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PHRM 825 Therapeutics > Final Exam - GERD + PUD > Flashcards

Final Exam - GERD + PUD Flashcards

1
Q

Barrett’s esophagus and esophageal adenocarcinoma are more common in ____

a. men
b. women

A

a. men

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2
Q

which of the following is known to cause or increase the risk of developing GERD?

a. faster gastric emptying
b. higher LES Pressure
c. increase in esophageal mucosal resistance
d. acid pocket formation

A

d. acid pocket formation

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3
Q

what is the preferred diagnostic test to assess mucosal injury and complications?

A

upper endoscopy

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4
Q

which diagnostic test for GERD is useful for patients who failed 2 trials of PPI with normal endoscopy findings?

a. barium radiography
b. manometry
c. reflux (pH) test

A

b. manometry

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5
Q

antacids decrease activation of ___ to ____

A

pepsinogen; pepsin

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6
Q

true or false: antacids decrease LES pressure

A

false

(increase)

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7
Q

too much calcium can cause ____

a. constipation
b. diarrhea

A

a. constipation

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8
Q

too much magnesium can cause ____

a. constipation
b. diarrhea

A

b. diarrhea

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9
Q

too much aluminum can cause ____

a. constipation
b. diarrhea

A

a. constipation

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10
Q

pepto-bismol and alka-seltzer are not recommended for children under 12 because of risk for _____ syndrome

A

Reye’s

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11
Q

which of these medications contains simethicone?

a. alka-seltzer
b. pepto-bismol
c. gas-X
d. tums

A

c. gas-X

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12
Q

H2RA’s mechanism of action: _____ inhibition of histamine receptors in the parietal cells

a. irreversible
b. reversible

A

b. reversible

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13
Q

max/day for pepcid

A

40 mg/day

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14
Q

which is not an H2RA?

a. cimetidine
b. omeprazole
c. nizatidine
d. famotidine

A

b. omeprazole

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15
Q

_____ occurs with long term use of H2RAs

A

tachyphylaxis

(the more you use it, the less it tends to work)

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16
Q

which H2RA has the most concern for lots of drug-drug interactions?

a. ranitidine
b. famotidine
c. cimetidine
d. nizatidine

A

c. cimetidine

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17
Q

PPIs mechanism of action: _____ inhibition of proton/potassium ATPase

a. reversible
b. irreversible

A

b. irreversible

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18
Q

true or false: dexlansoprazole can be taken without regard to meals

A

true

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19
Q

lansoprazole brand name

A

prevacid

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20
Q

omeprazole is metabolized by which CYP?

A

CYP2C19

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21
Q

what is the most common PPI found on hospital formularies?

a. omeprazole
b. lansoprazole
c. dexlansoprazole
d. esomeprazole
e. pantoprazole

A

e. pantoprazole

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22
Q

rabeprazole (AcipHex) should be administered ____ minutes before a meal

a. 15
b. 30
c. 60
d. 90

A

b. 30

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23
Q

which PPI interacts with clopidogrel and bisphosphonates and may decrease its effectiveness?

a. omeprazole
b. lansoprazole
c. pantoprazole
d. dexlansoprazole

A

a. omeprazole

24
Q

what is the problem with prokinetics such as metoclopramide and bethanechol as non-acid suppressing therapy?

A

they have undesired side effects and are not as effective as acid suppression therapy

25
Q

why do we taper PPI’s?

A

risk of rebound hyperacidity

26
Q

1st line therapy for pregnant patients with GERD: antacids or ______

A

sucralfate

27
Q

in children under 12 with GERD, we should not what two ingredients in antacids?

