Helicobacter pylori bacteria
The most common cause of gastric and duodenal ulcers.
bismuth (Pepto-Bismol)
Antibacterial and antacid given to disrupt the cell wall of H.pylori, inhibit enzyme release, and protect gastric mucosa.
Proton pump inhibitor function
Irreversibly inhibits the secretion of gastric acid. Withdrawl can cause rebound hypersecretion.
The Proton Pump Inhibitors
omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), and esomeprazole (Nexium).
Histamine-2 Receptor Antagonists
Prevents the activation of H-2 receptors on parietal cells to reduce acid formation.
H2RAs
cimetidine (Tagamet), and rantidine (Zantac).
sulcrafate (Carafate)
Forms a protective barrier over ulcer
misoprostol(Cytotec)
A prostaglandin that suppresses acid secretion, and promotes bicarbonate secretion and gastric blood flow.
Side effects of misoprostol(Cytotec)
Diarrhea, abdominal pain, and abortion.
Magnesium compounds
Rapid onset, high ANC (acid neutralizing capacity), avoid in renal impairment. SE: diarrhea.
Aluminum compounds
Slow acting, low ANC (acid neutralizing capacity), used in combination with magnesium. SE: constipation
Calcium carbonate
Rapid acting, high ANC (acid neutralizing capacity), source of dietary mineral.
Sodium compounds
Rapid onset, short duration, but very high in mineral.
Anticholinergics
Reduce acid production, but only in very high doses.
simethicone
Antiflatulent; reduces gas bubbles to small passable size.
Extra strength Maalox
Aluminum, magnesium, and simethicone compound.
Different Laxatives
Non-digestable Agents, Surfactant, Stimulant, Osmotic
Non-digestible Laxative
Fiber; psyllium(metamucil), and methylcellulose(Citrucel).
psyllium(Metamucil)
Absorbs water into stool, swells fecal mass, should be administered with plenty of fluids.
methylcellulose(Citrucel)
Absorbs water into stool, swells fecal mass, may be used to absorb dietary cholesterol.
Surfactant Laxative
Lowers surface tension of stool, allowing water to enter, prevents intestinal wall from absorbing water, stimulates secretion of water and electrolyes into stool.
docusate sodium (Colace)
A surfactant laxative; should be taken with a full glass of water. SE: diarrhea
Stimulant Laxative
Cathartic; stimulates peristalsis, secretion of water and electrolytes into stool, and prevents the absorbtion of water.
bisacodyl(Dulcolax, Correctol)
A stimulant laxative, can be administered as a suppository or orally. SE: cramping, excessive fluid loss.
senna(Ex-lax)
A stimulant laxative. SE: cramping, excessive fluid loss
Osmotic Laxative
Draws water into intestinal lumen, causes fecal mass to soften and swell, stretches intestinal wall, and stimulates peristalsis
magnesium hydroxide (Milk of Magnesia)
An osmotic laxative. SE: diarrhea, renal impairment.
lactulose(Chronulac)
A drug metabolized by colon bacteria to form acids that exert osmotic action producing soft stool in 1-3 days. Also binds with ammonia in hepatic failure.
polyethylene glycol(Miralax)
Isoosmotic laxative. Water and electrolyte balance is preserved, neither secretion nor absorbtion of either occurs. Must be taken in large quantities. Usually administered for diagnostic procedures.
Antiemetics
Serotonin Antagonists, Dopamine Antagonists, Glucocorticoids, Cannabinoids, Anticholinergics, and Antihistamines.
ondansetron(Zofran)
A serotonin antagonist antiemetic; used for nausea related to chemo, radiation, or anesthesia. SE: headache, constipation, CNS stimulation or depression.
chloropromazine (Compazine)
A dopamine antagonist antiemetic; used for nausea related to surgery, chemo, or toxins. SE: anticholinergic effects.
metaclopramide (Reglan)
A dopamine antagonist antiemetic; used for nausea related to surgery, chemo, or toxins. A prokinetic drug that increases tone and motility of the GI tract.
dronabinol (Marinol)
A cannabinoid antiemetic; used as a last resort for nausea related to chemo. SE: hypotension, tachycardia.
scopolamine (Transderm Scop)
An anticholinergic antiemetic used for motion sickness. Blocks muscarinic receptors in the ear and vomiting center of the medulla. SE: anticholinergic effects.
dypenhydramide (Benadryl)
Histimine antagonist antiemetic; blocks muscarinic receptors, and H-1 receptors. SE: drowsiness, CNS depression.
