NURS 368 - Ch. 7 GI

Front

Patho: gastric acid reflux to the esophagus & esophageal injury

S&S: heartburn, chest pains, nausea, belching

Treatment: Remove acid-causing food and drugs (alcohol, spicy/greasy foods), administer proton-pump inhibitors, administer H2 (histamine) receptor antagonists

CE: sit up after eating, hydrate

Back

Gastroesophageal Reflux Disease

(GERD)

Front

when GERD goes bad ....

Definition: breakdown in the lining of he GI mucosa which can lead to bleeding ulcers

Causes: bacterial infection by Helicobacter pylori bacteria, constant stress, some meds.

Back

Peptic Ulcer Disease

Front

Drugs Used to Treat GERD and Ulcers

(4)

Back

Antacids

Histamine-2 (H2) Antagonists

Proton Pump Inhibitors

Mucosal Protectants

Front

Indications: symptomatic relief of heartburn, acid indigestion, and upset stomach

MOA: Neutralize stomach acid and elevate pH

SE: constipation, hypercalcemia, rebound acidity when stopped

CI: kidney disease (can cause hypercalcemia) & GI obstruction (constipation from too much)

*affects the absorption of many other drugs

Back

Class: Antacids

Drug: Calcium carbonate (Tums)

Front

NI for Antacids (Calcium Carbonate)

Back

comes in tablets, chewable, capsules, and liquid

can take 3-4 times/day

do not administer within 1-2 hrs. or with other meds.

drink a full glass of water after administration

Front

Drugs to control Gastric Acidity

Back

Class: Histamine 2 receptor antagonists

Drugs: Famotidine (Pepcid)

Front

Indications: heartburn, GERD, peptic ulcer disease, erosive esophagitis, adjunct treatment for upper GI bleeding

MOA: blocks histamine-2 receptor sites of parietal cells which reduces hydrochloric acid

SE: constipation or diarrhea, CNS effects (headaches/dizziness)

CI: hepatic or renal dysfunction

Back

Famotidine (Pepcid)

Front

Famotidine (Pepcid) NI

Back

available OTC, given IV in hospital; take 15-60 minutes before eating or drinking to decrease acid before eating

Front

*The best drug to control gastric acidity*

directly blocks gastric acid production

can cause increased bacterial growth

decreases bioavailability of some drugs

Back

Class: Proton-pump inhibitors

Drug: Pantoprazole

Front

Indications: GERD, erosive esophagitis, prophylactic (preventative) with surgery, in combo with antibiotics for H. pylori infections short-term treatment of active duodenal ulcers

MOA: blocks the secretion of hydrochloric acid at the proton pump

Back

Proton pump inhibitors

Pantoprazole