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09- GI DISFUNCTIONS

09- GI DISFUNCTIONS - GI Tract Pathologies and Pharmacology...

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GI Tract  Pathologies and Pharmacology
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GI Tract Pharmacology Antacids Proton pump  inhibitors H 2  receptor  antagonists Emetics Anti-emetics Laxatives Anti-diarrheals Anti-flatulants IBS Tx Anti-cholinergics Anti-spasmotics Hemorhoids Hepatitis Appendicitis MISC. GI Lipase inhibitors G.I. stimulants
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UPPER GI
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Gastro-Esophageal Reflux Disease  (GERD)
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Gastro-esophageal reflux  Disease (GERD) - “Heartburn” or Acid Reflux Pathology: esophageal irritation (stomach acid) due to weak Sphincter muscle Etiology: esophageal sphincter allows stomach content into esophagus S&S: burning behind sternum Related issues to Sports Medicine (SM): high stress & repetitive pounding
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Peptic Ulcers
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Peptic Ulcers Pathology: gastric mucosal erosion Etiology: NSAID abuse or infection ( Helicobacter pylori) S&S: 3 pain burning cramping... Related issues to SM: Long term NSAID & antacid use
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Antacids Chemical compounds that buffer or neutralize acid in  the stomach Indications: 3 -Peptic ulcer -Gastritis -Gastro-esophageal reflux Disease (GERD) –  “Heartburn” Contraindications 3 -Intestinal obstruction -Appendicitis -Hypersensitivity
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Neutralize stomach acids - cause of heartburn Active ingredients – 3 Aluminum magnesium hydroxide calcium carbonate sodium bicarbonate Bases combine w/ acid to reduce pH Examples 3 Tums Maalox, Mylanta Pepto-Bismol Antacids 
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Proton Pump Inhibitors MOA- Suppress gastric acid secretion by inhibiting the final step in acid production Indications 2 -severe erosive esophagitis from GERD -Ulcer Contraindications 2 -Liver disease -Drug hypersensitivity Examples 3 -Lansoprazole (Prevacid) -Omeprazole (Prilosec) -Esomeprazol magnesium (Nexium) Adverse reaction- Stomach pain Diarrhea abdominal distress Dizziness Heartburn gas
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Histamine (H 2 ) Blockers (Acid Reducers) Presence of histamine cause the release of gastric acids in stomach (histamine mediated acid release) Action – prevent (limit) release of histamine by blocking receptor sites
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Histamine Three Different subtypes or classes of receptors have been discovered based on the binding ability of various chemical analogs of histamine (H 1 , H 2 and H 3 )---members of the superfamily of G protein-coupled receptors Widely distributed yet unevenly distributed in all mammalian tissues---mast cell is the predominate storage site although the blood and basophils contain large amounts Metabolism and inactivation involves two major pathways and are excreted in the urine 1. Ring methylation by histamine N-methyl transferase 2. Oxidative deamination by MAO Functions include: a role in allergic response, primary & powerful gastric secretagogue for stomach acid (H 2 receptor binding)
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