A nursing student is preparing a presentation for am in service to the staff nur

Question

A nursing student is preparing a presentation for am in service to the staff nurse on the unit where the clinical rotation is done. The in service Is being presented on medications for gastrointestinal orders, which are among the most common complaints seen in clinical practice .

a: what are the current theories about the pathophysiology process responsible for peptic ulcer disease?

b: what are the therapeutic actions for drugs used to decrease acid content (H2 receptor antagonist, antacids, proton pump inhibitors, and prostaglandins)?

c: how does acid rebound occur?

d: what are the therapeutic actions of sucralfate and misoprostol?

e: what are the considerations for older adults when using drugs that affect GI secretions?

f: what are the important teaching points to include for patient receiving ranitidine?

Explanation / Answer

a. The history of peptic ulcer disease shows how medical practitioners adapted the theoretical basis of their medical practice and later abandoned hypothesis and therapeutic regimens which no longer were in accord with current thinking.

The current theories about the pathophysiology process responsible for peptic ulcer disease are:-

Some of the theories are discussed below:-

1. Stress theory of Ulcer:

i.) A sudden increase in peptic ulcer was observed in the 20th century.

ii.) Two World Wars in the 20th century and the great depression.

iii.) Famous Freudian thoughts were prevalent in that period.

2. Acid and Pepsin theory of Ulcer: -

3. Infective Theory of Peptic Ulcer:

b. H2 antagonists: - They block the release of acid in response to parasympathetic release or gastrin. The adverse effects include confused state, arrhythmias of heart, dizziness, and galactorrhea. H2 blockers do not have any side-effects

Antacids: They are used to chemically neutralize and react with acid present in the stomach. They are known to cause GI alterations such as diarrhea or constipation and can alter the absorption of many drugs.They provide rapid relief from increased acid levels. They are weak bases which react with gastric HCL to form salt and water and reduce intragastric acidity.

Proton pump inhibitors: - They suppress gastric acid secretion by specifically inhibiting the hydrogen-potassium adenosine triphosphatase enzyme system on the secretory surface of the gastric parietal cells. This blocks the final step of acid production that lowers the acid levels in the stomach. They have high first pass metabolism. They resemble H2 antagonists in structure but their mechanism of action is completely different.

Prostaglandins: - Prostaglandins are derived enzymatically from fatty acids which increase bicarbonate and mucus production in the stomach and inhibit gastric acid secretion.

c. Acid rebound occurs when the stomach produces more gastrin and more acid (hypersecretion of gastric acid) in response to lowered acid levels in the stomach It commonly occurs when antacids containing calcium carbonate are used. The challenge is to balance the reduction of the stomach acid without increasing acid production.

d. Sucralfate: - The sucralfate is a GI protectant that forms a protective coating over the eroded stomach lining to protect it from acid and digestive enzymes thus allowing it to heal.
Misoprostol: - The misoprostol is a prostaglandin that blocks gastric acid secretion while increasing the production of bicarbonate and mucous lining in the stomach. It decreases your risk of serious ulcer complications such as bleeding.

e.

f.

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.