GI II

Question 1

What are the adverse effects seen with sucralfate?

Answer 1

Constipation, impaired drug absorption

Question 2

What pts should you be careful about administering sucralfate to? Why?

Answer 2

Renal insufficient pts

Al toxicity

Question 3

What are the common adverse effects of misoprostol?

Answer 3

Cramping, diarrhea

Question 4

What is the drug name of peptobismol?

Answer 4

Bismuth subsalicylate

Question 5

What are the severe adverse effects with bismuth subsalicylate?

Answer 5

Salicylate toxicty

Question 6

What population of pts should not be administered misoprostol? Why?

Answer 6

Pregnant patients

May stimulate uterine contractions

Question 7

What is the advantage of mucosal protective agents over PPIs?

Answer 7

Do not stop acid secretion, thus will not cause B12 deficiency

Question 8

What is misoprostol primarily used for?

Answer 8

NSAID induced ulcers

Question 9

What is the drug of choice for treating H.pylori, travelers diarrhea, and dyspepsia?

Answer 9

Bismuth subsalicylate

Question 10

What are the two cancers that H.pylori causes?

Answer 10

Gastric lymphoma

Adenocarcinoma

Question 11

What is the enzyme that allows H/pylori to thrive in the acidic environment?

Answer 11

Urease

Question 12

Is H.pylori gram negative or positive?

Answer 12

Negative

Question 13

True or false: most patients with gastric or duodenal ulcers are h.pylori positive

Answer 13

true

Question 14

How is h.pylori transmitted?

Answer 14

Fecal-oral route

Question 15

What is the first line defense (triple therapy) against H.pylori?

Answer 15

PPI
Clarithromycin
Amox/metronidazole

Question 16

True or false: it is okay to combine the triple therapy that treats h.pylori infection, with bismuth subsalocylate

Answer 16

True

Question 17

What role does serotonin play in the enteric nervous system?

Answer 17

Induces the release of ACh in gastric smooth muscle

senation from the GI system

Question 18

What role does dopamine play in the GI tract?

Answer 18

decreases the firing of ENS neurons, decreasing gastric motility

Question 19

What is the receptor that induces gastric motility?

Answer 19

M3

Question 20

What is motilin, and what is its effect on the GI tract?

Answer 20

Hormone that promotes gastric motility through ativation of GI smooth muscle

Question 21

What is the MOA of metoclopramide? What is it used for?

Answer 21

D2 antagonist

dyspepsia/GERD
Antiemetic

Question 22

What are the adverse effects of metoclopramide?

Answer 22

Parkinson like symptoms

Question 23

What is the MOA of bethanochol? Use?

Answer 23

M3 agonist

GERD/gastroparesis

Question 24

What is the MOA of neostigamine? Use?

Answer 24

AchE inhibitor

urinary retention

Question 25

What is the MOA of erythromycin? Use?

Answer 25

Motilin receptor agonist | Gastroparesis

Question 26

What is the trade name of metoclopramide?

Answer 26

Reglan

Question 27

What is the MOA of bulk forming laxatives?

Answer 27

Plants cell wall resistant to degradation (fiber) helps retain water in the GI lumen

Question 28

What do you need to ingest with bulk-forming laxatievs?

Answer 28

Water

Question 29

What is the MOA of stool softeners?

Answer 29

Coats/penetrates stool with oil

Question 30

What type of laxative is glycerin?

Answer 30

Stool softener

Question 31

What type of laxative is mineral oil?

Answer 31

Stool softener

Question 32

What is the MOA of osmotic laxatives?

Answer 32

Pull water into the GI tract using salts

Question 33

What type of laxative is MgOH (milk of magnesia)?

Answer 33

Osmotic agent

Question 34

What type of laxative is lactulose?

Answer 34

Osmotic agent

Question 35

What type of laxative is polyethylene glycol?

Answer 35

Osmotic agent

Question 36

What is the MOA of stimulant laxatives? (3)

Answer 36

Stimulation of the ENS induces gastric motility Induce leaky mucosa Inhibit Na uptake

Question 37

What type of laxative is senna?

Answer 37

Stimulant

Question 38

What type of laxative is methylcellulose?

Answer 38

Fiber (bulk forming)

Question 39

What are the adverse effects of methylcellulose?

Answer 39

gas/bloating

Question 40

What are the adverse effects of glycerin?

Answer 40

Nutrient malabsorption

Question 41

What are the adverse effects of laculose?

Answer 41

Electrolye imbalance

Question 42

What is the adverse effect of senna?

Answer 42

GI irritation

Question 43

Activation of what neurotransmitter receptors will result in increase ENS motility?

Answer 43

5HT-4

Question 44

What are the two MOA of serotonin receptors in the GI tract?

Answer 44

Stimulate Ach release Block pain signals

Question 45

What is the drug that stimulate 5HT-4 receptors?

Answer 45

Tegaserod

Question 46

What is the MOA of cloride channel activation laxatives?

Answer 46

Increase Cl in the gut lumen, water follows

Question 47

What is the Cl ion channel that can be targeted to promote gastric motility?

Answer 47

CIC-2

Question 48

Activation of mu-opioid receptors causes what?

Answer 48

Constipation

Question 49

What is the MOA of mu-opioid receptor antagonists?

Answer 49

Block the mu-opioid receptors, to prevent constipation

Question 50

Why is it important that mu-opioid receptor antagonists cannot cross into the CNS?

Answer 50

Allows for opioid action in the CNS