Antihistamine agents (H1 receptor blockers)
Inhibit ACh by binding to H1 receptors
Prevent cholinergic stimulation in vestibu
lar and reticular areas, thus preventing N
&V
Diphenhydramine (Benadryl), meclizine (
Antivert), promethazine (Phenergan)
Also used for nonproductive cough, aller
gy symptoms, sedation
96. Mechanism of Action (cont'd)
Neuroleptic agents
Block dopamine receptors on the CTZ
chlorpromazine (Thorazine), prochlorper
azine (Compazine)
Also used for psychotic disorders, intract
able hiccups
97. Mechanism of Action (cont'd)
Prokinetic agents
Block dopamine in the CTZ
Cause CTZ to be desensitized to impulse
s it receives from the GI tract
Also stimulate peristalsis in GI tract, enh
ancing emptying of stomach contents
Metoclopramide (Reglan)
Also used for GERD, delayed gastric emp
tying
98. Mechanism of Action (cont'd)
Serotonin blockers
Block serotonin receptors in the GI tract,
CTZ, and VC
Dolasetron (Anzemet), granisetron (Kytri
l), ondansetron (Zofran)
Used for N&V for patients receiving chem
otherapy and postoperative nausea and
vomiting
99. Mechanism of Action (cont'd)
Tetrahydrocannabinoids (THC)
Major psychoactive substance in marijua
na
Inhibitory effects on reticular formation,
thalamus, cerebral cortex
Alter mood and body’s perception of its s
urroundings
100. Mechanism of Action (cont'd)
Tetrahydrocannabinoids (cont'd)
dronabinol (Marinol)
Used for N&V associated with chemother
apy, and anorexia associated with weight
loss in AIDS patients
101. Side Effects
Vary according to agent used
Stem from their nonselective blockad
e of various receptors
102. Nursing Implications
Assess complete nausea and vomiting
history, including precipitating factors
Assess current medications
Assess for contraindications and pote
ntial drug interactions
103. Nursing Implications
Many of these agents cause severe dr
owsiness; warn patients about driving
or performing any hazardous tasks
Taking antiemetics with alcohol may c
ause severe CNS depression
Teach patients to change position slo
wly to avoid hypotensive effects
104. Nursing Implications
For chemotherapy, antiemetics are of
ten given ½ to 3 hours before a chem
otherapy agent
Monitor for therapeutic effects
Monitor for adverse effects
Editor's Notes
The action of the hydrogen-potassium-ATPase pump is the final step in the acid-secretion process of the parietal cell. If the chemical energy is present to run the pump it will transport the hydrogen ions out of the parietal cell, which increases the acid content of eh surrounding gastric lumen and lowers the pH. B/C hydrogen ions are protons (positively charged hydrogen atoms) this ion pump is also called the proton pump. The PPI bind irreversibly to the proton pump. The binding of this enzyme prevents the movement of the hydrogen ion out of the parietal cells into the stomach and therefore blocks all acid production. PPI effectively stop over 90% of acid production in the stomach. For acid secretion to return to normal after the pt. stops the PPI the parietal cell must synthesize new hydrogen potassium ATPase.
The are also used to prevent PUD in hospitalized patients.
b/c if the lining of your stomach broke down what would be exposed, the muscle which is protien.
Pepto-Bismol- is a salicytate and there fore if over used will cause the side effects such as tinnitus and hearing loss also dark stools and black gums if overused. Be careful with it use in children.
They have a narrow window of safe use in like the other antidiarrheals that can be less harmful if overused. That is why they are only available by prescription. Because these drugs are anticholinergics they have all the same side effects and can effect other systems such as increase HR, dysrhythmias, CNS excitation, restlessness, disorientation, dilated pupils see the box on page 308, box 20-2, these are3 all effects of the atropine.
What are the side effects of opiates and think of the danger of them if they are over usded.
Teach patient to take medications 1 hour before or 2 hours after other medications. Just to be safe don’t take with any other medicaitons.