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