E2: GI Drugs

Question 1

_________: Weak bases that interact with stomach acid to form water and salt

Answer 1

Antacids

Question 2

Where do antacids work?

Answer 2

locally

Question 3

What do antacids do to stomach pH?

Answer 3

raise gastric pH

Question 4

Antacids Do NOT inhibit ____ production by parietal cells

Answer 4

HCl

Question 5

Best antacids are those that buffer to a pH of ___-___

Answer 5

pH of 3-4

Question 6

What is a SIDE EFFECT of Antacids?

Answer 6

Constipation

Question 7

Which one of these combinations is TUMS? Aluminum hydroxide, magnesium hydroxide or calcium carbonate

Answer 7

Calcium Carbonate

Question 8

What are the 2 Magnesium antacid products?

Answer 8

Milk of Magnesia,Maalox

Question 9

Which antacid can be used to remineralize enamel? Watch out! it can cause a gun metal grey stain for a bit…

Answer 9

milk of magnesia

Question 10

Which part of Maalox absorbs the H+ ions?

Answer 10

The SILICA (magnesium trisilicate)

Question 11

Aluminum is astringent to stop bleeding

Answer 11

Aluminum

Question 12

Watch out! Aluminum Antacids interfere with absorption of which antibiotic???

Answer 12

tetracyclines

Question 13

BOARDS loves this antacid: Forms complexes with albumin, fibrinogen and globulin on ulcer surface, thus creating protective barrier to acid and pepsin…. Interferes with the absorption of many medications…Also binds pepsin directly….Not absorbed

Answer 13

SU-CRAL-FATE (Carafate)

Question 14

Which drug is preferred by Gastroenterologists? (brand name and class)

Answer 14

ZANTAC-a Histamine H2 Receptor Antagonist

Question 15

Which drug class binds to H+/K+-ATPase enzyme system in parietal cells?

Answer 15

Proton Pump Inhibitors

Question 16

Proton Pump Inhibitors are for ____ term acid suppression that has a _____ pace of onset.

Answer 16

long term…slow

Question 17

What are 3 really popular Proton Pump Inhibitors?

Answer 17

1.Nexium 2.Prevacid 3.Prilosec

Question 18

NEXIUM is Better at healing _________ than Prilosec

Answer 18

erosive lesions

Question 19

Think this might be important?? THIS drug is Indicated for use for prevention and treatment of NSAID-induced gastrointestinal lesions

Answer 19

Nexium (proton pump inhibitors)

Question 20

DENTAL considerations!!! Antacids neutralize pH = interferes with absorption of many drugs = wait ___ hours

Answer 20

2 hours

Question 21

WHICH DRUG does Histamine antagonists decrease?

Answer 21

antifungals

Question 22

WHICH DRUG does Histamine antagonists alter?

Answer 22

warfarin

Question 23

Proton pump inhibitors decrease absorption of systemic _______

Answer 23

antifungals

Question 24

Excessive salivation: mediated by ______ nerve in response to excessive gastric acid coming into oral cavity

Answer 24

vagus nerve

Question 25

Which disease are these people most susceptible to?Smokers, Heavy drinkers, Hyperparathyroidism, Renal dialysis patients, Use of NSAIDS (chronic use)

Answer 25

Peptic Ulcer Disease

Question 26

Etiology of Peptic Ulcer Disease--__________ infection is Present in 90% of cases

Answer 26

Helicobacter pylori

Question 27

DID YOU KNOW Helicobacter pylori resides in our ______?!

Answer 27

oral cavity!?!

Question 28

Use of NSAIDS for > 1 month can cause this stomach condition.

Answer 28

peptic ulcer disease

Question 29

H pylori associated with cancer of gastric mucosa = ________

Answer 29

lymphoma

Question 30

Peptic ulcers RARELY undergo transformation to carcinoma, BUT Ulcers in __________ of stomach more likely to become malignant

Answer 30

greater curvature

Question 31

Atrophic gastritis caused by chronic use of PROTON PUMP INHIBITORS increases risk for _______ cancer

Answer 31

stomach

Question 32

What are the 4 Antibiotics used in combination to treat peptic ulcers?

Answer 32

TCAM 1. Tetracycline 2.CLARithromycin 3.Amoxicillin 4.Metronidazole

Question 33

The standard first-line therapy is a one week TRIPLE therapy consisting of the antibiotics:

Answer 33

CA: CLARithromycin, amoxicillin...a proton pump inhibitor Nexium, Prevacid, Protonix, Aciphex..Prilosec

Question 34

What happens if I hit the peptic ulcer with the triple thereby and the H Pylori is resistant?

Answer 34

levofloxacin (Levaquin) added as part of the therapy

Question 35

AVOID ______ and _______ with Peptic Ulcer disease

Answer 35

Avoid aspirin, NSAIDS

Question 36

What are the 2 Oral manifestations of peptic ulcer disease??

Answer 36

1. Vascular malformations of lip 2.Enamel erosion

Question 37

________ antibiotics (erythromycin) cause GI distress and diarrhea = caution in patients with inflammatory bowel disease...IN FACT, they can cause THIS condition!

Answer 37

Macrolide antibiotics (erythromycin)...Pseudomembraneous colitis

Question 38

What are the 2 distinct conditions of Irratable Bowel syndrome?

Answer 38

Ulceratic Colitis and Cj Crohn's disease

Question 39

What 2 drugs are FIRST LINE against Tx of IBS?

Answer 39

Anti-inflammatories; corticosteroids

Question 40

What are the 3 drugs to stay away from when Rx'ing to a IBS dental Pt?

Answer 40

CorticoSteroids, Immunosup drugs, aspirin/NSAIDS

Question 41

cobblestone mucosal lesions

Answer 41

Crohn's Disease

Question 42

Anti-Diarrheal: Bismuth subsalicylate (Pepto-Bismol)..Caution with _____ allergy

Answer 42

salicylate

Question 43

codeine causes ________ as a side effect

Answer 43

constipation

Question 44

loperamide(________)=OTC...Muscle relaxant...Relieves spasm and decreases gut motility

Answer 44

imodium

Question 45

Laxatives: Bulk – carboxymethyl _______ with psyllium 􏰀 Absorb water to form softened stools by increasing bulk of intestinal contents

Answer 45

cellulose

Question 46

Laxatives: Osmotic – _________ salts (magnesium citrate = OTC)...Used as prep for _________

Answer 46

magnesium...colonoscopy

Question 47

Laxatives: Contact – bisacodyl (Dulcolax), _____ oil... bisacodyl also used in high doses as colonoscopy prep

Answer 47

castor

Question 48

Laxatives: Lubricants – ______ oil, glycerin...Act as emollients

Answer 48

mineral