GERD pharmacology + Probiotics

Question 1

Proton Pump inhibitors MOA

Answer 1

Specific and selective effects on the gastric proton pump
- forms covalent irreversible bond with proton pumps which causes to increase half life even with a short plasma half-life

Question 2

H2RA MOA

Answer 2

• competitive binding to H2 receptor on parietal cells of stomach
• highest efficacy against nocturnal secretion (but can also work during the day)

Question 3

Antacids MOA

Answer 3

Antacid (base) interacts with H+ to form salt and water (w or w/o CO2 production)
- can also prostaglandin production

Question 4

Which antacid does not form CO2

Answer 4

Mg/aluminum hydroxide

Question 5

Why are magnesium and aluminum hydroxide administered together?

Answer 5

Magnesium causes diarrhea, aluminium salt cause constipation

Question 6

Misoprostol MOA

Answer 6

Prostaglandin receptor agonist (activates PGE2)
- decreases acid secretion
- promotes bicarb and mucous secretion

Question 7

Bismuth compounds MOA

Answer 7

• Coats erosions and ulcers
• stimulates prostaglandin production
• Stimulates mucous and bicarb secretion
• Decreases GI secretion to treat diarrhea
• Direct ABX effects, including against H. pylori

Question 8

Sucralfate MOA

Answer 8

Sucrose + aluminum hydroxide = viscous solution in water
- binds/coats area of GI tract with negative charge (areas around ulcers)

Question 9

Promotility agents MOA
- what does it result in?

Answer 9

Block D2 receptors –> block dopamine release –> dis-inhibit Ach release (stimulation cholinergic smooth muscle)

what does it result in?
- increased peristalsis, increased esophageal tone
- promotes gastric emptying

Question 10

Domperidone drug class
Metoclopramide

Answer 10

D1 D2

Meto: 5-HT4 D2

Question 11

Differentiate between probiotics, prebiotics, synbiotics

Answer 11

Probiotics
- Live microorganisms which when administered have a health benefit

Prebiotics
- non-digestible substances that stimulate growth of potentially beneficial microorganisms

Synbiotic
- products that combine probiotics and prebiotics

Question 12

Which bacteria can be probiotics

Answer 12

Lactobacillus or bifidobacterium
can also be yeast ( saccharomyces)

Question 13

What is the indication of Culturelle? (2)

Answer 13

• Antibiotic associated diarrhea
• infectious diarrhea in children

Question 14

What is the indication of Florastor? (5)

Answer 14

• infectious diarrhea
• traveler’s diarrhea
• antibiotic diarrhea
• C. diff
• H. pylori

Question 15

What is the indication of Biogai? (3)

Answer 15

• colic
• antibiotic diarrhea
• acute diarrhea in children

Question 16

What is the indication of BioK? (2)

Answer 16

• Antibiotic diarrhea
• C. diff

Question 17

What is the indication of align? (1)

Answer 17

IBS

Question 18

What is the indication of activia? (2)

Answer 18

• IBS
• Constipation

Question 19

Most common ADR is GI issues due to probiotics T/F

Answer 19

F
- due to condition being treated

Question 20

What did the cochrane review for probiotics with antibiotic diarrhea state in children?

Answer 20

Reduced duration of diarrhea by 1 day

Question 21

Probiotics reduced incidence of C. diff T/F

Answer 21

False

Question 22

Probiotics have fewer adverse events during CDI T/F

Answer 22

T

Question 23

Probiotics for INFECTIOUS diarrhea have no reduction of risk of diarrhea lasting 48+ hr and no reduced duration T/F

Answer 23

True

Question 24

Probiotics are not efficacious in IBS T/F

Answer 24

False

Question 25

Probiotics for Atopic Dermatitis helps prevent AD not treat T/F

Answer 25

True

Question 26

What are additional indications of probiotics (6)

Answer 26

- Colic - inflammatory bowel - Treatment of bacterial vaginosis - Prevention of URTI - H. pylori infection (inc killing of it) - Lowering cholesterol and LDL