Gastrointestinal drugs

Question 1

defensive factors

Answer 1

mucus, bicarbonate, prostaglandin, blood flow, restitution and regeneration

Question 2

principal mechanism of action is reduction of intragastric acidity

Answer 2

antacids

Question 3

After a meal approximately ____ of hydrochloric acid is secreted

Answer 3

45 mEq/h

Question 4

Enumerate the variables that determine acid-neutralization capacity

Answer 4

rate of dissolution, rate of water solubility, rate of gastric emptying and rate of reaction with acid

Question 5

Reacts rapidly with HCL to produce carbon dioxide and sodium chloride

Answer 5

Sodium bicarbonate

Question 6

Formation of carbon dioxide results in what symptoms?

Answer 6

gastric distention and belching

Question 7

unreacted alkali is readily absorbed potentially causing _______

Answer 7

metabolic alkalosis

Question 8

Sodium chloride absorption may exacerbate fluid retention in what conditions?

Answer 8

hypertension, renal insufficiency and heart failure

Question 9

less soluble and reacts more slowly than sodium bicarbonate with HCL ?

Answer 9

calcium carbonate

Question 10

Excessive doses of either sodium bicarbonate or calcium carbonate witn calcium containing dairy products can lead to what syndrome?

Answer 10

Milk- alkali syndrome (hypercalcemia, metabolic alkalosis, renal insufficiency)

Question 11

unabsorbed magnesium salts may cause ______

Answer 11

osmotic diarrhea

Question 12

aluminum salts may cause ____

Answer 12

constipation

Question 13

It is not given within 2 hours of doses of tetracycline, itracinazole, fluconazole, iron

Answer 13

Antacids

Question 14

Give four example of H2 antagonists

Answer 14

Cimetidine, ranitidine, famotidine, nizatidine

Question 15

undergo first-pass hepatic metabolism resulting in bioavailability of approximately 50%

Answer 15

cimetidine, ranitidine, famotidine

Question 16

type of GI drug that are cleared by a combination of hepatic metabolism, glomerular filtration, and renal tubular secretion

Answer 16

H2 receptor antagonists

Question 17

Exhibit competitive inhibition at the parietal cell H2 receptor and suppress basal and meal -stimulated acid secretion

Answer 17

H2 antagonists

Question 18

inhibit nocturnal acid secretion

Answer 18

H2 antagonists

Question 19

H2 antagonist, inhibit ______% of total 24 hour acid secretion

Answer 19

60-70%

Question 20

Duration of H2 antagonists acid inhibition?

Answer 20

less than 6 hours

Question 21

What consist the acid peptic diseases?

Answer 21

GERD, peptic ulcer(gastric, duodenal), stress related mucosal injury

Question 22

causes of peptic ulcer

Answer 22

Helicobacter pylori and NSAIDs

Question 23

Other uses of calcium carbonate?

Answer 23

osteomalacia and osteoporosis

Question 24

Clinical uses of H2 antagonists

Answer 24

GERD, PUD, nonulcer dyspepsia, prevention of bleeding from stress related gastritis

Question 25

Example of stress related mucosal injuries?

Answer 25

burn, sepsis, massive injury such as head trauma

Question 26

Adverse effects of H2 antagonists?

Answer 26

diarrhea, constipation, headache, myalgia, fatigue

Question 27

adverse effects of use of IV H2 antagonists?

Answer 27

increased risk of nosocomial pneumonia in critically ill patients and mental status changes

Question 28

Advers effects of rapid IV H2 antagonists?

Answer 28

bradycardia and hypotension

Question 29

Inhibits binding of dihydrotestosterone to androgen receptors, inhibits metabolism of estradiol and increase prolactin levels?

Answer 29

Cimetidine

Question 30

Crosses the placenta and secreted into breast milk?

Answer 30

H2 antagonists

Question 31

Administered as inactive prodrugs

Answer 31

proton pump inhibitors

Question 32

Should be taken on empty stomach because it decreases the bioavailability

Answer 32

proton pump inhibitors

Question 33

How many days of medication are required before the full acid inhibiting potential of proton pump inhibitor is reached?

Answer 33

3 to 4 days

Question 34

when is the best time to take the proton pump inhibitor?

Answer 34

taken 1 hour before a meal usually breakfast

Question 35

Undergo rapid first pass and systemic hepatic metabolism?

Answer 35

proton pump inhibitors

Question 36

Proton pump inhibitors works by blocking the final common pathway of acid secretion inhibiting __________

Answer 36

inhibit both fasting and meal stimulated secretion

Question 37

drugs that causes subnormal B12 levels

Answer 37

proton pump inhibitors

Question 38

Reduced calcium absorption that occurs in proton pump inhibitor increases the risk for _______

Answer 38

hip fracture

Question 39

Risks factors for gastric adenocarcinoma related to use of proton pump inhibitors?

Answer 39

atrophic gastritis and intestinal metaplasia

Question 40

Decreased acidity caused by proton pump inhibitors causes decreased absorption of what drugs?

Answer 40

Digoxin, atazanavir, ketoconazole and itraconazole

Question 41

inhibit the metabolism of warfarin, diazepam and phenytoin?

Answer 41

omeprazole

Question 42

decreases the metabolism of diazepam

Answer 42

Esomeprazole

Question 43

Lansoprazole enhances the clearance of ______

Answer 43

theophylline

Question 44

GI drug that reduces clopidrogel activation and its antiplatelet action?

Answer 44

proton pump inhibitors

Question 45

Aggressive factors

Answer 45

acid, pepsin, bile

Question 46

Forms a viscious, tenacious paste that binds selectivly to ulcers or erosions for up to 6 hours

Answer 46

Sucralfate

Question 47

used in NSAID-induced ulcers

Answer 47

misoprostol

Question 48

Methyl analog of PGE 1

Answer 48

Misoprostol

Question 49

what are the 2 bismuth compounds?

Answer 49

bismuth subsalicylate and bismuth subcitrate

Question 50

Coats ulcers and erosions. stimulate the production of prostaglandin, mucus and bicarbonate secretion

Answer 50

bismuth compounds

Question 51

Signs and symptoms of bismuth toxicity?

Answer 51

Confusion, Ataxia, Seizures and Headaches

Question 52

adverse effects of bismuth compounds?

Answer 52

blackening of the stool and darkening of the tongue

Question 53

It is used for patients who have dyspepsia, traveler's diarrhea and in eradication of H. pylori?

Answer 53

Bismuth compounds