Pharmacology Final Study Guide
Pharm Final
Ch 50- Acid Controlling Drugs * Pathophysiology * Stomach glands * Cardiac * Cardiac sphincter (gastroesophageal) * Cardiac glands * Fundic * Gastric glands- most numerous * Highly specialized secretory glands composed of: * Parietal cells * Produce and secrete HCl * What stimulates? food, chocolate, alcohol, large fatty meals, stress * Chief cells * Secrete pepsinogen- becomes pepsin breaks down proteins * Mucous cells (surface epithelial cells) * Secrete mucous that acts as protective coating against the digestive action of HCl and digestive enzymes * Pyloric * Pyloric glands * Imbalance in these cells causes disease- hypersecretion: PUD, esophageal cancer, GERD * Over time can lead to: Barrett esophagus * Acidity of stomach (1-4)= digest food and protect against microbial infection * H. Pylori- 90% pts w/ duodenal ulcer; 70% gastric ulcer * ICU * Stress ulcer prophylaxis * NG tubes, ventilator, stay longer than 1wk, occult bleeding, GI bleed, sepsis, steroids= risk for GI lesions * Overview * Antacids * MOA * Neutralize gastric acidity * Low dose- promote defenses by stimulating secretion of mucus, prostaglandins, HCO3 from cells inside gastric glands * Indications * ACUTE relief of peptic ulcer, gastritis, gastric hyperacidity, heartburn * Contraindications * Severe renal failure * Electrolyte disturbances * GI obs * Adv * Milk of Mag- diarrhea * Al- constipation * Ca- constipation, kidney stones, hyperacidity * NaHCO3- systemic alkalosis, high Na- exacerbate
Ch 50- Acid Controlling Drugs * Pathophysiology * Stomach glands * Cardiac * Cardiac sphincter (gastroesophageal) * Cardiac glands * Fundic * Gastric glands- most numerous * Highly specialized secretory glands composed of: * Parietal cells * Produce and secrete HCl * What stimulates? food, chocolate, alcohol, large fatty meals, stress * Chief cells * Secrete pepsinogen- becomes pepsin breaks down proteins * Mucous cells (surface epithelial cells) * Secrete mucous that acts as protective coating against the digestive action of HCl and digestive enzymes * Pyloric * Pyloric glands * Imbalance in these cells causes disease- hypersecretion: PUD, esophageal cancer, GERD * Over time can lead to: Barrett esophagus * Acidity of stomach (1-4)= digest food and protect against microbial infection * H. Pylori- 90% pts w/ duodenal ulcer; 70% gastric ulcer * ICU * Stress ulcer prophylaxis * NG tubes, ventilator, stay longer than 1wk, occult bleeding, GI bleed, sepsis, steroids= risk for GI lesions * Overview * Antacids * MOA * Neutralize gastric acidity * Low dose- promote defenses by stimulating secretion of mucus, prostaglandins, HCO3 from cells inside gastric glands * Indications * ACUTE relief of peptic ulcer, gastritis, gastric hyperacidity, heartburn * Contraindications * Severe renal failure * Electrolyte disturbances * GI obs * Adv * Milk of Mag- diarrhea * Al- constipation * Ca- constipation, kidney stones, hyperacidity * NaHCO3- systemic alkalosis, high Na- exacerbate