GI Drugs

Question 1

What are the 3 drugs used for Gastric acidity?

Answer 1

1. Antacids
2. H2 receptor blockers
3. Proton pump inhibitors

Question 2

What are the most commonly used drugs?

Answer 2

Proton pump inhibitors

Question 3

Which drug blocks the stimulation to secrete acid?

Answer 3

H2 receptor blockers

Question 4

Which drug blocks the direct secretion of acid into the stomach?

Answer 4

Proton pump inhibitors

Question 5

What are the types of antacids used?

Answer 5

1. Al, Mg, Ca

2. Hydroxide or carbonate

Question 6

What drugs would you use to treat episodic minor gastric discomfort from overeating or from certain incompatible foods?

Answer 6

Antacid

Question 7

What are some ADRs of Antacids?

Answer 7

1. Al=constipation
2. Mg = diarrhea
3. Acid rebound due to negative feedback loop
4. May alter metabolism of drugs that rely on acidic stomach

Question 8

Which drug may have antibacterial actions against H. Pylori?

Answer 8

Proton pump inhibitor

Question 9

What are some adverse effects of PPI?

Answer 9

1. Acid rebound

2. osteoporosis

Question 10

Bacteria thought to cause or potentate gastroduodenal ulcers?

Answer 10

H. pylori (treat with antibiotics and/or PPI)

Question 11

What are some other, not often used, drugs for gastric ulcers

Answer 11

Anticholinergics and metoclopramide

Question 12

Stimulates mucus secretions; helps with GI damage caused by NSAIDs

Answer 12

Prostaglandins

Question 13

Disaccharide; protective effect on mucosa, may cause constipation

Answer 13

Sucralfate

Question 14

How would you want to treat someone with diarrhea?

Answer 14

1. Replace electrolytes

2. Replace fluids

Question 15

Drugs used for diarrhea that decrease GI motility; may reduce fluid loss; low risk of tolerance and addiction

Answer 15

Opioid derivatives (lomitil, imodium)

Question 16

Drugs used that absorbs irritants from GI tract to reduce diarrhea

Answer 16

Absorbents (Kaolin [clay], pectin [fruit], attapulgite)

Question 17

Drug that stimulates water reabsorption; antibacterial; inhibits prostaglandin synthesis that irritates intestinal lining; used for mild-to-moderate diarrhea

Answer 17

Bismuth salicylate (pepto-bisomol); you can overdose if combined with aspirin

Question 18

Drugs used to treat constipation

Answer 18

Laxatives (gentle)

cathartics (rapid)

Question 19

What patients often used laxatives and cathartics

Answer 19

1. Prolonged bed rest
2. SCI
3. Infrequent or painful bowel movements
4. Pts who should avoid straining

Question 20

Absorb water and stimulate intestinal motility

Answer 20

Bulk-forming laxatives (citrucel, fiber all, metamucil)

Question 21

Draw water to GI tract, increase peristalsis

Answer 21

Hyperosmotic (milk of magnesia, epsom salt, miralax)

Question 22

Facilitate entry of water into fecal mass; permit easier defication

Answer 22

lubricants and stool softeners (colace

Question 23

Irritant or stimulate GI nerves (cathartic)

Answer 23

Stimulant laxatives (castor oil, exlax, purge, Percolace)

Question 24

Induce vomiting

Answer 24

Emetics (apomorphine, ipecac)

Question 25

Aid in digestion; main ones contain pancreatic enzymes or bile salts; used for CF and pancreatitis

Answer 25

Digestants

Question 26

Decrease nausea and vomiting

Answer 26

Antimentics (antihistamines, anticholinergics, D2 blockers, 5-HT3 receptor blockers, cannabinoids)

Question 27

Older drugs for Hep C

Answer 27

1. Riravirn 2. Interferon ADR = flu like symptoms and emotional problems

Question 28

Drug for Hep C; generic antiviral drug; treatment length depends on hep c genotype (1 ,4, 5, 6), prior tx, and cirrhosis; 93-99% success for 24 weeks but costs $94.5k or $189k

Answer 28

Harvoni (ledipasvir, sorosbuvir, with or without ribavarin)

Question 29

What are some ADRs for Harvoni?

Answer 29

Most common: fatigue, headache, weakness | - Heart problems

Question 30

What drugs should you take with food?

Answer 30

1. Antibiotics [cefuroxime and erythromycin] 2. High cholesterol medication [lovastatin] 3. Mania medication [lithium]

Question 31

What drugs should you take without food?

Answer 31

1. Antibiotics [Ampicillin, ciprofloxaxin, azitrhomycin, doxycycline or tetracycline] 2. HTN and heart failure [Captopril] 3. HIV protease inhibitor [Indinavir]

Question 32

What can happen if you have grapefruit juice with some drugs?

Answer 32

1. it can increase effective drugs 5x | 2. can block the enzyme involved with the metabolism of many drugs (doesn't allow drug to have proper effect)

Question 33

What can happen if you are taking Warfin and have a high protein diet?

Answer 33

Causes elevated serum albumin may decrease INR; increased risk of clot

Question 34

What are two dietary things that will effect anti-coagulant drugs)?

Answer 34

1. Dark-green leafy vegetables (antagonize effect of command by competitive inhibition, advisory is to keep intake level) 2. Cranberry juice (increases half life)

Question 35

What are some cardiac drugs that can be effected by diet?

Answer 35

1. Anti-HT (sodium restricted diet) 2. Propranolol ( serum level increase with high protein foods) 3. Paleolitich diets

Question 36

What drug can cause hypertensive crisis if you eat tyramine-containing foods (Matured cheese, red wine, ripe bananas, yogurt, salami)?

Answer 36

MAO - I | can get transdermal patch to eliminate food-drug interactions

Question 37

What drug type is associated with glucose intolerance

Answer 37

atypical antipsychotic drugs (non-dopamine)

Question 38

When should tetracyclines be taken?

Answer 38

1 hour before meal or 2 hours after meal (binds iron and calcium, reducing bioavailability)

Question 39

Should tylenol be taken with food? NSAIDs?

Answer 39

No; yes

Question 40

What drugs can be affected by black licorice?

Answer 40

anti-HT and anti-arrhythmic medications; may increase BP