15. GERD, Anti-Ulcer, and Anti-Asthmatic

Question 1

GERD - PPI MoA

How long to reach steady state?

Examples?

Answer 1

Decreases gastric acid secretion by blocking parietal cell H-K ATPase

5-7 days to reach steady state

Examples: Omeprazole and esomeprazole

Question 2

PPI adverse effects?

Answer 2

Dizziness, cough, systemic lupus, cutaneous lupus, diahrhea

Question 3

PPI drug interactions

• Bisphophonates
• Itraconazole/ketoconazole
• Multivitamins

Answer 3

1. Diminished therapeutic effect
2. Decreased serum concentration
3. Decreased serum concentration (esp iron)

Question 4

GERD - H2 antagonists MOA

Examples?

Answer 4

Competitive inhibition of histamine at H2 receptors of gastric parietal cells

Cimetidine, rantidine

Question 5

H2 antagonist adverse effects?

Answer 5

1. Confusion
2. Nausea/vomiting
3. Skin rash
4. Vit B12 deficiency

Question 6

H2 antagonist drug interactions with anti-fungal?

Answer 6

Itraconazole/ketoconazole - decreased serum concentration

Question 7

Inhaled corticosteroids - MoA (3)

Answer 7

Anti-inflammatory, reduce airway hyper-responsiveness, inhibit inflammatory cell migration and activation

Question 8

What immunomodulator (antibody) is used as an adjunctive therapy for patients with allergies?

Answer 8

Anti-IgE - Helps prevent binding of IgE to the high affinity receptors on basophils and mast cells

Question 9

What short acting B2 agonist is used as a rescue inhaler?

Answer 9

Alberterol (relaxes smooth muscle as a bronchodilator)