McKenna's Pharmacology for Nursing, 2e

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Drugs affecting gastrointestinal secretions

Learning objectives Upon completion of this chapter, you should be able to: 1. Describe the current theories on the pathophysiological process responsible for the signs and symptoms of peptic ulcer disease. 2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions and important drug–drug interactions associated with drugs used to affect gastrointestinal (GI) secretions. 3. Discuss the drugs used to affect GI secretions across the lifespan. 4. Compare and contrast the prototype drugs used to affect GI secretions with other agents in their class and with other classes of drugs used to affect GI secretions. 5. Outline the care considerations, including important teaching points, for people receiving drugs used to affect GI secretions.

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Glossary of key terms acid rebound: reflex response of the stomach to lower-than-normal acid levels; when acid levels are lowered through the use of antacids, gastrin production and secretion are increased to return the stomach to its normal acidity antacids: a group of inorganic chemicals that neutralise stomach acid digestive enzymes: enzymes produced in the gastrointestinal tract to break down foods into usable nutrients GI protectant: drug that coats any injured area in the stomach to prevent further injury from acid or pepsin histamine-2 (H 2 ) antagonist: drug that blocks the H 2 receptor sites; used to decrease acid production in the stomach (H 2 sites are stimulated to cause the release of acid in response to gastrin or parasympathetic stimulation) peptic ulcer: erosion of the lining of stomach or duodenum; results from imbalance between acid produced and the mucus protection of the GI lining or possibly from infection by Helicobacter pylori bacteria prostaglandin: any one of numerous tissue hormones that have local effects on various systems and organs of the body, including vasoconstriction, vasodilation, increased or decreased GI activity, and increased or decreased pancreatic enzyme release proton pump inhibitor: drug that blocks the H + , K + -ATPase enzyme system on the secretory surface of the gastric parietal cells, thus interfering with the final step of acid production and lowering acid levels in the stomach

DRUGS USED TO TREAT GASTRO-OESOPHAGEAL REFLUX DISEASE AND ULCER DISEASE Histamine-2 antagonists

DRUGS USED TO TREAT DIGESTIVE ENZYME

Antacids aluminium salts calcium salts magnesium salts sodium bicarbonate Proton pump inhibitors esomeprazole lansoprazole

omeprazole pantoprazole rabeprazole GI protectant sucralfate Prostaglandin misoprostol

DYSFUNCTION pancrelipase

cimetidine famotidine nizatidine ranitidine