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Transcript
Chapter 8
Drugs for
Gastrointestinal
Disorders
1
Gastrointestinal (GI)
Disorders





Peptic ulcer disease
Gastroesophageal reflux disease
Diarrhea
Constipation
Intestinal gas
2
Peptic Ulcer Disease (PUD)



Mucosa erosion – stomach or duodenum
Often asymptomatic
Damage from
– Alcohol abuse
– Cigarette smoking
– NSAIDs
3
Signs and symptoms of
PUD






Dull stomach ache
Poor appetite
Bloating
Burping
Nausea
Vomiting
4
Treatment Options for
PUD

Directed towards relieving pain, accelerating
ulcer healing, and minimizing recurrence
–
–
–
–
–
–
H2 receptor antagonists (Tagamet, Zantac)
Proton pump inhibitors (Prilosec, Prevacid)
Antacids (Tums, Rolaids)
Sucralfate (prescription only)
Bismuth compounds (Pepto-Bismol)
Antibiotics
5
Adverse Effects








Diarrhea
Constipation
Headache
Stomach cramps
Dizziness
Rash
Nausea
Vomiting
6
Gastroesophageal Reflux
Disease (GERD)


Movement of gastric contents into the
esophagus
Lower esophageal sphincter (LES)
does not close properly
7
GERD (cont.)

Possible problems with GERD
– Esophageal strictures (narrowing or
constriction)
– Esophageal ulcers
– Perforations
– Hemorrhage
– Aspiration
– Motility disorders
8
Heartburn




Most common symptom of GERD
Pain in center of chest
Most do not seek treatment right away
Aggravated by
–
–
–
–
Foods high in fat
Spices, onions, citric juices, coffee (caffeine)
Alcohol
Body position
9
Treatment and Adverse
Effects

Goals of treatment
–
–
–
–

Eliminate symptoms
Limit frequency and duration
Promote healing
Prevent complications
Alter factors that cause reflux
– Lose weight, proper diet
– Loose-fitting clothes
– Limit smoking, alcohol, laying down after eating
10
Antacids

Relieve mild to moderate symptoms
– Decrease gastric acidity



Rapid onset, short duration
Taken with food = last up to 3 hours
Adverse effects
– Diarrhea
– Constipation
11
Table 8-2: Antacid
Classifications*
12
Diarrhea



Genetic Disorder
Abnormal frequency and liquidity of
fecal discharge
Origin
– Infection (Salmonella)
– Toxic
– Drug-induced
– Diet
13
Acute or Chronic

Acute (sudden onset)
– Food induced (traveler’s)

Chronic (2 weeks or longer)

Stress or Irritable bowel syndrome
14
Treatment and Adverse
Effects

Goals of treatment
– Control the loss of fluids (athletes)
– Identify and treat cause
– Provide symptomatic relief

Refer to physician if
– Persists for several days
– Blood in stool
– Severe abdominal pain, cramps

If from a bacterial infection – do not
stop movement
15

Antiperistaltic agents (Imodium)
– Dizziness, dry mouth , rash

Bismuths (Pepto-Bismol)

Figure 8-1, pg 111
16
Constipation







Decrease in the frequency of fecal
elimination (hard/dry stool)
Diet low in fiber
Lack of exercise
Insufficient fluid intake
Excessive intake of foods
Resisting defecation impulses
Diabetes, pregnancy
17

Antidiarrheal medications
– Can cause constipation
– Low back pain, headache, distension,
abdominal pain
18
Treatment

Increase fiber intake
– Bulk-forming laxatives
– FiberCon, Metamucil



Increase fluid intake
Aerobic exercise
Stimulant laxatives
– Dulcolax

Saline salt laxatives
– Phillips’ Milk of Magnesia/Fleet enema

Implications for athletes, pg 113
19
Intestinal Gas


Belching, abdominal discomfort,
bloating, flatulence
Results from malabsorption of
carbohydrates and proteins
– Fruits, vegetables, lactose


Simethicone (Gas-X)
Alpha-galactoside (Beano)
20
Athletic Trainer’s
Responsibility


Recognize and refer
Trusting relationship
21