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GI - Week 1 > Peptic ulcers & H. pylori > Flashcards

Peptic ulcers & H. pylori Flashcards

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1
Q

a disruption of the mucosal integrity of the stomach and/or duodenum leading to a local defect or excavation due to active inflammation

A

Peptic ulcer

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2
Q

These three compounds are GPCRs associated with stimulation of gastric acid production

A

Histamine
Acetylcholine
Gastrin

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3
Q

These 2 compounds are GPCRs that inhibit gastric acid production

A

Somatostatin
Prostaglandins

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4
Q

Prostaglandins and somatostatin inhibit this pathway, which is usually activated by the stimulation of the histamine H2 receptors

A

Adenylate cyclase

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5
Q

Prostaglandins and somatostatin inhibit the adenylate cyclase pathway, which is usually activated by the stimulation of these receptors

A

Histamine H2

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6
Q

The primary mechanism by which the gastric mucosa is protected from the acidic luminal environment is the production of this by the surface mucous cells

A

Mucus-bicarbonate gel layer

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7
Q

During the formation of ulcers, the gastric mucosal barrier is broken, and these two compounds begin to erode the mucosa

A

HCl and Pepsin

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8
Q

This stimulates the release of histamine from cells in the submucosa

A

Acid

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9
Q

What forms a bleeding ulcer?

A

Acid and pepsin gain access to vasculature at the basolateral side of the damaged region

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10
Q

The MOA of these drugs are simple neutralization of gastric acid
Cytoprotective action on gastric mucosa mediated by endogenous prostaglandin release

A

Antacids

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11
Q

Antacids have cytoprotective action on gastric mucosa mediated by endogenous release of this

A

Prostaglandin

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12
Q

Formulations of these drugs for peptic ulcer disease are metal-based salts, such as aluminum, calcium, magnesium, sodium

A

Antacids

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13
Q

This type of drug for peptic ulcer disease interacts with drugs that chelate metals, and drugs dependent on acid for dissolution, absorption, and excretion

A

Antacids

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14
Q

Combination of these drugs with calcium antacids can lead to hypercalcemia

A

Thiazide diuretics

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15
Q

Thiazide diuretics combined with this type of drug for peptic ulcer disease, can lead to hypercalcemia

A

Calcium antacids

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16
Q

Thiazide Diuretics combined with calcium antacids can lead to this

A

Hypercalcemia

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17
Q

Antacid formulations with magnesium salts particularly have this adverse reaction

A

Diarrhea

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18
Q

Antacid formulations with calcium and aluminum particularly have this adverse reaction

A

Constipation

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19
Q

Patients with renal insufficiency may experience a prolonged hypercalcemia from continuous use of this type of drug for peptic ulcers

A

Calcium-based antacids

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20
Q

Patients with renal insufficiency may experience prolongation of this adverse reaction from continuous use of calcium-based antacids

A

Hypercalcemia

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21
Q

Patients with this condition may experience a prolonged hypercalcemia from continuous use of calcium-based antacids

A

Renal insufficiency

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22
Q

This type of drug for peptic ulcers remove potentiation, resulting in attenuation of acetylcholine and gastrin too
However, they do not abolish the effects of acetylcholine and gastrin

A

H2 receptor antagonists

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23
Q

Do H2 receptor antagonists remove potentiation, resulting in attenuation of acetylcholine and gastrin?

A

Yes

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24
Q

Do H2 receptor antagonists abolish the effects of acetylcholine and gastrin?

