25) Drugs Affecting Acid Secretion

Question 1

What are the defensive factors affecting the integrity of the gastric mucosa?

Answer 1

Epithelial integrity
Cell replication
Mucus
Vascular supply

Question 2

What are the aggressive factors affecting the integrity of the gastric mucosa?

Answer 2

Acid
H.pylori
Drugs

Question 3

What substances stimulate acid secretion?

Answer 3

ACh, histamine, gastrin

Question 4

What substances inhibit acid secretion?

Answer 4

Prostaglandin E2, secretin, glucagon, somatostatin

Question 5

When are antacids indicated?

Answer 5

GORD and ulcers

Question 6

What are the side effects of antacids?

Answer 6

Diarrhoea, cramps, N&V

Question 7

What is the mechanism of action of alginates?

Answer 7

Adhere to exposed mucosa and form a raft over the mucosa

Question 8

Give examples of H2 receptor antagonists:

Answer 8

Cimetidine, ranitidine

Question 9

When are H2 receptor antagonists indicated?

Answer 9

Ulcers, reflux oesophagitis, functional dyspepsia

Question 10

What are the side effects of H2 receptor antagonists?

Answer 10

Diarrhoea, headache, gynaecomastia (cimetidine)

Question 11

When are PPIs indicated?

Answer 11

Ulcers, H. pylori eradication, GORD, dyspepsia, Zollinger-Ellison

Question 12

What are the side effects of PPIs?

Answer 12

Abdo pain, constipation, flatulence, headache, arthralgia, N&V, diarrhoea

Question 13

What lifestyle advice can be given to people with GORD?

Answer 13

Eat smaller, more frequent meals
Avoid alcohol
Stop smoking
raise head in bed
Maintain healthy weight

Question 14

What pharmacological treatment can be given to people with GORD?

Answer 14

Antacids, H2 receptor antagonists/PPIs

Question 15

Why do PPIs have a delayed onset of action?

Answer 15

Only bind to active proton pumps

Question 16

How should peptic ulcers be managed?

Answer 16

Stop NSAIDs and give PPI/H2 anatagonists

Question 17

How can H. pylori be eradicated?

Answer 17

Clarithromycin, amoxicillin, PPI