Upper GI Disorders (Exam 2)

Question 1

Histamine (H2) Receptor Antagonists MOA

Answer 1

competitively and reversibly inhibit histamine at parietal cell receptor sites
reduce volume and H+ of gastric secretions

Question 2

H2 Antagonists are suppressors of ______ and _____ stimulated by food, vagus nerve, and gastrin

Answer 2

basal gastric acid output

acid output

Question 3

Histamine (H2) Receptor Antagonists

Answer 3

Cimetidine (Tagamet)
Famotidine (Pepcid, Zantac)
Nizatidine (Axid)
these are all OTC + prescription

Question 4

Cimetidine (Tagamet)

Answer 4

first H2 receptor antagonist used for peptic acid disorders

Question 5

Cimetidine (Tagamet) side effects

Answer 5

reversible gynecomastia
hepatotoxicity
hematological disorders
CYP450 inhibitor drug interactions

Question 6

Proton Pump Inhibitors MOA

Answer 6

Suppress gastric acid secretion by inhibiting H+/K+ ATPase enzyme system

Question 7

PPI are most efficient when taken

Answer 7

30-60 minutes before breakfast

Question 8

Best agents to treat peptic ulcer disease

Answer 8

PPIs

Question 9

Proton Pump Inhibitors

Answer 9

Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Rabeprazole (Aciphex)
Pantoprazole (Protonix)
Dexlansoprazole (Dexilant)

Question 10

____ is indicated only for GERD and H. pylori

Answer 10

Dexlansoprazole (Dexilant)

Question 11

Which PPIs are available OTC?

Answer 11

Omeprazole
Esomeprozole
Lansoprazole

Question 12

Which PPIs are available IV?

Answer 12

Pantoprazole
Esomeprazole

Question 13

Which PPIs can you NOT crush?

Answer 13

Rabeprazole (Aciphex)
Pantoprazole (Protonix) tablets

Question 14

Which PPIs can you open the capsules?

Answer 14

Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Dexlansoprazole (Dexilant)

Question 15

Most potent inhibitors CYP450

Answer 15

Omeprazole (Prilosec)
Lansoprazole (Prevacid)
Rabeprazole (Aciphex)

Question 16

Mucosal Protectants

Answer 16

Sucralfate (Carafate)
-aluminum salt of sulfated sucrose

Question 17

Mucosal Protectants MOA

Answer 17

in acidic medium, aluminum splits off, remaining complex attaches to lesion and forms protective barrier

Question 18

Mucosal Protectants Adverse Effects

Answer 18

constipation, hypophosphatemia, osteomalacia

Question 19

Avoid Mucosal Protectants in patients with

Answer 19

chronic renal insufficiency –> prevent AI-induced neurotoxicity

Question 20

Drug interactions in Mucosal Protectants

Answer 20

Antacids: decrease mucosal binding, take 30-60 mins apart
Interferes w/ absorption of digoxin, tetracycline, phenytoin, fluroquinolones

Question 21

Prostaglandin Analogues

Answer 21

Misoprostol (Cytotec)
-prostaglandin E1 derivative

Question 22

Prostaglandin Analogues MOA

Answer 22

replenish mucosal PG which may be depleted by NSAIDs
increases mucus bicarb secretion, stimulates blood flow, enhances mucosal defense

Question 23

Prostaglandin Analogues have both _____ and _____ effects

Answer 23

anti-secretory

mucosal protective

Question 24

Prostaglandin Analogues are used in patients at high risk for

Answer 24

NSAID induced ulcers

Question 25

Prostaglandin Analogues adverse effects

Answer 25

diarrhea, abdominal pain/cramping

Question 26

Can you use Prostaglandin Analogues in pregnant women?

Answer 26

NO Category X

Question 27

Antacids MOA

Answer 27

Neutralize gastric acid and treat ulcer pain

Question 28

Antacids maintain intragastric pH ____.

Answer 28

> 4

Question 29

Antacids mainly used for

Answer 29

dyspepsia

Question 30

When should you take antacids?

Answer 30

1-3 hrs after each meal and at bedtime

Question 31

Which form of antacids have better buffering capacity?

Answer 31

Liquids >> tablets

Question 32

Antacid mixtures

Answer 32

more sustained action than single agents allow for lower dosage negate side effects

Question 33

Antacids cause

Answer 33

acid-base disturbances

Question 34

Calcium carbonate adverse effects

Answer 34

constipation over production of gastric acid hypercalcemia hypophosphatemia milk-alkali syndrome

Question 35

Aluminium salts adverse effects

Answer 35

constipation hypophosphatemia osteomalacia avoid in renal insufficiency

Question 36

Magnesium salts adverse effects

Answer 36

diarrhea renal toxicity avoid in renal insufficiency

Question 37

Sodium bicarb adverse effects

Answer 37

fluid retention

Question 38

Antacids drug interactions

Answer 38

Bind w/ tetracyclines + fluroquinolones - decrease efficacy Destroy enteric coated drugs - premature dissolution Reduces absorption of sucralfate

Question 39

Antacids

Answer 39

ALternaGel Gaviscon Maalox/Mylanta (Plus, Supreme, Ultra) Rolaids Pepcid Complete Riopan Milk of Magnesia Brioschi