Pharmacology

Question 1

List the 4 antacids.

Answer 1

Sodium bicarbonate
Calcium bicarbonate
Magnesium hydroxide
Aluminum hydroxide

Question 2

State the differences between the antacids.

Answer 2

Sodium bicarbonate-
More soluble, react faster
Gastric distention and belching
Metabolic alkalosis

Calcium bicarbonate-
Less soluble, react slower
Belching, metabolic alkalosis
Excessive use- hypercalcemia and renal insufficiency

Magnesium and aluminum hydroxide-
No belching
No metabolic alkalosis
Unabsorbed Mg salts can lead to diarrhea
Unabsorbed Al salts can lead to constipation
Avoid long term use with pts with renal insufficiency.

Question 3

State the function of Histamine H2 receptors antagonist.

Answer 3

1. It blocks histamine secretion by binding to the parietal cell H2 receptor.
2. Blocks direct stimulation of parietal cell on gastrin or reduced AcH effect on acid secretion.

Question 4

State the clinical uses of H2 receptor antagonist for GERD and Peptic ulcer diseases

Answer 4

GERD- administer twice daily doses of H2 blockers

Peptic ulcer diseases-
A) gastric and duodenal ulcers: administer bedtime one daily. STOP the use of NSAIDs.
B) H. Pylori: administer 10-14 day course of PPI and two antibiotics.

Question 5

State the clinical uses of proton pump inhibitors for GERD

Answer 5

— one dose daily (standard)
— Long term maintained required for reoccurrence
— Twice daily doses for 3mths for extra complications.

Question 6

State the clinical uses of proton pump inhibitors on H. Pylori peptic ulcer diseases.

Answer 6

— it heals ulcer and eradicates microbe.
— triple therapy: once or twice daily PPI
— quadruple therapy: PPIs and H2-RA (qd or bid)
— bismuth, metronidazole and tetracycline

Question 7

State the clinical uses of proton pump inhibitors on NSAIDs associated ulcers.

Answer 7

Stop the use of NSAIDs
Administer one or twice daily PPIs.

Question 8

List the antiemetic medications used on GERD pts who fail to respond to conventional therapy.

Answer 8

Metoclopramide
Domperidone

Treat nausea and vomiting.
Inhibits cholinergic smooth muscle stimulation in the gastrointestinal tract ( increase gastric motility)

Question 9

List the antidiarrheal agents.

Answer 9

Diphenoxylate
Loperamide
Kaolin
Pectin

Note: Treat diarrhea.

Question 10

List the osmotic laxatives

Answer 10

Magnesium hydroxide
Sodium phosphate
Sorbitol lactulose