A

aluminum or bismuth subsalicylate

28
Q

true or false: Children’s Pepto is safe to use in kids under 12 years old

A

true

(contains calcium carbonate and not bismuth subsalicylate)

29
Q

3 most common etiologies for peptic ulcer disease

A

bugs, drugs, stress

30
Q

true or false: a duodenal ulcer would be relieved by eating food

A

true

31
Q

true or false: a stomach ulcer would be relieved by eating food

A

false

32
Q

H. pylori induced peptic ulcer disease is confirmed via ______

A

endoscopy

33
Q

the _____ breath test can be done to confirm H. pylori induced PUD

A

urea

34
Q

quadruple therapy for H. pylori induced PUD includes what 4 things?

A
  1. PPI BID
  2. bismuth subsalicylate
  3. metronidazole
  4. tetracycline

(x 10-14 days)

35
Q

clarithromycin-based therapies are no longer recommended in the US due to _____

A

resistance

36
Q

levofloxacin triple therapy includes what 3 things?

A
  1. PPI BID
  2. levofloxacin 500 mg daily
  3. amoxicillin 1 g BID
37
Q

what is levofloxacin LOAD therapy?

A

quadruple therapy (spells out LOAD)

  1. levofloxacin 250 mg daily
  2. omeprazole (or other high dose PPI) daily
  3. nitazoxanide (alinia) 500 mg BID
  4. doxycycline 100 mg daily
38
Q

helidac is _____ therapy for H. pylori induced PUD

a. triple
b. quadruple

A

quadruple

39
Q

true or false: Pylera is a 3-in-1 capsule containing bismuth subcitrate potassium, metronidazole, and amoxicillin

A

false

(contains tetracycline, not amoxicillin)

40
Q

rifabutin is salvage therapy for H. pylori induced PUD containing what 3 things?

A
  1. omeprazole 40 mg q8h
  2. amoxicillin 1 gm q8h
  3. rifabutin 50 mg q8h

(x 14 days)

41
Q

______ are the backbone of H. pylori induced PUD therapy

A

BID PPIs

42
Q

which PPI is not FDA-approved for treating PUD?

a. omeprazole
b. esomeprazole
c. dexlansoprazole
d. lansoprazole
e. pantoprazole

A

c. dexlansoprazole (dexilant)

43
Q

bismuth salts mechanism of action for H. pylori PUD

A

topical bactericidal effect

44
Q

adverse effect of tetracyclines for PUD

a. tendon rupture
b. GI upset
c. photosensitivity
d. QTC prolongations

A

c. photosensitivity

45
Q

which antibiotic can cause tendon rupture?

a. metronidazole
b. amoxicillin
c. clarithromycin
d. levofloxacin

A

d. levofloxacin

46
Q

probiotics could potentially be used as ______ for H. pylori colonization

A

prophylaxis

47
Q

NSAID-induced PUD is due to the fact that NSAIDs inhibit ____

A

prostaglandins

48
Q

PPIs, H2RAs (for duodenal ulcer only), or ______ can be used for prophylaxis of NSAID induced PUD

A

misoprostol

49
Q

which is not used for treatment of NSAID induced PUD?

a. PPIs
b. H2RAs
c. misoprostol
d. sucralfate

A

c. misoprostol

50
Q

all of these are dosed at 40 mg daily for NSAID-induced ulcers except for which one?

a. lansoprazole
b. omeprazole
c. esomeprazole
d. pantoprazole

A

a. lansoprazole

51
Q

misoprostol mech of action of NSAID-induced PUD

A

prostaglandin E1 analog

52
Q

sucralfate mech of action

A

sucrose-sulfate-aluminum complex that interacts with albumin and fibrinogen to form a physical barrier over an open ulcer

53
Q

if a patient has CV problems, what is the preferred non-selective NSAID to use?

A

naproxen

54
Q

H2RAs are only used for _____ ulcer prevention

a. duodenal
b. gastric

A

a. duodenal

55
Q

the boxed warning for misoprostol makes it contraindicated in what patient population?

a. women
b. males
c. pregnancy
d. pediatrics

A

c. pregnancy

PHRM 825 Therapeutics (25 decks)

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