A

No

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25
Cimetidine is this type of drug
H2 receptor antagonists
26
Ranitidine is this type of drug
H2 receptor antagonists
27
Famotidine is this type of drug
H2 receptor antagonists
28
Are H2 receptor antagonists effective in NSAID-induced ulcers?
No
29
This type of drug for peptic ulcers is limited by tolerance, and only therapeutically beneficial for 2-3 weeks
H2 receptor antagonists
30
This H2 receptor antagonist has more relative adverse reactions and drug interactions than others, on a "per use" basis
Cimetidine
31
These two H2 receptor antagonists are being removed due to the presence of N-nitrosodimethylamine (NMDA)
Ranitidine and Nizatidine
32
Ranitidine and Nizatidine are H2 receptor antagonists being removed due to the presence of this compound
N-nitrosodimethylamine (NMDA)
33
This is the primary elimination process for H2 receptor antagonists
Renal excretion (Biotransformation by cytochrome P450 is secondary)
34
Confusion and hallucinations occur especially in elderly with this type of drug for peptic ulcers Other toxicities include seizures, QT prolongation, cardiac conditions, bone marrow depression
H2 receptor antagonists
35
These are the preferred drugs for the treatment of acid hypersecretion disorders
Proton pump inhibitors (PPIs)
36
Proton pump inhibitors (PPIs) irreversibly block this, which is located on the apical side of the parietal cell
H+/K+ - ATPase (the proton pump)
37
This type of drug for peptic ulcers blocks both basal as well as stimulated gastric acid secretion carried out by histamine, acetylcholine, and gastrin
Proton pump inhibitors (PPIs)
38
Omeprazole is this type of drug
Proton pump inhibitors (PPIs)
39
Are Proton pump inhibitors (PPIs) effective in preventing NSAID-related ulcers?
yes
40
This type of drug for peptic ulcers is considered superior to H2 receptor antagonists in the treatment of moderate to severe GERD
Proton pump inhibitors (PPIs)
41
Proton pump inhibitors (PPIs) are extensively metabolized by this
Cytochrome p450 (in liver)
42
The half life of Proton pump inhibitors (PPIs) is less than this
8 hours (but the duration of proton pump inhibition is significantly longer)
43
This type of drug for peptic ulcers is provided in enteric-coated granules to protect from acid
Proton pump inhibitors (PPIs)
44
This type of drug for peptic ulcers delays elimination of drugs metabolized by mixed function oxidases (warfarin, diazepam, phenytoin)
Proton pump inhibitors (PPIs)
45
This type of drug for peptic ulcers has increased risk of fractures of hip, wrist, and spine Possibly related to disruption of calcium and magnesium absorption
Proton pump inhibitors (PPIs)
46
This type of drug for peptic ulcers has possible increased risk of C. diff colitis
Proton pump inhibitors (PPIs)
47
Omeprazole reduces the efficacy of the anti-clotting agent clopidogrel (Plavix) since both are extensively metabolized by this
Cytochrome p450 2C19
48
This PPI reduces the efficacy of the anti-clotting agent clopidogrel (Plavix) since both are extensively metabolized by the cytochrome p450 2c19
Omeprazole
49
Omeprazole reduces the efficacy of this anti-clotting agent since both are extensively metabolized by the cytochrome p450 2c19
Clopidogrel (Plavix)
50
Hypomagnesia can be an adverse effect of this type of drug for peptic ulcers, and can be severe
Proton pump inhibitors (PPIs)
51
This type of drug for peptic ulcers has been linked to an increased risk of hospital-acquired pneumonia
Proton pump inhibitors (PPIs)
52
This drug for peptic ulcers is a stable analog of prostaglandin E1
Misoprostol
53
Misoprostol is a stable analog of this
Prostaglandin E1
54
This drug for peptic ulcers has potent antisecretory and cytoprotective effects
Misoprostol
55
This drug for ulcers is able to directly inhibit gastric acid secretion by parietal cells, through inhibition of the adenylate cyclase pathway
Misoprostol
56
Misoprostol is able to directly inhibit gastric acid secretion by parietal cells through inhibition of this pathway
Adenylate cyclase
57
Misoprostol is cytoprotective, as it increases the secretion of these two compounds
Mucus, Bicarbonate
58
This drug opposes many of the ulcerogenic actions of NSAIDs, which reduces prostaglandin production
Misoprostol
59
Is Misoprostol or H2 receptor antagonists better for preventing NSAID-caused ulcers?
Misoprostol
60
Excessive GI toxicity limits use of this drug for peptic ulcers
Misoprostol (PPIs are better tolerated in this indication)
61
This drug for peptic ulcers can cause uterine contractions, and can induce complete or incomplete abortion during the first trimester
Misoprostol
62
Is Misoprostol safe in pregnancy?
NO Can cause uterine contractions, and induces complete or incomplete abortion during the first trimester
63
This drug for peptic ulcers leads to increased intestinal mucosal secretion, increased motility, decreased transit time and reduced absorption
Misoprostol
64
This drug for peptic ulcers is a basic aluminum salt of sucrose octasulfate In acid, it forms a viscous, sticky gel that adheres to epithelial cells and very strongly to ulcer craters Bind and sequester pepsin and bile salts Stimulates local growth factors Antibacterial (but not against H. pylori)
Sucralfate
65
What is the main MOA of Sucralfate in ulcers?
In acid, it forms a viscous, sticky gel that adheres to epithelial cells and ulcer craters
66
Does Sucralfate have antibacterial action?
Yes - but not against H. pylori
67
This drug for peptic ulcers has no significant absorption from the GI tract, and continues the healing process, even in smokers
Sucralfate
68
Does Sucralfate have significant absorption from the GI tract?
No
69
Does Sucralfate continue the healing process, even in patients who smoke?
Yes
70
Sucralfate contains this metal
Aluminum (use with caution in renal impaired patients)
71
This drug for peptic ulcers interferes the absorption of a variety of agents, including tetracycline, phenytoin, quinidine, theophylline, digoxin, fluoroquinolones
Sucralfate
72
Is Helicobacter pylori gram positive or negative?
Negative
73
What is the shape of Helicobacter pylori?
Curved rod
74
Does Helicobacter pylori have a flagella?
Yes Has a polar flagella, enabling them to move
75
Is Helicobacter pylori urease positive?
Yes
76
Is Helicobacter pylori catalase positive?
Yes
77
Is Helicobacter pylori oxidase positive?
Yes
78
Helicobacter pylori is a frequently asymptomatic inhabitant of this organ
Stomach
79
This is the route of transmission for Helicobacter pylori
Fecal-oral
80
This is the most important virulence factor for Helicobacter pylori Neutralizes gastric acid Causes gastric mucosal injury (by ammonia)
Urease
81
Does Helicobacter pylori colonize the intestinal epithelium?
No
82
Helicobacter pylori appears as bluish flecks on this stain
Warthin-Starry
83
This laboratory test for diagnosis of Helicobacter pylori only shows eposure
Blood antibody test
84
This is the most useful diagnostic tool for Helicobacter pylori, which is very sensitive and specific
Stool antigen (using ELISA)
85
Is culture useful for diagnosing Helicobacter pylori?
No
86
This is the first line treatment for Helicobacter pylori
Optimized bismuth quadruple therapy 1. PPI 2. Bismuth 3. Tetracycline 4. Metronidazole
87
Quadruple therapy for Helicobacter pylori includes these 4 drugs
PPI Bismuth Tetracycline Metronidazole
88
This drug is a potassium competitive acid blocker (PCAB)
Vonoprazan
89
Vonoprazan is a competitive acid blocker of this ion
Potassium
90
These three drugs comprise Pylera
Bismuth Tetracycline Metronidazole

GI - Week 1 (11 decks)

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