VNRS B50A-ADVANCED
PHARMACOLOGY PART A
Stephanie Engler, RN
Monday 1:15-2:30pm
sengler@bakersfieldcollege.edu
WELCOME TO PHARMACOLOGY!
• Syllabus
• Content is board approved- some review,
but we will be digging deeper!
• Expectations from this class….
• Please do your homework
• Be ready to participate in class
• Please bring 3 scantrons to class
• How can I help you succeed???
TO BE SUCCESSFUL IN THIS
CLASS………
• Come to class with homework prep
questions answered- find on website
• Bring lecture notes to class- print from
website
• Bring a blank concept map to class for
additional note taking
• Study from your lecture notes and
additional notes in class- use your text book
for clarification of material covered
• Participate in group “round tables” when
available- good time to review exams and
ask questions
LET’S GET STARTED…………
Unit 1- Introduction
• See class handout
Unit 2- Medications Administered for
Gastrointestinal Disorders
• GI reviewhttp://www.youtube.com/watch?v=Z7xKYNz9
AS0&feature=fvsr
• Liver disease, Pancreatitis & Insulin notes
• Groups- answer discussion ?’s
GI MEDS AND PLAN OF CARE
PLAN FOR THE DAY:
• Quick Notes Review
• Case Study
• NCLEX Questions
GASTRIC ACID
System
• Esophagus
• Stomach
• Liver/gallbladder
• Pancreas
• Small/large intestine
Gastric acid production
• Parietal cells- H+ production
• Receptors- histamine2
Function
• Stomach pH 1-4
• Digestion
• Defense against infection
WHAT DO WE DO WITH THE
OVERPRODUCTION OF THIS ACID????
****Give antacids= to neutralize!
•
Milk of Magnesia (magnesium
hydroxide)
• TUMS (calcium carbonate)
Heartburn, gastritis, peptic ulcer
disease (PUD)
****Suppress gastric acid!
H2 receptor blockers- bind to H2
receptor
• Pepcid (famotidine)
• Decrease HCl acid production
• Decrease heartburn
GERD, erosive esophagitis, PUD,
H. pylori, gastritis, prevent stress
ulcers
WHAT DO WE DO WITH THE OVERPRODUCTION
OF THIS ACID????
****Suppress gastric acid!
Proton pump inhibitors (PPI)blocks proton pump, stops HCl
production
• Prevacid (lansoprazole)
• Prilosec (omeprazole)
• Protonix (pantoprazole)
Decrease HCl production, decrease
heartburn
• Caution with hepatic disease!!!!
Gastric barrier- adheres to
gastric mucosa/ binds to ulcer
• Carafate (sucralfate)
Decrease heartburn
• http://www.youtube.com/watch?
v=_fa60VhclNo&feature=related
HOMEWORK QUESTIONS- SELECTED GI DISORDERS=
HELICOBACTER PYLORI (H. PYLORI)
GASTROESOPHAGEAL REFLUX DISEASE
(GERD)
PEPTIC ULCER DISEASE
GASTROINTESTINAL CASE STUDY
History of present illness (HPI):
Mr. D- 70 year old male- enters your clinic with a complaint of
severe upper abdominal pain that occurs mostly in the evening
hours. It is relieved by food, although he vomits his meals several
times each week. Wife states intermittent confusion in last month.
Past medical history (PMH):
 He has a history of peptic ulcers and alcohol abuse
 Smoking has been reduced to two packs per week
 He is taking no drugs, other than Rolaids for his indigestion
Workup: Vital signs- BP- 106/60, HR- 108, RR- 12, Temp- 98.6, O2- 98
on 2L NC, 2/10 pain
GASTROINTESTINAL CASE STUDY
Lab results:
+blood in stool
Na 138
K+ 3.2
Glucose 100
Ca 8.0
BUN 12
Creat 1.2
AST 100
ALT 150
Albumin 1.8
Hgb 10.2
Hct 28.6
NCLEX
1. Which of the following best describes the
mechanism of the action of sucralfate
(Carafate)?
a.
b.
c.
d.
Kill H. pylori
Reduce the secretion of acid
Increase the secretion of bicarbonate
Add a gel-like protective mucus over the
ulcer
NCLEX
2. The nurse would administer amoxicillin
(Amoxil) or clarithromycin (Biaxin) for peptic
ulcers in order to:
a.
b.
c.
d.
Kill H. pylori
Reduce the secretion of acid
Increase the secretion of bicarbonate
Add a gel-like protective mucus over the
ulcer
NCLEX
3. Which class of drugs acts by neutralizing
stomach acid?
a.
b.
c.
d.
H2-receptor blockers
Serotonin receptor blockers
Proton-pump inhibitors
Antacids
NCLEX
4. Which of the following is the most effective
class of drugs used to treat diarrhea?
a.
b.
c.
d.
Phenothiazines
Antihistamines
Anticholinergics
Opioids