NURS 366- EXAM 1 PHARM QUESTIONS & ANSWERS
What is peptic ulcer disease (PUD)? - Answers :- Group of upper GI disorders
- Degrees of erosion of the gut wall
- Severe erosion can be complicated by hemorrhage and perforation
What causes peptic ulcer disease? - Answers :Imbalance between mucosal and
aggressive factors
What are risk factors for ulcer development? - Answers :Age over 60 years, history of
ulcers, high-dose NSAID therapy
What are defensive factors against peptic ulcers? - Answers :- Mucus
- Bicarbonate
- Blood flow
- Prostaglandins
How does mucus defend against peptic ulcers? - Answers :- Secreted cells of the GI
mucosa
- Forms a barrier to protect underlying cells from acid and pepsin
How does bicarbonate defend against peptic ulcers? - Answers :- Secreted by epithelial
cells of stomach and duodenum
- Most remains trapped in mucus layer to neutralize hydrogen ions that penetrate the
mucus
How does blood flow defend against peptic ulcers? - Answers :Poor blood flow can lead
to ischemia, cell injury, and vulnerability to attack
How do prostaglandins defend against peptic ulcers? - Answers :Stimulate the secretion
of mucus and bicarbonate
What are aggressive factor of peptic ulcers? - Answers :- H. pylori
- NSAIDs
- Gastric acid
- Pepsin
- Smoking
What is the most common cause of gastric and duodenal ulcers? - Answers :H. pylori
What is the second most common cause of gastric and duodenal ulcers? - Answers
:NSAIDs
What is H. pylori? - Answers :- Gram-negative bacillus that can colonize the stomach
and duodenum
- Lives between epithelial cells and the mucus barrier
, - Escapes destruction by acid
- Eradication of the bacterium promotes healing of the PUD and minimized recurrence
of PUD
How long can H. pylori remain in the GI tract? - Answers :- Can remain in the GI tract for
decades
- Half of the world is infected, but most people do not develop symptomatic peptic ulcer
disease (PUD)
How many patients with peptic ulcer disease have an H. pylori infection? - Answers
:60% to 70%
What kind of cancer does H. pylori promote? - Answers :gastric cancer
How do NSAIDs act as aggressive factors for peptic ulcers? - Answers :- Inhibit the
biosynthesis of prostaglandins
- Reduce blood flow, mucus, and bicarbonate
How does gastric acid act as an aggressive factor for peptic ulcers? - Answers :-
Causes ulcers directly by injuring cells of the GI mucosa and indirectly by activating
pepsin
- Increased acid alone does not increase ulcers but is a definite factor in PUD
- Zollinger-Ellison syndrome
How does pepsin acid act as an aggressive factor for peptic ulcers? - Answers
:Proteolytic enzyme in gastric juice
How does smoking act as an aggressive factor for peptic ulcers? - Answers :Delays
ulcer healing and increases risk for recurrence
What are the goals of drug therapy? - Answers :- Alleviate symptoms
- Promote healing
- Prevent complications
- Prevent recurrence
- *Drugs do not alter the disease process; they create conditions conducive to healing*
What are the classes of antiulcer drugs? - Answers :- Antibiotics
- Antisecretory agents
- Mucosal protectants
- Antisecretory agents that enhance mucosal defenses
- Antacids
What are the 3 ways antiulcer drugs work? - Answers :- Eradicate H. pylori (antibiotics)
- Reduce gastric acidity (antisecretory agents, misoprostol)
- Enhance mucosal defenses (sucralfate, misoprostol)
What is peptic ulcer disease (PUD)? - Answers :- Group of upper GI disorders
- Degrees of erosion of the gut wall
- Severe erosion can be complicated by hemorrhage and perforation
What causes peptic ulcer disease? - Answers :Imbalance between mucosal and
aggressive factors
What are risk factors for ulcer development? - Answers :Age over 60 years, history of
ulcers, high-dose NSAID therapy
What are defensive factors against peptic ulcers? - Answers :- Mucus
- Bicarbonate
- Blood flow
- Prostaglandins
How does mucus defend against peptic ulcers? - Answers :- Secreted cells of the GI
mucosa
- Forms a barrier to protect underlying cells from acid and pepsin
How does bicarbonate defend against peptic ulcers? - Answers :- Secreted by epithelial
cells of stomach and duodenum
- Most remains trapped in mucus layer to neutralize hydrogen ions that penetrate the
mucus
How does blood flow defend against peptic ulcers? - Answers :Poor blood flow can lead
to ischemia, cell injury, and vulnerability to attack
How do prostaglandins defend against peptic ulcers? - Answers :Stimulate the secretion
of mucus and bicarbonate
What are aggressive factor of peptic ulcers? - Answers :- H. pylori
- NSAIDs
- Gastric acid
- Pepsin
- Smoking
What is the most common cause of gastric and duodenal ulcers? - Answers :H. pylori
What is the second most common cause of gastric and duodenal ulcers? - Answers
:NSAIDs
What is H. pylori? - Answers :- Gram-negative bacillus that can colonize the stomach
and duodenum
- Lives between epithelial cells and the mucus barrier
, - Escapes destruction by acid
- Eradication of the bacterium promotes healing of the PUD and minimized recurrence
of PUD
How long can H. pylori remain in the GI tract? - Answers :- Can remain in the GI tract for
decades
- Half of the world is infected, but most people do not develop symptomatic peptic ulcer
disease (PUD)
How many patients with peptic ulcer disease have an H. pylori infection? - Answers
:60% to 70%
What kind of cancer does H. pylori promote? - Answers :gastric cancer
How do NSAIDs act as aggressive factors for peptic ulcers? - Answers :- Inhibit the
biosynthesis of prostaglandins
- Reduce blood flow, mucus, and bicarbonate
How does gastric acid act as an aggressive factor for peptic ulcers? - Answers :-
Causes ulcers directly by injuring cells of the GI mucosa and indirectly by activating
pepsin
- Increased acid alone does not increase ulcers but is a definite factor in PUD
- Zollinger-Ellison syndrome
How does pepsin acid act as an aggressive factor for peptic ulcers? - Answers
:Proteolytic enzyme in gastric juice
How does smoking act as an aggressive factor for peptic ulcers? - Answers :Delays
ulcer healing and increases risk for recurrence
What are the goals of drug therapy? - Answers :- Alleviate symptoms
- Promote healing
- Prevent complications
- Prevent recurrence
- *Drugs do not alter the disease process; they create conditions conducive to healing*
What are the classes of antiulcer drugs? - Answers :- Antibiotics
- Antisecretory agents
- Mucosal protectants
- Antisecretory agents that enhance mucosal defenses
- Antacids
What are the 3 ways antiulcer drugs work? - Answers :- Eradicate H. pylori (antibiotics)
- Reduce gastric acidity (antisecretory agents, misoprostol)
- Enhance mucosal defenses (sucralfate, misoprostol)
