Gastro

Question 1

Name class members : Antagoniste des récepteurs H2

Answer 1

-TIDINE
* Famotidine (Pepcid)
* Ranitidine (Zantac)
* Nizatidine
* Cimetidine

Question 2

Name indications : Antagoniste des récepteurs H2

Answer 2

As **anti-secretory agent **:
* Peptic ulcer
* GERD
* Stress ulcer prophylaxis
* Aspiration prophylaxis during anesthesia

Question 3

Name adverse effect : Antagoniste des récepteurs H2 (5)

Answer 3

• Headache
• Vit B12 deficiency
• Thrombocytopenia
• CNS effects
• Gynecomastia and impotence (Cimetidine only)

Question 4

Name end result : Antagoniste des récepteurs H2 (1)

Answer 4

Block the gastric acid secretion by gastric parietal cells

Question 5

Name caution : Antagoniste des récepteurs H2 (1)

Answer 5

Elderly uses : Use with caution in patients with age voer 60 y.o. = Risk of confusion and delirium

Question 6

Name class members : IPP (3)

Answer 6

• PRAZOLE
• dexlansoprazole (Dexilant)
• oméprazole (Losec)
• pantoprazole (Pantoloc)

Question 7

Name indication : IPP (3)

Answer 7

As anti-secretory agent :
* Peptic ulcer
* GERD
* H.pylori eradicaiton (part of triple therapy)

Question 8

Name adverse effect : IPP (4)

Answer 8

• Headache
• Vit B12 deficiency
• RIsk of Clostrioides difficile infection
• Risk of IBD

Question 9

Name end result : IPP (1)

Answer 9

Supress gastric acid secretion in the stomach

Question 10

Describe triple therapy for H.Pylori (3)

Answer 10

14 days
* PPI standard dose
* Clarithromycin
* Amoxicillin or Metronidazole

Question 11

Describe interaciton of IPP

Answer 11

Do not use with Clopidogrel
Will lead to decrease in clopidogrel’s active metabolite

Question 12

Describe administration : IPP (1)

Answer 12

30-60 minutes before breakfast for max effect

Question 13

Name class members : Bulk-forming laxatives (3)

Answer 13

• Psyllium seed (Metamucil)
• Methylcelllulose
• Calcium polycarbophil

Question 14

Name mechanism : Bulk-forming laxatives (4)

Answer 14

1. Absorb water in the intestinal tract
2. Provide BULK and increase fecal mass
3. Promote peristalsis
4. End result : Reduce transit time

Question 15

Name indication : Bulk-forming laxatives (1)

Answer 15

Constipation

Question 16

Name adverse effects : Bulk-forming laxatives (4)

Answer 16

• Abdominal cramp
• Flatulence
• Intestinal obstruction
• Diarrhea

Question 17

Name caution : Bulk-forming laxatives (2)

Answer 17

In elderly
* Predispose fecal impaction
* Bowel obstruction

Question 18

Name counselling points : Bulk-forming laxatives (1)

Answer 18

• Adequate fluid intake is required to avoid intestinal obstruction

Question 19

Name class members : Osmotic laxatives (2)

Answer 19

• Lactulose
• Polyethylene glycol (Lax a day)

Question 20

Name indication : Osmotic laxatives (2)

Answer 20

• Constipation
• Hepatic encepalopathy (Lactulose)

Question 21

Name adverse effect : Osmotic laxatives (4)

Answer 21

• Abdominal distention
• Flatulence
• Diarrhea
• Dehydration

Question 22

Name mechanism : Osmotic laxatives (3)

Answer 22

1. Produce osmotic effect in the colon
2. Cause intestinal water secretion
3. End result : Promote peristalsis

Question 23

Name counselling points : Osmotic laxatives (1)

Answer 23

Electrolyte imbalances - may occur on chronic uses

Question 24

Name caution : Osmotic laxatives (1)

Answer 24

Patients with diabetes
Use alctulose with caution as it countains alactose and lactose

Question 25

Name class member : Stool softener (2)

Answer 25

* Docusate sodium (**Colace**) * Liquid paraffin

Question 26

Name indication : Stool softener (2)

Answer 26

* Constipation * Ceruminolytic (off-label uses)

Question 27

Name adverse effects : Stool softener (3)

Answer 27

* **Anal irritation** * **Abdominal cramp** * Diarrhea

Question 28

Describe end result : Stool softener (1)

Answer 28

Soften stool, and easier to defecate

Question 29

Describe administration : Stool softener (2)

Answer 29

* For rectal use, do not give to patients with haemorrhoids or anal fissures * Do not use docusate + liquide paraffin together

Question 30

Name class members : Antiacid (6)

Answer 30

* Aluminum hydroxide * Calcium carbonate * Magnesium trisilicate * Manesium hydroxide * Magnesium carbonate * Sodium bicarbonate

Question 31

Name indications : Antiacid (3)

Answer 31

* Limited role in peptic ulcer as H2RA and PPI is already very effective * Other uses : GERD, heartbur symptoms itself

Question 32

Name adverse effects : Antiacid (3)

Answer 32

* Aluminium : Constipation * Calcium : Hypophosphatemia, milk-alkali syndrome * Mg : Diarrhea

Question 33

Name end-result : Antiacid (1)

Answer 33

Facilitate peptic ulcer healing

Question 34

Describe aluminium toxicity (2)

Answer 34

* Neurotoxicity * Anemia

Question 35

Describe calcium toxicity (2)

Answer 35

* Vascular calficiation * Exacerbate nephrolithiasis

Question 36

Describe Mg toxicity (2)

Answer 36

* Nausea * Stomach cramps

Question 37

Describe caution : Antiacid (1)

Answer 37

* Patients with renal failure : Can lead to retention of Aluminum, calcium or Mg

Question 38

Name class members : Stimulant laxatives (3)

Answer 38

* **Bisacodyl** * Senna * **Sodium picosulfate (Picolax)**

Question 39

Name indication : Stimulant laxatives (1)

Answer 39

Constipation

Question 40

Name adverse effect : Stimulant laxatives (3)

Answer 40

* Abdominal cramp * Flatulence * No-vo

Question 41

Describe end-result : Stimulant laxatives (1)

Answer 41

Stimulate peristalsis