what does our stomach do?
functions- store food, mic food, emptying
types of secretory cells
- chief- secrete pepsinogen
- partiel- secrete hydrochloric acid
- mucus- secrete mucus
gastroesophageal reflex disease (GERD)
AKA- heart burn
symptoms:
- burning
- bloating
- belching
- regurgitation
peptic ulcer disease (PUD)
several stomach disorders: commonly gastric and duodenal ulcers
peptic ulcer disease
symptoms: burning, gnawing, aching
treatment of Gerd and pud
education: weight reduction, smoking cessation, consume smaller meals, avoid eating at bedtime, avoid tight clothing over abdomen
drug therapy for Gerd and pud
used to relieve symptoms, promote healing, prevent recurrence
gerd and pud
limit use of NSAIDS switch to acetaminophen if feasible
drug class: antacids action
buffer hydrochloric acid to a lower concentration
antacids uses
treat heartburn from excessive eating and drinking; acute ulcer treatment requires large volumes
commonly adverse effects; constipation (with calcium aluminum), diarrhea, (with magnesium)
Antacids; aluminum salts
often recommend for patients with renal disease (more easily excreted)
H. pylori symptomatic , what medication do you treat it with?
antibiotics and PPI
calcium or antacids
can cause constipation
magnesium
diarrhea
antacids; magnesium salts
milk of mag , gaviscon , maalox, mylantaa
antacids; calcium salts
may cause consitpation, kidney stones
example; tums
antacids; sodium bicarbonate
buffers the acidic properties of HCI
can cause metabolic alkalosis
Histamine-2 receptor antagonists
block H2 receptors resulting in decreased volume of acid secreted
Famontidine (Pepcid)
most popular drug for treatment of acid related disorders
h2 antagonists
use with caution in patients who are confused, disoriented, or older
take 1 or 2 hours before antacids
misoprostol (cytotec)
prevents and treats gastric ulcers caused by NSAIDS (including aspirin)
contraindicated in pregnancy: risk of miscarriage, uterine contractions
proton pump inhibitors
inhibit gastric secretion by inhibiting gastric acid pump of the partial cells
can cause fractures, especially in prolonged use.
coating agents
adheres to craters of an ulcer, protecting it from acids, pepsin, or bile salts.
common adverse effects: constipation, dry mouth, dizziness
antacids
neutralize or dilute
h2
lowers the acid
sucralfate
coats
prokinetic agents
metoclopramide (reglan)
reduces reflux, increases stomach contractions, relaxes pyloric valve, increases peristalsis
treatment of gastric: reflux esophagitis, diabetic gastroparesis; antiemtic
serious adverse effects: extrapyramidal symptoms, risk of seizures
chronic constipation
symptoms present for at least 3 months
treatment for constipation
- high-fiber diet, adequate hydration, exercise
- avoid use of laxatives
treatment for diarrhea
depends on specific causes of diarrhea
antidiarrheals: mechanism of action
absorbents
coats the walls of the gastrointestinal (GI) tract
Antimotility drugs: opiates
decrease bowel motility and reduce pain by relief of rectal spasms
- considered a narcotic
Anticholinergics
decreased intestinal muscle tone and peristalsis of GI tract
-dries you up; can't see, can't pee and can't poop