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Can occur anywhere in GI tract that contacts gastric hydrochloric acid, pepsin oSymptoms depend on location. Gastric ulcer pain – 1-2 hrs. after meal; Duodenal ulcer pain- 2-4 hrs. after meal & involves night pain oComplications – perforation, hemorrhage, obstruction oStress Ulcer– ulcer caused by acute/chronic stress. Occur in critically ill pt.’s -Helicobacter Pylori Infection oH. pylori – gram negative spiral bacterium; colonizes gastric mucosa oFound in half of world population oMust be treated/infection will persist oH. pylori infection associated w/ other diseases oH. pylori infection occurs in many pt.’s w/ gastritis, gastric ulcers, duodenal ulcers, gastric cancer oDiet high in fruits & vegetables may help prevent ulcer & infection w/ H. pylori oSmoking & H. pylori infection alter concentration of surface active phospholipids in gastric mucosa, contributes to ulcer formation -Treating Helicobacter Infection oElimination of H. pylori from GI tract decreases recurrence of ulcers oEradication therapy standard for pt.’s w/ peptic ulcer
Unit 4 – GIDrugs oIndications to treat H. pylori infection include polyps, hyperplastic gastropathy, gastric cancer post resection, acute gastritis (H. pylori caused) oFDA has approved six different treatment options. Double antibiotic therapy w/ use of anti-secretory drug preferred therapy (very effective). -Pancreatitis oDigestive enzymes, normally inactive while stored in pancreas, become active & destroy parts of gland oDestruction of pancreas decreases amount of enzymes produced. Result = lack of enzymes vital to digestion oRepeated acute attacks of pancreatitis can become chronic state oWe can treat lack of enzymes by providing outside source for pancrelipase, digestive enzyme -Obesity oIncreasing at alarming rate, both in USA as well as world wide oLook 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. oWhen obesity occurs there is mismatch b/t calories ingested & those expended through activity oLife style in our country is sedentary oDiet often includes high fat foods, processed foods, fast foods oOther 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) oPharmacotherapeutics/Uses Treat heartburn, GERD, gastric, duodenal ulcer oPharmacokinetics/Administration Oral route, has enteric coated form Admin before breakfast on empty stomach Onset: 1hr; Peak: 2hr; Duration: 72hrs. Pregnancy Category C oPharmacodynamics/Mode of Action Suppresses gastric enzyme system responsible for last phase of gastric acid production Binding irreversibly to H+& K+Proton pump inhibitor oAdverse Effects: Omeprazole (Prilosec) Common – headache; nausea, diarrhea, rash, ab pain CNS – dizziness, muscle weakness oContraindications/PrecautionsHypersensitivity oInteractions Drug/Drug