Jen's GI pharm

Question 1

Bind bile acids and inhibit peptic activity. Promote angiogenesis in injured mucosa. Heavy metals suppress H. pylori

Answer 1

antacids

Question 2

General class of pharm treatment that antacids interfere with

Answer 2

antibiotics

Question 3

Inhibit acid secretion by blocking histamine H2 receptors on the parietal cell

Answer 3

MOA of H2 blockers

Question 4

Can rarely cause gynecomastia and impotence, oolymyositis, Interstitial nephritis. Cleared through the P450 system so has multiple drug interactions

Answer 4

Cimetidine

Question 5

Prevents chemical induced mucosal damage. Heals chronic ulcers

Answer 5

Sulcralfate (Carafate)

Question 6

Binds to the ulcer base best at a pH below 3.5 so should be administered 30-60 min prior to meals

Answer 6

Sulcralfate (Carafate)

Question 7

Should not be administered in combination with aluminum antacids in patients with renal failure. No administration w/citrate containing compounds

Answer 7

Sulcralfate (Carafate)

Question 8

What is the suffix for all proton pump inhibitors?

Answer 8

-azole

Question 9

What are the generic names for the proton pump inhibitors?

Answer 9

Prilosec, prevacid, protonix, nexium, kapidex, aciphex

Question 10

MOA of proton pump inhibitors

Answer 10

blocks acid secretion of parietal cells

Question 11

At what time of day should PPIs be admininstered?

Answer 11

before the first meal of the day

Question 12

PPI with the lowest potential for P450 drug interactions

Answer 12

Pantoprazole (Protonix)

Question 13

PPIs metabolized via CYP2C19 and have the greatest potential for drug interactions

Answer 13

Omeprazole (Prilosec, Zegrid) and esomeprazole (Nexium)

Question 14

Common blood thinner that has a significant interaction with omeprazole

Answer 14

clopidogrel (Plavix)

Question 15

Long term administration of PPIs may increase the incidence of what two infections

Answer 15

c. difficile and pneumonia

Question 16

Long term administration of PPIs may lead to the malabsorption of what dietary elements?

Answer 16

B12, Mg+ (magnesium), and Fe (iron)

Question 17

Suppresses H. pylori infection. Not helpful in treatment of non H pylori induced ulcers

Answer 17

Bismuth

Question 18

Inhibition of peptic activity but not pepsin secretion. Recruits macrophages to the edge of the ulcer crater to promote healing

Answer 18

Bismuth

Question 19

First line therapy for gastroparesis for no longer than 12 weeks unless benefits outweigh risks

Answer 19

Metaclopramide (Reglan)

Question 20

Improves gastric emptying by increasing gastric antral contractions and decreasing postprandial fundus relaxation

Answer 20

Metaclopramide (Reglan)

Question 21

Dopamine receptor antagonist. 5-HT4 agonist. Weak 5-HT3 receptor antagonist

Answer 21

Metaclopramide (Reglan)

Question 22

Extrapyradimal side effects associated with metaclopramide (Reglan)

Answer 22

dystonia and tardive dyskinesia

Question 23

Name the phenothiazines that can be used as antiemetics because of their effects as dopamine receptor antagonists

Answer 23

Prochlorperazine (Compazine) and Promethazine (Phenergan)

Question 24

What is the treatment for EPS side effects that can be caused by phenothiazines?

Answer 24

Benadryl or Cogentin

Question 25

Which phenothiazein has a higher incidence of EPS side effects?

Answer 25

Prochlorperazine (Compazine)

Question 26

Great for postoperative and chemotherapy induced emesis. Does poor job with vestibular system etiology. Commonly given 30" prior to chemo tx.

Answer 26

Serotonin 5-HT3 Antagonists

Question 27

What is the suffix for Serotonin 5-HT3 Antagonists?

Answer 27

-setron

Question 28

What are the generic names for Serotonin 5-HT3 Antagonists?

Answer 28

Zofran, Kytril, Anzemet, Aloxi

Question 29

caution for serotonin syndrome, QT prolongation, monitor liver function tests if prolonged use

Answer 29

Odansetron (Zofran)

Question 30

What is the antiemetic that is also good for treating pruritis?

Answer 30

Hydroxyzine (Atarax, Vistaril)

Question 31

Contraindications for the use of Antihistamines/Anticholinergcs as antiemetics

Answer 31

narrow angle glaucoma, asthma, prostatic hypertrophy

Question 32

Only for symptomatic treatment of patients with acute diarrhea in whom fever is absent or low grade and the stools are not bloody

Answer 32

Loperamide (Imodium)

Question 33

Bile acid-binding agent used for hyperlipidemia. Good for diarrhea post-cholecystectomy

Answer 33

Cholestyramine (Questran)

Question 34

First line pharmacotherapy for the treatment of constipation

Answer 34

``` Psyllium (Metamucil) and Ducosate sodium (Colace) ```

Question 35

First line pharmacotherapy for the treatment of constipation used for infants

Answer 35

Glycerin

Question 36

Not systemically absorbed. Bind to the fecal contents and pull water into the stool. Softens and lubricates the stool. NEEDS TO BE TAKEN WITH WATER

Answer 36

Bulk forming agents (ie Metamucil)

Question 37

What bulk forming agent can decrease absorption of tetracycline and quinolones?

Answer 37

Fibercon

Question 38

Surfactant laxatives. Reduces the surface tension of the liquid contents of the bowel. Commonly referred to as “stool softeners”

Answer 38

Ducusate derivatives

Question 39

Use for patients who should not strain with bowel movements and for those on narcotics. Only prevent constipation – don’t treat

Answer 39

Ducusate derivatives

Question 40

Is a saline laxative. Draws water into the bowel through osmosis. Increases intraluminal pressure & motility.

Answer 40

milk of mangesia

Question 41

Use if failed bulk forming agents, mangnesium hydroxide (MOM). Hyperosmotic laxatives. Use with caution in diabetics

Answer 41

Lactulose or sorbitol

Question 42

Not for long term use. Increase peristalsis through direct effects on the smooth muscle of the intestines. Promote fluid accumulation in the colon and small intestine

Answer 42

Senna (Senokot) and Bisacodyl (Dulcolax)

Question 43

Contraindications to Senna (Senokot) and Bisacodyl (Dulcolax)

Answer 43

surgical abdomen, fecal impaction

Question 44

Used for bowel prep for endoscopy procedures

Answer 44

Magnesium citrate

Question 45

Considered best for colonic disease, although also considered 1st line therapy for Crohn’s

Answer 45

Sulfasalazine (Asulfidine)

Question 46

Often used with proximal intestinal Crohn’s

Answer 46

Mesalamine (Asacol, Pentasa)

Question 47

Blocks prostaglandin production. Perhaps interferes with production of inflammatory cytokines. May inhibit natural killer cells, lymphocytes and macrophages

Answer 47

aminosalicylates

Question 48

Immune modulator with short half life that is pregnancy category D

Answer 48

6-mercaptopurine

Question 49

Has drug toxicity with concurrent use of Allopurinol

Answer 49

immune modifiers

Question 50

Immune modifier that is pregnancy category X and Inhibits the metabolism of folic acid

Answer 50

methotrexate

Question 51

Name the TNF inhibitor that neutralizes TNF that is a last ditch effort in severe Crohn's

Answer 51

Infliximab (Remicade)

Question 52

Black box warning of Infliximab (Remicade)

Answer 52

Reactivation of latent TB