GI

Question 1

What are the H2 blockers? What is their mechanism of action? What are they used for? What are their side effects?

What are the Proton Pump Inhibitors? What is their mechanism of action? What are they for?

What are the main ingredients in Pepto bismol?

What is Misoprostol? What does it cause?

Answer 1

If you are about ti dine** you should take Cime_tidine, ranitidine, famotidine, or nizatidine. **Reversible** H2 receptor blocker => reduced gastric acid produced by Parietal cells. Taken before expected heart burn. Cimetidine is potent P-450 inhibitor_**, antiandrogenic, crosses BBB and placenta. Both Cimetidine and ranitidine decreases renal GFR (creatinine excretion)

OMG this heartburn is so bad I prazole** much for Ome_prazole_ or Lanso_prazole_**. Irreversibly inhibits H/K ATPase in Parietal cells. More severe/Constant heart burn

Bismuth/Sucralfate

Prostaglandin E1 analog. More gastric mucosa, decrease acid, keep PDA open, diarrhea, and induces labor

Question 2

What is Octreotide?

What is it for?

What are the side effects?

Answer 2

Long-acting somatostatin analog.

Stop hormones; Acute variceal bleeds, acromegaly, VIPoma (Vasoactive Intestinal peptide), and carcinoid tumors.

Nausea, cramps, and steatorrhea.

Question 3

What can all antacids cause?

What can Aluminum hydroxide antacids cause?

What can Magnesium hydroxide antacids cause?

What can Calcium carbonate antacids cause

Answer 3

Hypokalemia.

Constipation (Aluminimum amount of feces), hypophosphatemia => proximal muscle weakness, osteodystrophy, and seizures.

Diarrhea (_M_ust _G_et to a bathroom), hyporeflexia, hypotension, and cardiac arrect.

Hypercalcemia, rebound acid, and can chelate drugs

Question 4

What is lactulose’s common for? What is its less common treatment? How?

Answer 4

Osmotic laxative. Hepatic encephalopathy (through bacteria => lactic/acetic acid => NH4)

Question 5

What is Infliximab? What is it used in? What are the side effects?

Answer 5

monoclonal antibody to TNF-α. Used for Crohn’s/Rheumatoid arthritis, may cause infection, fever, and hypotension

Question 6

What is Sulfasalazine?

What is it used in?

What are the possible side effects?

Answer 6

combo of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory) that are activated by colonic bacteria. Crohn’s/Ulcerative colitis.

malaise, nausea, sulfonamide toxicity, reversible oligo(sparce)spermia

Question 7

What is Metoclopramide?

What is it used for?

What are the side effects?

Answer 7

D2 receptor antagonist

gastroparesis (stomach semi-paralysis)

parkinsonian effects, fatigue, and depression