GIT Drugs

Question 1

Drugs whose mode of action is the reduction of intragastric acidity

Answer 1

Antacids

Question 2

New types of drugs that are now currently used as opposed to Antacids

Answer 2

H2 receptor antagonists and Proton pump inhibitors

Question 3

List of regularly Used Antacids

Answer 3

Sodium Bicarbonate
Calcium Bicarbonate
MgOH and AlOH3
Simethicone

Question 4

Can cause renal insuffciency, metabolic aklalosis and belching

Answer 4

Sodium Bicarbonate and Calcium Bicarbonate

Question 5

Can cause Hypercalcemia

Answer 5

Calcium Bicarbonate

Question 6

Does not cause belching and metabolic alkalosis when used together

Answer 6

MgOH2 and AlOH3

Question 7

MgOH2 and AlOH3 should not be taken within 2 hours of doses of these drugs

Answer 7

Tetracycline
Fluoroquinolones
Itraconazole
Iron

Question 8

Anti foaming agent that decreases the surface tension of gas bubbles causing them to combine into larger bubbles in the stomach that can be passed easily.

Does not reduce or prevent the formation of gas, it increases the rate at which it exits the body.

Answer 8

Simethicone

Question 9

“-tidines”-
H2 blockers
Work by competitive inihibition of histamine binding to H2 receptors.

Answer 9

H2 Receptor antagonists

Question 10

MOA of H2 receptor antagonists

Answer 10

Competitive inihibition of histamine binding to H2 receptors.

Question 11

Characteristics of H2 blockers

Answer 11

Effective in inhibiting nocturnal gastric acid secretion

Raises nocturnal and fasting intragastric pH to 4-5

Question 12

Examples of H2 blockers

Answer 12

Cimetidine (Prototype)
Ranitidine
Famotidine
Nizatidine

Question 13

H2 blocker that inhibits CYP450

Answer 13

Cimetidine

Question 14

H2 Blocker that does not inhibit CYP450 and has little first pass effect (almost 100% bioavailabaility)

Answer 14

Nizatidine

Question 15

Uses of H2 blockers

Answer 15

GERD
PUD
Intermittent Non Ulcer Dyspepsia
Rebleeding from stress related Gastritis

Question 16

ADE of H2 blockers

Answer 16

Increased risk of nosocomial pneumonia

Mental status changes due to Cimetidine

Question 17

ADE of H2 blockers

Answer 17

Gynecomastia and impotence in males
Galactorrhea in females (Cimetidine)
Due to inhibtiion of DHT binding to androgen receptor.

Question 18

Which drug interferes with CYP450

Answer 18

Cimetidine

Question 19

H2 Blockers that has no CYP450 interactions

Answer 19

Famotidine and Nizatidine

Question 20

H2 blockers that inhibit 1st pass metabolism of ethanol

Answer 20

Cimetidine
Ranitidine
Nizatidine

Question 21

Mode of action of proton pump inhibitors

Answer 21

Irreversibly inactivate parietal cell H/K Atpase

Question 22

Common suffix of PPIs

Answer 22

“azoles” from substituted benzimidazoles

Question 23

Prototype PPI

Answer 23

Omeprazole

Question 24

Other PPI examples

Answer 24

Esomeprazole
Lansoprazole
Dexlansoprazole
Rabeprazole
Pantoprazole

Question 25

Active form of PPIs

Answer 25

Thiophilic Sulfonamide

Question 26

Type of linkage PPIs form

Answer 26

covalent disulfide linkage

Question 27

True or False | It is best to give PPIs on a full stomach

Answer 27

False | Give PPIs on empty stomach

Question 28

How many hours before meal to give PPIs?

Answer 28

1 hour before meal

Question 29

Clinical Uses of PPis

Answer 29

``` GERD PUD NSAID Ulcers Non Ulcer Dyspepsia Stress Related Mucosal Bleeding Stress- Related Mucosal Blreeding Gastrinoma and Hypersecretion ```

Question 30

First line Treatment for GERD

Answer 30

PPIs

Question 31

Best approach for treating PUD

Answer 31

Triple Therapy 10-14 day regimen of Clarithromycin Amoxicillin PPI

Question 32

Adverse effects of PPIs

Answer 32

Minor decrease in B12 absorption Increase in risk of nosocomial infections Rebound hypegastrinemia

Question 33

Significant Drug interaction of PPIs

Answer 33

Decrease in activation of clopidogrel | Omperazole/ Esmeprazole