Can occur anywhere in GI tract that contacts gastric hydrochloric acid pepsin o

Can occur anywhere in gi tract that contacts gastric

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Can occur anywhere in GI tract that contacts gastric hydrochloric acid, pepsin o Symptoms depend on location. Gastric ulcer pain – 1-2 hrs. after meal; Duodenal ulcer pain- 2-4 hrs. after meal & involves night pain o Complications – perforation, hemorrhage, obstruction o Stress Ulcer – ulcer caused by acute/chronic stress. Occur in critically ill pt.’s - Helicobacter Pylori Infection o H. pylori – gram negative spiral bacterium; colonizes gastric mucosa o Found in half of world population o Must be treated/infection will persist o H. pylori infection associated w/ other diseases o H. pylori infection occurs in many pt.’s w/ gastritis, gastric ulcers, duodenal ulcers, gastric cancer o Diet high in fruits & vegetables may help prevent ulcer & infection w/ H. pylori o Smoking & H. pylori infection alter concentration of surface active phospholipids in gastric mucosa, contributes to ulcer formation - Treating Helicobacter Infection o Elimination of H. pylori from GI tract decreases recurrence of ulcers o Eradication therapy standard for pt.’s w/ peptic ulcer
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Unit 4 – GI Drugs o Indications to treat H. pylori infection include polyps, hyperplastic gastropathy, gastric cancer post resection, acute gastritis (H. pylori caused) o FDA has approved six different treatment options. Double antibiotic therapy w/ use of anti-secretory drug preferred therapy (very effective). - Pancreatitis o Digestive enzymes, normally inactive while stored in pancreas, become active & destroy parts of gland o Destruction of pancreas decreases amount of enzymes produced. Result = lack of enzymes vital to digestion o Repeated acute attacks of pancreatitis can become chronic state o We can treat lack of enzymes by providing outside source for pancrelipase, digestive enzyme - Obesity o Increasing at alarming rate, both in USA as well as world wide o Look at normal, overweight, obesity in terms of person’s BMI. Normal BMI is 18.5-24.9. Overweight is defined as BMI of 25-29.9. Obesity is defined as BMI greater than 29.9. o When obesity occurs there is mismatch b/t calories ingested & those expended through activity o Life style in our country is sedentary o Diet often includes high fat foods, processed foods, fast foods o Other medical problems associated w/ obesity include HTN, diabetes, coronary heart disease, hyperlipidemia, gall bladder disease, osteoarthritis Drugs Affecting GI Secretions (Upper GI Tract) - Proton Pump Inhibitors - Omeprazole (Prilosec) o Pharmacotherapeutics/Uses Treat heartburn, GERD, gastric, duodenal ulcer o Pharmacokinetics/Administration Oral route, has enteric coated form Admin before breakfast on empty stomach Onset: 1hr; Peak: 2hr; Duration: 72hrs. Pregnancy Category C o Pharmacodynamics/Mode of Action Suppresses gastric enzyme system responsible for last phase of gastric acid production Binding irreversibly to H + & K + Proton pump inhibitor o Adverse Effects: Omeprazole (Prilosec) Common – headache; nausea, diarrhea, rash, ab pain CNS – dizziness, muscle weakness o Contraindications/Precautions Hypersensitivity o Interactions Drug/Drug
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  • Fall '15
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