CHAPTER 22
Hepatic and Pancreatic Disorders
PART 7 Learning Objectives Pronunciations After completing this chapter, you should be able to Amylase (AM-ill-ayss) 1. Define the following: Ascites (uh-SIE-teez) • Ascites • Hepatitis • Pancreatitis Bilirubin (bill-ee-ROO-bin) • Cirrhosis • Jaundice • Portal hypertension Cholecystokinin (KOH-leh-SIS-tih- KYE-nin) • Encephalopathy • Malabsorption • Pseudocyst Edema (eh-DEE-mah) • Esophageal varices Encephalopathy (en-sef-uh-LOP-uh- 2. Recall common causes and complications of chronic liver disease thee) 3. Review the role and mechanism of common drug treatments for cirrhosis Fibrosis (fye-BROH-sis) 4. Review adverse effects and drug interactions for medications used in the treatment Gynecomastia (gie-nee-koh-MAS- of chronic liver disease tee-uh) 5. Identify key patient counseling points for medications used to treat complications of Hepatocyte (heh-PAT-oh-siet) chronic liver disease Jaundice (JON-dis) 6. Describe the anatomy and normal physiology of the liver and pancreas Kupffer (KUP-fer) 7. Recognize common medications used in the management of acute pancreatitis Paracentesis (payr-uh-sen-TEE-sis) 8. Review adverse effects, drug interactions, and key patient counseling points for Protease (PROH-tee-ayss) medications used in the treatment of chronic pancreatitis Sinusoid (SIE-nyoo-soyd) Steatorrhea (stee-at-or-EE-ya) Matching I Varices (VAYR-ih-seez)
Match each definition or description with the corresponding term. Definitions Terms 1. a bdominal organ responsible for synthesizing proteins, a. ascites cholesterol, and bile b. b ile 2. a bnormal accumulation of fluid in the abdominal cavity c. cirrhosis 3. b rain/nervous system dysfunction caused by ammonia d. hepatic and waste products in the blood encephalopathy 4. e nlarged veins in the upper GI tract, which may burst e. hepatitis and bleed easily f. jaundice 5. i ncreased pressure in the main vein of the liver 6. infection of ascitic fluid in the peritoneal cavity g. l iver 7. i nflammation of the liver h. p ancreas 8. i nflammation of the pancreas i. pancreatitis 9. liver disease in which scar tissue replaces normal tissue j. portal hypertension 10. organ that secretes insulin, glucagon, somatostatin, and some digestive enzymes k. spontaneous bacterial 11. substance that helps remove fat-soluble substances peritonitis from the body and aids in intestinal fat absorption 12. yellow discoloration of skin and eyes caused by bili- l. varices rubin accumulation Workbook for Understanding Pharmacology for Pharmacy Technicians 82
Matching II 7. Octreotide is administered as an intravenous infusion for five days when used in the treat- Match each brand name drug to its generic and note whether ment of variceal bleeding. it is used to treat conditions associated with liver disease (L) 8. Albumin infusions can help reduce blood or pancreatic disease (P). For additional study, identify the volume and flow to the kidneys in patients with condition (e.g., ascites) each medication is used to treat. liver disease. 9. Pancreatic enzyme replacement must be accom- Generic Disease plished by injection. Brand Names Names Type Condition 1. Aldactone 10. Vitamin supplements for patients with chronic pancreatitis usually have high concentrations of 2. Creon the fat soluble vitamins A, D, E, and K. 3. Enulose 4. Inderal LA Short Answer 5. Lasix 6. Neo-Fradin 1. What are the major complications of cirrhosis? 7. Noroxin 8. Sandostatin 9. Xifaxan 10. Zenpep
Generic Names 2. How can lactulose be administered to hospitalized a. furosemide f. pancrelipase patients who are unable to swallow? b. lactulose g. propranolol c. neomycin h. rifaximin d. norfloxacin i. spironolactone e. octreotide True or False 3. What antibiotics are typically administered to treat For additional study, try to change the false statements to patients hospitalized with acute spontaneous bacterial make them true. peritonitis? 1. Cirrhosis is also known as end stage liver disease. 2. Variceal bleeding is the term used to refer to increased pressure in the portal vein that results from cirrhosis.
3. The most common diuretic regimen for treating 4. Why is albumin used sparingly in the treatment of ascites is a combination of furosemide with a complications of cirrhosis? thiazide, usually hydrochlorothiazide (HCTZ). 4. The laxative agent lactulose is often used to treat hepatic encephalopathy, the change in mental function associated with liver disease. 5. Patients who develop spontaneous bacterial peritonitis as a complication of chronic liver disease should be treated with antibiotics on a 5. What adverse effect of pancreatic enzyme therapy may continuous regimen for the rest of their lives. occur if doses are above the recommended level? 6. Rifaximin is not as effective as lactulose, neomycin, and metronidazole for the treatment of SBP but is sometimes used because it is less expensive.