Gastrointestinal a proton pump inhibitors omeprazole

13) Gastrointestinal

A. Proton Pump Inhibitors
–
Omeprazole ( Prilosec )
B.
Histamine-2 (H
2
) Antagonists
– Cimetidine ( Tagamet HB )
- Famotidine ( Pepcid ) - Pediatric
C.
Antacids –
Sodium bicarbonate ( Bell-ans )
- Calcium carbonate ( Oystercal , Tums , and others)
- Magnesium salts ( Milk of Magnesia , and others) –
Diarrhea
I.
Actions - Act at specific secretory surface receptors to prevent the final step of acid
production and thereby decrease the level of acid in the stomach (Inhibits final stage of
gastric secretion)
II.
Indications - Short-term treatment of active duodenal ulcers , GERD , erosive
esophagitis , and benign active gastric disease
- Long-term treatment of pathological hypersecretory conditions
III.
Contraindications - Allergy
IV.
Adverse Effects - CNS effects - Dizziness, headache, asthenia, vertigo, insomnia,
Apathy (Diarrhea, abdominal pain and tongue atrophy- 2 weeks)
I. Action - Selectively block histamine-2 receptor sites
- reduction in gastric acid secretion and reduction in overall pepsin
production
II. Indications - duodenal ulcer or benign gastric ulcer
- hypersecretory conditions such as Zollinger–Ellison syndrome
- Prophylaxis of stress-induced ulcers and acute upper GI bleeding in
critical patients.
- Relief of symptoms of heartburn , acid indigestion , and sour stomach
(OTC preparations)
III. Adverse Effects - GI effects, CNS effects, Cardiac arrhythmias and hypotension
- Galactorrhea, Gynecomastia – Man boob
- Aluminum salts ( Amphojel , and others)
- Constipation
I. Action - Neutralize stomach acid by direct chemical reaction
II. Indication - Symptomatic relief of upset stomach associated with hyperacidity, as well as
hyperactivity

III. Adverse Effects -
Relate to their effects on acid-base levels and electrolytes - Imbalance
- Rebound acidity – Hyperacidity
- Alkalosis
- Hypercalcemia
- Constipation – Aluminum salts
- Diarrhea – Magnesium salts
- Hypophosphatemia
IV. Drug-drug interaction –

14) Diabetes Mellitus
• Hyperglycemia : Increased blood sugar
• Glycosuria : Sugar is spilled into the urine
• Polyphagia : Increased hunger
• Polydipsia : Increased thirst
• Polyuria : Increased Urine Frequency
• Lipolysis : Fat breakdown
• Ketosis : Ketones cannot be removed effectively
• Acidosis : Liver cannot remove all of the waste products
Signs of Impending Dangerous Complications of Hyperglycemia
I. Fruity breath as the ketones build up in the system and are excreted through the lungs
II. Dehydration as fluid and important electrolytes are lost through the kidneys
III. Slow, deep respirations (Kussmaul’s respirations) as the body tries to rid itself of high acid
levels
IV. Loss of orientation and coma
A. Insulin – tells glucose to go in the cell
1. Actions - Hormone that promotes the storage of the body’s fuels
- Simulates the synthesis of glycogen from glucose
2. Pharmacokinetics