Documente Academic
Documente Profesional
Documente Cultură
The stomach secretes acid, enzyme and hormones that are essential to digestive
physiology
• Chief cells secretes the enzyme pepsinogen, which is then activated to become
pepsin, which is the digestive enzyme that breakdown proteins form food.
• Parietal cells secrete gastric (Hydrochloric) acid in the stomach., which provides
strong acidic environment that promotes conversion of pepsinogen to pepsin,
helps breakdown food and kills microbes that might have been digested.
o Secrete intrinsic factors, which is essential for absorption of Vit B12.
parietal cells are target for classes of drugs that reduce acid secretion.
Parietal cells receive messages from several sources, which tells them to increase or
decrease acid production. The cells contain receptors for the hormone, gastrin, histamine,
and neurotransmitter acetylcholine Which are the three principle physiologic stimuli that
regulate acid secretion from proton pump or H+, K+,-ATPase, located on the surface of
parietal cells.
PEPTIC ULCER
• Is a lesion or erosion located on either the stomach(gastric) or small
intestine( duodenal) mucosa that is associated with inflammation
PROTON PUMP INHIBITOR
• Drug of choice in the therapy o f Peptic Ulcer disease
• Mechanism of action: acts by blocking H+,K+, ATPase (an enzyme responsible
for secreting HCL in the stomach)
• Half life 1.5 hours
• Excreted in the urine(80%) and feces (20%)
-1-
• Proton Pump Inhibitor Drugs
o OMEPRAZOLE (Prilosec)
o ESOMEPRAZOLE (Nexium)
o LANZOPRAZOLE(Prevacid)- used for patient having swallowing
capsules, its capsule can be easily opened and its content mixed with food.
Available as a PO disintegrating tablet (Prevacid Solutab) that is place
under the tongue and disintegrates within 1 minute.
o PANTOPRAZOLE ( Protonix)
• OMEPRAZOLE
o Route: PO
o OTC, indicated to relieve Heart burn
o Mechanism of Action: Reduces Acid Secretion in the stomach by binding
irreversibly to the enzyme H+,K+, ATPase. It inhibits the final pathway
involved in acid secretion and effectively inhibits the active proton pumps.
-2-
o Indicated for Gastric Ulcer, Duodenal ulcer, and GERD to promote
healing and prevent recurrence.
o Route: PO, IM,IV
o Gastric ulcers heal more slowly than duodenal ulcer and thus require
longer therapy. Duoudenal ulcer requires 6-8weeks and gastric ulcers
requires 12 of therapy
o Adequate healing of ulcer 4-8 weeks
o Ranitidine blocks the H2 receptors on the parietal cells I the stomach to
decrease acid production. Both daytime and nocturnal basal gastric acid
secretion are suppressed
o Nursing Responsibility:
Administer the IV form of this medication slowly over several
minutes to prevent Bradycardia and hypotension due to the
antagonism of histamine receptors located in the heart.IntraVenous
preparation of H2 blockers are utilized for the prevention of stress
ulcer seen in intensive care unit(ICU) setting in critical ILL
PATIENTS
Take drug with meals because the bufferng effect of food may
increase the therapeutic effect
ANTACIDS
• Are alkaline substance that neutralize stomach acid to treat symptoms of
heartburn.
• Provide temporary relief of heartburn
• They relieve symptoms of antacid, but do not promote ulcer healing because
they do not protect or coat the stomach wall
• Antacids are inorganic compound that contain aluminum, magnesium,
sodium, or calcium that neutralize gastric acid and inactivates pepsin.
• ANTACID Drugs:
• 1.ALUMINUM HYDORXIDE(Alterna GEL)
• 2.SODIUM BCARBONATE ( Alka –Seltzer)
• 3.MAGNESIUM HYDORXIDE and ALUMINUM HYDROXIDE with
sinethicon (Maalox)
• 4.MAGNESIUM HYDROXIDE (Milk of Magnesia)
• 5.CALCIUM CARBONATE ( Tums)
• ALUMINUM HYDROXIDE
o Nursing Intervention::
Assess for bowel changes:
• Magnesium based products may cause Diarrhea.
• Calcium and Aluminum may cause constipation
Take antacids at least 2 hours before other PO medications,
because drug absorption maybe affected. Take 1 antacid 1 hour
before meal or 2 hours after meal.
-3-
This drug may make stool appear white
-4-