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Chapter 10

Chapter 10. Drugs for Gastrointestinal and Related Diseases. Chapter 10 Definitions. Gastrointestinal (GI) tract GI transit time GERD Peptic Disease Ulcer. The Gastrointestinal System. Gastrointestinal (GI) tract is a continuous tube

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Chapter 10

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  1. Chapter 10 Drugs for Gastrointestinal and Related Diseases

  2. Chapter 10 Definitions • Gastrointestinal (GI) tract • GI transit time • GERD • Peptic Disease • Ulcer

  3. The Gastrointestinal System • Gastrointestinal (GI) tractis a continuous tube • Starts at mouth  pharynx  esophagus  stomach  small intestine  large intestine  ends at anus • Digestive and absorptive process take place in the GI tract

  4. GI Transit Time • Speeding up transit time = less absorption • Slowing transit time = more absorption

  5. Gastroesophageal Reflux Disease (GERD) • Symptoms • Radiating burning or pain in chest • Acid taste • Recurrent abdominal pain • Meal-related esophagitis due to reflux (backflow) of acidic stomach contents through incompetent esophageal sphincter

  6. H2 Histamine Receptor Antagonists • Block gastric acid and pepsin secretion • Blocks action of histamine in the stomach- decreasing the production of acid • All available OTC in some strengths • Bedtime dose is most important

  7. Therapeutic Uses of ranitidine (Zantac, Zantac 75) • Active duodenal ulcers and benign gastric ulcers • Long-term prevention of duodenal ulcers • Gastric hypersecretory states • GERD • Postoperative ulcers • Preventing stress ulcers • Upper GI bleeding

  8. Therapeutic Uses of ranitidine (Zantac, Zantac 75) • Precautions: • Pregnancy-B • Do not crush, chew or break • Side-Effects: • Increase risk of Pneumonia • HA, dizziness, insomnia, decreased sex drive, swollen breast-men, nausea, vomiting, diarrhea, constipation

  9. Dispensing Issues of Ranitidine Look-alike and sound-alike • Ranitidine (H2 antagonist) • Amantadine (for flu) • Rimantadine (antiviral)

  10. Dispensing Issues of Zantac • Look-alike and sound-alike • Zantac • Xanax (antianxiety)

  11. Proton Pump Inhibitors • An enzyme maintains acidity in gastric secretions by pumping • Acidic hydrogen ions (protons) into stomach • Nonacidic potassium ions out • Proton pump inhibitors (PPIs) block this enzyme, reducing stomach acidity • PPIs must be taken daily

  12. omeprazole (Prilosec) • Indicated for short-term treatment of esophagitis, GERD, and hypersecretory conditions • Take before meals • Also indicated for peptic disease caused by bacterium Helicobacter pylori (H. pylori)

  13. omeprazole (Prilosec) • Precautions: • Pregnancy Cat C • Do not crush, chew or break • Side Effects: • Fever • Cold symptoms • Stomach pain • Nausea, vomiting, diarrhea • headache

  14. lansoprazole (Prevacid) • Indicated for short-term therapy of ulcers and esophagitis • Indicated for long-term treatment of hypersecretory disorders and Zollinger-Ellison syndrome (hypersecretion from a tumor)

  15. lansoprazole (Prevacid) • Not for immediate relief of heartburn • Precautions: • 1Q24H for 14days, 4 months between treatments • Pregnancy Cat. B • Do not crush, chew or break • Side Effects: • Headache, nausea, stomach pain, diarrhea, constipation

  16. esomeprazole (Nexium) • Very similar to Prilosec, but metabolized slower which increases duration of acid suppression • Take on an empty stomach

  17. esomeprazole (Nexium) • Not for immediate relief of heartburn • 4-8 weeks full glass of water, 1 hr before food • Precautions: • Severe liver disease, low levels of magnesium • Pregnancy Cat B • Side Effects: • Headache, drowsiness, diarrhea, nausea, stomach pain, constipation, dry mouth

  18. Agents for GERDCombinations • calcium carbonate-famotidine-magnesium hydroxide (Pepcid Complete) • lansoprazole-naproxen (PrevacidNapraPAC)

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