Diarrhea is determined by:
Frequency and/or Consistency of stool.
Nonspecific antidiarrheals
Treat the symptoms of diarrhea. Decreases secretion of fluid into bowel, reduces cramping. Opioids, bulk-forming agents, anticholinergics, flora modifiers, and bismuth subsalicylate (Pepto-Bismol).
loperimide (Imodium)
Opioid antidiarrheal; decreases intestinal motility, decreases secretion of fluid, increases absorbtion of fluid and salts. Low/no potential for abuse.
dicyclomine (Bentyl)
Anticholinergic antidiarrheal.
diphenoxylate/atropine (Lomotil)
Opioid antidiarrheal; a morphine-like drug. High dose would cause euphoria and anticholinergic side effects. Schedule 5 drug.
Prokinetic Agents
Increase tone and motility of the GI tract. Used to treat GERD, nausea/vomiting, gastroparesis, migraines.
Gallstone dissolvers
Reduce hepatic production of cholesterol, reducing cholesterol in bile, and reducing gallstone size.
Anemia
A decrease in erythrocyte number, size, or hemoglobin content.
Causes of anemia
Blood loss, hemolysis, increased need, bone marrow dysfunction, deficiency.
ferrous fumarate (Femiron)
33% elemental iron. Used to treat iron-deficiency anemia.
Iron Deficiency Anemia
Characterized by microcytic or hypochromic RBCs with reduced oxygen carrying capacity. Treatment includes increasing dietary iron intake, and iron supplements.
B-12 Deficiency Anemia
Characterized by macrocytic RBCs that cannot divide. Deficiency takes years to develop. Can be the result of an intrinsic factor deficiency, or absence of stomach acid.
Results of B-12 Anemia
Demyelination of CNS neurons, leukopenia, thromocytopenia, hypoxia, heart failure, and dysrhythmias.
cyanocobalamin (Cyanoject)
Purified form of vitamin B-12. Can be administered orally, IM, SubQ, or intranasally. SE: potassium depletion. Can cause digoxin toxicity.
Folic Acid Deficiency Anemia
Characterized by: megaloblastic RBCs, leukopenia, thromocytopenia, injury to mucosa, and neural tube defects in embryos.
Antipuritics
Anti-itch meds: antihistamines, glucocorticoids.
Glaucoma
A malfunction of aqueous humor circulation that causes pressure on the optic nerve and a gradual loss of vision. The leading cause of preventable blindness.
First line Glaucoma drugs
Beta blockers, Alpha-2 adrenergic agonists, prostaglandin analogs.
timolol (Tenormin)
Beta blocker used to treat glaucoma. Decreases aqueous formation. SE: decreases far vision.
brimonidine (Alphagan)
Alpha-2 Agonist used to treat glaucoma. Decrease aqueous formation, dilates. SE: HA, conjunctivitis.
Second line Glaucoma drugs
Cholinergic agonists, indirect Cholinergic agonists, Carbonic Anhydrase Inhibitors (CAIs).
pilocarpine (IsoptoCarpine)
A Cholinergic agonist used to treat glaucoma. Increases aqueous outflow.
Midratics
Dilate the pupil for eye exams and surgeries. Anticholinergics and Adrenergics
Cycloplegics
Paralyze ciliary muscles to facilitate eye exams and surgeries. Anticholinergics
Demulcents
Isotonic artificial tears.
Fluorescein
A water soluble dye that produces an intense green color to highlight cornea lesions.
Macular Degeneration (ARMD)
A blurring of central vision due to a macular injury or breakdown.
Dry MD
A gradual breakdown of the photoreceptors of the macula.
Wet MD
A rapidly progressive decrease of photoreceptors in the macula due to growth of subretinal blood vessels and leaking blood that displaces the macula.