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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 - PowerPoint PPT Presentation
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The Gastrointestinal System
• Gastrointestinal (GI) tract is 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
GI Transit Time
• Speeding up transit time = less absorption
• Slowing transit time = more absorption
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
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
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
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
Dispensing Issues of Ranitidine
Look-alike and sound-alike – Ranitidine (H2 antagonist)– Amantadine (for flu) – Rimantadine (antiviral)
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
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)
omeprazole (Prilosec)
• Precautions:– Pregnancy Cat C– Do not crush, chew or break
• Side Effects:– Fever– Cold symptoms– Stomach pain– Nausea, vomiting, diarrhea– headache
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)
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
esomeprazole (Nexium)
• Very similar to Prilosec, but metabolized slower which increases duration of acid suppression
• Take on an empty stomach
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
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