Chapter 59: Peptic Ulcer Disease & GERD Flashcards | Knowt (2024)

1. Results when acidic stomach contents enter esophagus

2. lower esophageal sphincter weakening or relaxation occurs

3. decreased salivary secretions

4. diminished esophageal motility

1. infection w/ Helicobacter pylori

2. close family history of PUD

3. use of drugs

   • glucocorticoids, NSAIDs, platelet inhibitors

4. smoking tobacco

5. consumption of beverages and foods w/ excessive caffeine

6. excessive psychologic stress

• relieve symptoms

• promote healing of ulcer

• prevent complications

• prevent future recurrence

1. eradicate H. pylori

2. discontinue NSAID/other ulcer-promoting meds when possible

1. Proton pump inhibitors (PPIs)

2. H2-receptor antagonists

3. antacids

4. miscellaneous drugs

1. domestic crowding

2. unclean water

3. exposure to gastric content of an infected individual

1. kill bacteria while minimizing emergence of resistance

2. PPI or histamine 2 receptor antagonist use

   *eradication rates = good w/ 10 day course AB, 14 day course AB= slightly better

• reduces acid secretion in stomach by binding to H+,K+, ATPase

• inhibits final pathway involved in acid secretion and active proton pumps

1. omeprazole

2. esomeprazole (Nexium)

3. lansoprazole (Prevacid)

4. pantoprazole (Protonix)

   1. ^can be given IV

• antiulcer drug

• OTC = relief of heartburn

  • prx = short-term (4-8 weeks) for active duodenal & gastric ulcers, GERD, or maintenance of erosive esophagitis

• should be taken 20-30 mins BEFORE 1st major meal of day (due to it being activated by food)

*usually minor

1. headache

2. nausea

3. diarrhea

4. rash

5. abdominal pain

*DR Omeprazole = higher risk of C. diff in hospitalized pt’s

Warfarin

• may increase likelihood of bleeding

Blocks h2 receptors of parietal cells in stomach

• this decreases acid production

1. famotidine (PepcidAC)

2. cimetidine (Tagamet)

• antiulcer drug

• USE:

  • duodenal and gastric ulcers

  • acute stress-induced bleeding ulcers

  • hypersecretory conditions in hospitalized pt’s

  • Heartburn

  • GERD

• Antacids should NOT be given w/in 1 hour of H2-receptor antagonists

• smoking decreases effectiveness

• reacts w/ gastric acid = neutral salts/salts of low acidity

• reduces destruction of gut wall by neutralizing acid

• Caution in use w/ renal impairment

1. aluminum hydroxide (AlternaGel)

2. calcium carbonate (Titralac, Tums)

3. calcium carbonate w/ magnesium hydroxide (Rolaids)

4. Sodium bicarbonate (Alka-Seltzer)

5. magnesium trisilicate & Aluminum hydroxide (Gaviscon)

6. magnesium hydroxide & Aluminum hydroxide w/ simethicone (Mylanta)

1. Sodium - fluid retention

2. Magnesium - fatigue, hypotension, dysrhythmias, interact w/ laxatives

3. Calcium - constipation, aggravated kidney stones, milk-alkali syndrome

4. Aluminum - constipation, hypophosphatemia

5. Bicarbonate - metabolic acidosis, bloating, belching

1. bismuth compounds (Kaopectate, Pepto)

2. sucralfate (Carafate)

• stimulates mucosal bicarb and prostaglandin production

• inhibits H. pylori from attaching to tissue

• NOT used for kids if salicylate is contained

• CAN cause black stools!

• stimulates mucus, bicarb, and prostaglandin secretion

• creates effective protective barrier (up to 6 hours)

• requires 4 daily dosing @ each meal & bed time

• CAN cause constipation

• MAY interfere w/ sucralfate

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