Acid Controlling Drugs
What is Simethicone?
-- Anti gas/flatulent drug, helps to decrease gas
What is the main side effect of the Magnesium Hydroxide antacids?
-- DIARRHEA!
What are the brand names of the Calcium Carbonate antacids?
(If you get this correct, 100 more points will be added)!
-- Rolaids and Tums
-- Renal failure
(1) Why is one of the H2 Receptor Antagonist preferred over the other?
(2) When is the optimal time to take an H2 Receptor Antagonist?
(If you get double questions correct, 200 more points will be added)!
(1) Potential drug interactions
(2) Bedtime
What happens if there is too much acid in the stomach?
-- Leads to reflux/GERD, esophageal disease, ULCER DISEASE
-- Peptic ulcer disease can lead to Cancer
What are the classes used to tx too much acid in the stomach?
-- Antacids
-- H2 receptor antagonists
-- Proton Pump Inhibitors (PPI's)
What are the brand names of the aluminum hydroxide antacids?
-- Maalox and Mylanta
-- Contributes to the acid-neutralizing capacity and also counteracts the constipating effects of aluminum and calcium.
---ALL ANTACIDS CAN INTERFERE WITH OTHER ORAL DRUGS IF GIVEN AT THE SAME TIME, SEPARATE ADMINISTRATION TIMES BY 2 HOURS.
What population of hospital pts will be prescribed H2 Receptor Antagonist prophylactically and why?
-- USED FOR STRESS ULCER PROPHYLAXIS IN CRITICALLY ILL PTS (ICU)!
--SUP is commonly administered to critically ill pts for the prevention of clinically important stress-related mucosal upper GI bleeding.
How do antacids work on stomach acid?
-- Neutralize stomach acid, and relieve symptoms of heartburn, dyspepsia, GERD, and pain as an adjunct to peptic ulcer tx
What are the 3 salts used as antacids?
-- Aluminum Hydroxide
-- Calcium Carbonate
-- Magnesium Hydroxide
What electrolyte imbalance can occur with the use of Calcium Carbonate antacids?
-- Hypercalcemia
What should we caution pts who frequently take antacids about?
-- Milk-alkali syndrome: H/A, nausea, alkalosis, and hypercalcemia
-Terminology:
-- Alkalosis: An abnormal pathophysiological condition characterized by the buildup of excess base of alkali in the body. It results in an abnormally high serum pH.
What is Zollinger-Ellison Syndrome?
-- A rare digestive disorder that results in too much gastric acid. This excess gastric acid can cause peptic ulcers in your stomach and intestine. Symptoms include abdominal pain, N/V/D, and weight loss.
What is the main side effect of the aluminum hydroxide antacids?(Name all side effects as well)!
--CONSTIPATION (MAIN ONE)
-- May color stools white/cause white streaks
-- Monitor for hypophosphatemia and hypercalcemia
--Terminology:
-Hypophosphatemia: blood has low levels of phosphorous (Low levels can cause a host of health challenges, including muscle weakness, respiratory or HF, seizures, or comas).
What are the common side effects of the Calcium carbonate antacids?
-- CONSTIPATION, GAS, BELCHING (GIVE W/ SIMETHICONE)!
-- Watch for S/S's of hypercalcemia: kidney stones
-- Pt can OD on this med!
How do antacids effect other oral medications?
-- ABSORPTION OF OTHER DRUGS TO ANTACIDS, WHICH REDUCES THE ABILITY OF THE OTHER DRUG TO BE ABSORBED INTO THE BODY.
-- Increased stomach pH, which increases the absorption of basic drugs and decreases the absorption of acidic drugs.
-- Increased urinary pH, which increases the excretion of acidic drugs and decreases the excretion of basic drugs.
What are the indications to use an H2 Receptor Antagonist?
-- Gerd, PU, Erosive esophagitis, PROPHYLACTIC STRESS ULCES IN PTS IN THE ICU, ZOLLINGER-ELLISON SYNDROME
What are the side effects of Cimetidine?
-- IMPOTENCE AND GYNECOMASTIA (OVERDEVELOPMENT OF BREAST TISSUE IN MALES)
-- CYTOCHROME P-450 (BINDS ENZYMES. INCREASE BLOOD CONCENTRATIONS OF CERTAIN DRUGS).
What causes too much acid in the stomach?
-- d/t bacterial infection w/ H. PYLORI, ZOLLINGER ELLISON SYNDROME, drugs, disease, smoking, predisposition, stress
-TERMINOLOGY
--Zollinger-Ellison syndrome: A rare digestive disorder that results in too much gastric acid.
What is the secondary indication of the use of Calcium Carbonate antacids?
-- Relieve symptoms of heartburn, dyspepsia, GERD, and pain as an adjunct to Peptic Ulcer tx.
-- Hyperactivity
--Terminology:
- Dyspepsia: A pain or an uncomfortable feeling in the upper middle part of the stomach area.
How do H2 Receptor Antagonis work to decrease stomach acid?
Block histamine receptors on parietal cells and significantly reduce acid production.
What are the names of the 3 H2 Receptor Antagonists? ("dine")
-- Cimetidine (Tagamet)
-- Famotidine (Pepcid)
-- Nizatidine
"Helps your stomach feel better when you dine"
How do Proton Pump Inhibitors (PPI) work to reduce stomach acid?
-- Bind to proton pump (hydrogen-potassium-ATPase pump) and blocks hydrogen ion secretion for parietal cell--blocks gastric acid secretion!