Quiz 33: Agents That Affect Intestinal Motility

Nursing

Functions of gastrointestinal tract are food ingestion, absorption and digestion. During digestion the nutrients are absorbed by the system. The GI includes mouth, esophagus, stomach and intestine. The upper GI tract digest and absorb the food ingested while the stomach and small intestine secret the hormones, enzymes and the digestive juices to help the process of digestion and absorption of nutrients. The stomach secretes the gastric juice and proteolytic enzymes for digestion of food. There are three phases of gastric acid secretion as cephalic, gastric and intestinal. Any destruction or alteration in the GI tract function leads to gastrointestinal disorders. The production of gastric acid in the evening between two meals and during the sleeping reduces the production of H. pyroli bacterium. Thus reduces the chances of causing the infection. An interference with protective function of GI tract leads to peptic ulcer formation. Peptic ulcer is the result of destruction of mucosal layer of stomach or alteration in the production of gastric acid. Peptic ulcers are the open sores. These sores are developed on the mucosal lining of the stomach and intestine (duodenum). They are caused due to the increased production of gastric acid. It is an infection of H. pylori. There are certain others factor that can lead to ulcer production in an individual such as smoking, alcohol and increased cholinergic activity. These factors stimulate the acid secretion which increase the risk of ulcer formation. NSAIDs and steroids are also ulcerogenic due to their inhibition to secret the mucus. Any type of ulcer is associated with the acid-induced injury caused to the mucosal lining of stomach. Genetic factors also plays important role as some people are genetically susceptible to peptic ulcers formation. Drugs that can cure the peptic ulcer possess two mechanisms like reduction of gastric juice acidity and enhancement of defence for mucosal barrier.

Functions of the gastrointestinal tract are food ingestion, absorption and digestion. During digestion the nutrients are absorbed by the system. The GI includes mouth, esophagus, stomach and intestine. The upper GI tract digest and absorb the food ingested while the stomach and small intestine secret the hormones, enzymes and the digestive juices to help the process of digestion and absorption of nutrients. The stomach secretes the gastric juice and proteolytic enzymes for digestion of food. There are three phases of gastric acid secretion as cephalic, gastric and intestinal. Any destruction or alteration in the GI tract function leads to gastrointestinal disorders. The production of gastric acid in the evening between two meals and during the sleeping reduces the production of H. pyroli bacterium. Thus reduces the chances of causing the infection. An interference with protective function of GI tract leads to peptic ulcer formation. Peptic ulcer is the result of destruction of mucosal layer of stomach or alteration in the production of gastric acid. There are certain others factor that can lead to ulcer production in an individual such as smoking, alcohol and increased cholinergic activity. Drugs that can cure the peptic ulcer possess two mechanisms like reduction of gastric juice acidity and enhancement of defence for mucosal barrier. Drugs to treat the peptic ulcer includes proton pump inhibitors (PPI), H 2 - receptor antagonist (antihistamines), prostaglandins, anticholinergic drugs and antacids. Tagment and Zantac are the H 2 - receptor antagonist. They can cause drug interactions with certain drugs. Cimentidine (Tagment) interacts with diazepam (Valium) used for anxiety to provide calming effects. It also interacts with metoprolol (Toprol) which is a selective beta-1 blocker used to treat hypertension and warfarin (Coumadin) which is an anticoagulant. When tagment interacts with all the above drug then the blood levels of these drugs increases. So tagment is recommended only with Donnatal (belladonna) used by patient (d) to treat ulcers or bowel syndrome. In case of Zantac, it reacts with warfarin (Coumadin) which is an anticoagulant and also with diazepam (Valium) used for anxiety to provide calming effects. When Zantac interacts with the warfarin, it may lead to decrease the clearance of warfarin and can cause hypo prothrombinemia. In case of Dizepam, Zantac alters the drug absorption and thus leads to decreased levels of diazepam in blood. So Zantac is recommended for patient (a) and (d).

The cephalic phase begins before entrance of the food into the stomach. This means it starts at the time when the food is being eaten. The colonic phase is when food enters the colon. The function is to mix and knead the contents of the food i.e. process of peristalsis. In the intestinal phase the duodenum responds to the bolus of the food i.e. chyme and thus influence the gastric activity through hormones and nervous reflexes. An area of the medulla oblongata that receives the reflexes from blood-borne drugs or hormones is known as chemoreceptor trigger zone (CTZ). Hence the incorrect options are A, B and D. After food has entered the stomach, gastric phase i.e. vagovagal reflex is initiated by the distension of the stomach. This further stimulates the secretion of pancreatic exocrine products. Hence the correct option is img .

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