14 Acid-reducing Medication

Question 1

Parietal cell 分泌胃酸的調控機制（膜上五個受體）？分別走 G protein 哪條路徑？

Answer 1

M3 receptor: ACh (Vagus n.), Gq
CCKb receptor: Gastrin (G cell), Gq
H2 receptor: Histamine (ECL Cell), Gs
PGE2 receptor: PGE2, Gi
Somatostatin receptor: Somatostatin (D cell)

Question 2

Antacid 中可能造成腹瀉的是？

Answer 2

氧化鎂

Question 3

Antacid 中可能造成便秘的是？

Answer 3

氫氧化鋁、碳酸鈣

Question 4

-tidine

Answer 4

H2 antagonist

Question 5

Pirenzepine

Answer 5

M1 blocker

Question 6

Propantheline

Answer 6

M1 blocker

Question 7

-prazole

Answer 7

PPI

Question 8

哪種藥需要經過代謝才能作用？（小腸吸收肝臟代謝）

Answer 8

PPI

Question 9

根除幽門桿菌的治療

Answer 9

Omeprazole + Clarithromycin + Amoxicillin/Metronidazole

Bismuth + Metronidazole + Tetracycline

Question 10

Misoprostol

Answer 10

PGE agonist, 孕婦不能用

Question 11

促進腸胃蠕動有哪三個機轉？

Answer 11

D2 antagonist
Cholinomimetic agents
5-HT4 agonist

Question 12

Metacholopramide

Answer 12

D2 antagonist, 會有 Extrapyramidal symptoms

止吐&促進腸胃蠕動

Question 13

Domperidone

Answer 13

D2 antagonist

止吐&促進腸胃蠕動

Question 14

Bethanechol

Answer 14

Cholicomimetic agent (less)

Question 15

Cisapride

Answer 15

5-HT4 agonist, 已下架, 會 Arrhythmia

Question 16

Tegaserod

Answer 16

5-HT4 agonist

Question 17

造成嘔吐的三個原因

Answer 17

腸胃滯留、阻塞 ➔ Vagus n. ➔ 5-HT3 receptor ➔ 延腦嘔吐中樞
化療藥 ➔ 刺激第四腦室 ➔ D2, 5-HT3, Neurokinin receptor ➔ 延腦嘔吐中樞
暈車 ➔ 前庭系統 ➔ mAChR, H1 receptor ➔ 延腦嘔吐中樞

Question 18

Tropisetron

Answer 18

5-HT3 antagonist

化療用止吐

Question 19

Ondansetron

Answer 19

5-HT3 antagonist

化療用止吐

Question 20

Aprepitant

Answer 20

Neurokinin antagonist, 止吐

Question 21

Antihistamine or anticholinergic

Answer 21

治療暈眩造成的嘔吐

Question 22

Simethicone

Answer 22

消脹氣

Question 23

Infliximab

Answer 23

Anti-TNFα，治療 IBD (Crohn disease & Ulcerative colitis)

Question 24

Lorcaserin

Answer 24

5-HT2c agonist, 刺激下視丘 POMC neuron 增加飽足感

Question 25

Orlistat

Answer 25

Pancreatic lipase inhibitor, 台灣唯一合法減肥藥