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Chapter 8 Drugs for Gastrointestinal Disorders

Chapter 8 Drugs for Gastrointestinal Disorders. Gastrointestinal (GI) Disorders. Peptic ulcer disease Gastroesophageal reflux disease Diarrhea Constipation Intestinal gas. Peptic Ulcer Disease (PUD). Mucosa erosion – stomach or duodenum Often asymptomatic Damage from Alcohol abuse

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Chapter 8 Drugs for Gastrointestinal Disorders

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  1. Chapter 8Drugs for Gastrointestinal Disorders

  2. Gastrointestinal (GI) Disorders • Peptic ulcer disease • Gastroesophageal reflux disease • Diarrhea • Constipation • Intestinal gas

  3. Peptic Ulcer Disease (PUD) • Mucosa erosion – stomach or duodenum • Often asymptomatic • Damage from • Alcohol abuse • Cigarette smoking • NSAIDs

  4. Signs and symptoms of PUD • Dull stomach ache • Poor appetite • Bloating • Burping • Nausea • Vomiting

  5. Treatment Options for PUD • Directed towards relieving pain, accelerating ulcer healing, and minimizing recurrence • H2 receptor antagonists (Tagamet, Zantac) • Proton pump inhibitors (Prilosec, Prevacid) • Antacids (Tums, Rolaids) • Sucralfate (prescription only) • Bismuth compounds (Pepto-Bismol) • Antibiotics

  6. Adverse Effects • Diarrhea • Constipation • Headache • Stomach cramps • Dizziness • Rash • Nausea • Vomiting

  7. Gastroesophageal Reflux Disease (GERD) • Movement of gastric contents into the esophagus • Lower esophageal sphincter (LES) does not close properly

  8. GERD (cont.) • Possible problems with GERD • Esophageal strictures (narrowing or constriction) • Esophageal ulcers • Perforations • Hemorrhage • Aspiration • Motility disorders

  9. Heartburn • Most common symptom of GERD • Pain in center of chest • Most do not seek treatment right away • Aggravated by • Foods high in fat • Spices, onions, citric juices, coffee (caffeine) • Alcohol • Body position

  10. Treatment and Adverse Effects • Goals of treatment • Eliminate symptoms • Limit frequency and duration • Promote healing • Prevent complications • Alter factors that cause reflux • Lose weight, proper diet • Loose-fitting clothes • Limit smoking, alcohol, laying down after eating

  11. Antacids • Relieve mild to moderate symptoms • Decrease gastric acidity • Rapid onset, short duration • Taken with food = last up to 3 hours • Adverse effects • Diarrhea • Constipation

  12. Table 8-2: Antacid Classifications*

  13. Diarrhea • Genetic Disorder • Abnormal frequency and liquidity of fecal discharge • Origin • Infection (Salmonella) • Toxic • Drug-induced • Diet

  14. Acute or Chronic • Acute (sudden onset) • Food induced (traveler’s) • Chronic (2 weeks or longer) • Stress or Irritable bowel syndrome

  15. Treatment and Adverse Effects • Goals of treatment • Control the loss of fluids (athletes) • Identify and treat cause • Provide symptomatic relief • Refer to physician if • Persists for several days • Blood in stool • Severe abdominal pain, cramps • If from a bacterial infection – do not stop movement

  16. Antiperistaltic agents (Imodium) • Dizziness, dry mouth , rash • Bismuths (Pepto-Bismol) • Figure 8-1, pg 111

  17. Constipation • Decrease in the frequency of fecal elimination (hard/dry stool) • Diet low in fiber • Lack of exercise • Insufficient fluid intake • Excessive intake of foods • Resisting defecation impulses • Diabetes, pregnancy

  18. Antidiarrheal medications • Can cause constipation • Low back pain, headache, distension, abdominal pain

  19. Treatment • Increase fiber intake • Bulk-forming laxatives • FiberCon, Metamucil • Increase fluid intake • Aerobic exercise • Stimulant laxatives • Dulcolax • Saline salt laxatives • Phillips’ Milk of Magnesia/Fleet enema • Implications for athletes, pg 113

  20. Intestinal Gas • Belching, abdominal discomfort, bloating, flatulence • Results from malabsorption of carbohydrates and proteins • Fruits, vegetables, lactose • Simethicone (Gas-X) • Alpha-galactoside (Beano)

  21. Athletic Trainer’s Responsibility • Recognize and refer • Trusting relationship

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