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marshenski
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What three endogenous compounds stimulate the production of gastric acid?
- Acetylcholine
- HistamineB
- Gastrin
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What do prokinetic drugs do related to GI?
Block acetylcholine at the receptors
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What to H2 receptor antagonists do related to GI?
block H2 receptors
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What receptors is the substance gastrin related to?
gastrin (G) receptors
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What 2 intracellular messengers are used to stimulate the H+/K+ ATPase pump?
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How does prostoglandin decrease acid production?
Binds to the PgE2 receptors and suppresses the production of C-AMP
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What blocks the action of prostoglandin?
Cytologic agents block the prostoglandin receptors
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What is ATPace?
and enzyme that produces gastric acid?
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Atacids
- MOA: Neutralize Acid in the GI tract
- Indications: Heartburn, sour stomache, hydperphosphatemia in CKD, hypocalcemia in postmenopause or osteoporosis
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examples of antacids?
- Aluminum hydroxide - stays in GI, may have a constipating effect
- Mag hydroxide- Stays in GI, may have a laxative effect
- Calcium carbonate- Strong acid neutralizer, not confined to GI, may cause alkelemia in high doses
- Sodium bicarbonate- Strong acid neutralizer, not confined to the GI, may cause alkelemia in high doses
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True or False: Chronic use of Mg or Al based antacids may increase absorption of them?
True, they are not normally absorbed from the GI tract.
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How are Ca++ containing antacids secreted from the body?
in the feces
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What situation(s) would you want to avoid Ca++ containing antacids?
hypercalcemia or renal calculi
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In what circumstances are Al or Mg containing antacids contraindicated?
- Mg-Pt's with RF or Renal insufficiency
- Al-Pt's with RF on dialysis
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What are some common interactions antacids have?
- Effects absorption of most drugs
- administration of other drugs should be separated by two hrs
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T or F:Antacids should be used for the symptomatic relief of heartburn.
True, not first line for chronic disease
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How should antacids be used in Peptic Ulcer disease?
- as adjuncts in treatment
- administration should occur after meals and before bedtime
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How should antacids be used in the treatment of GERD?
- maintenance after meals and prior to bedtime
- H2 receptors are first line treatment for GERD
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Can Ca++ containing antacids be used for supplementation of Ca++?
- Yes, In CKD 1000 mg daily
- In osteoporosis prevention 1000 mg daily in postmenopausal and men
- -in postmenopausal 1500 mg daily
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Are doses of Ca++ greater than 2000 mg/day recommend?
no, only so much can be absorbed
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Are there any specific items to monitor when antacids are used by the elderly?
Mg levels in elderly pt's using Mg containing
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What drugs should we be more cognizant of deccrease absrtion related to antacid use?
Sezure meds - dilantin and levodopa; Sinimet-alzhmrs, ASA, dig, quinidine, sulfonureas-DM, ticlid-stroke prevention, H2 receptors, TB drugs thyroid meds, ABX Iron
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What should we teach pt's about the use of antacids?
- contact provider if used longer than two weeks
- report symptoms of GI bleed
- possible side effects (constipation, diarrhea)
- lifestyle changes to help prevent heartburn
- -smoking, elevate HOB, avoid spicy foods and alcohol; foods that decrease LES tone: chocolate, fatty food, caffeine.
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Does diarrhea usually require treatment?
NO
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