30 - Gastrointestinal pharmacology

Question 1

Neutralize stomach acid by reacting with protons in the lumen

Answer 1

Antacids (TOPNOTCH)

Question 2

Antacids impair the absorption of these drugs: (3)

Answer 2

tetracyclines

flouroquinolones

itraconazole

iron

Question 3

Antacids

Answer 3

Magnesium-Aluminum Hydroxide, Calcium carbonate, Sodium bicarbonate (TOPNOTCH)

Question 4

Competitive pharmacologic block of H2 receptors ; for peptic ulcer disease, Zollinger-Ellison syndrome, Gastroesophagal reflux, dyspepsia

Answer 4

H2 Receptor Blockers (TOPNOTCH)

Question 5

H2 Receptor Blockers

Answer 5

Cimetidine, Ranitidine, Famotidine, Nizatidine (TOPNOTCH)

Question 6

Highly effective in suppressing nocturnal acid secretion but only modest effect on meal- stimulated secretion

Answer 6

H2 Receptor Blockers (TOPNOTCH)

Question 7

Irreversible blockade of H/K ATPase in active gastric panetal cells. Long lasting reduction of meal stimulated and nocturnal acid secretion

Answer 7

Proton Pump Inhibitors (TOPNOTCH)

Question 8

Proton Pump Inhibitors

Answer 8

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 9

usually enetric coated, needs 3-4 days treatment to achieve full effectiveness

Answer 9

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 10

SE: Diarrhea, headache, abdominal pain, Malaabsorption (Vit B12, Ca, Fe, Zn), Infections (respiratory, enteric), Hypergastrinemia, Atrophic gastritis

Answer 10

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 11

Binds to injured tissue and forms a protective covering with ulcer beds. Accelerates healing of peptic ulcers and reduces recurrence rate

Answer 11

Sucralfate (TOPNOTCH)

Question 12

Forms a protective coating on ulcerated tissue. Stimulates mucosal protective mechanisms, direct antimicrobial effects and sequestration of enterotoxins

Answer 12

Bismuth Salicylate (TOPNOTCH)

Question 13

SE: Abdominal pain, Diarrhea, Uterine cramping, Miscarriage

Answer 13

Misoprostol (TOPNOTCH)

Question 14

Activates EP receptors. Causes incresed HCO3 and mucus secretion in stomach. Uterine contraction

Answer 14

Misoprostol (TOPNOTCH)

Question 15

SE: Black stools, darkening of tongue, Encephalopathy (Atraxia, headaches, confusion, seizures)

Answer 15

Bismuth Salicylate (TOPNOTCH)

Question 16

Increases gastric emptying and intestinal motility

Answer 16

Metoclopramide, Domperidone, Erythromycin (TOPNOTCH)

Question 17

______ and ______ block D receptors ; _______ stimulates motilin receptors

Answer 17

Metoclopramide and domperidone, Erythromycin (TOPNOTCH)

Question 18

T or F: Domperidone does not cross the BBB (less toxic)

Answer 18

TRUE (TOPNOTCH)

Question 19

Indigestible, hydrophilic colloids that absorb water, forming a bulky emollient gel that distends the colon and promotes peristasis

Answer 19

Bulk-forming Laxatives: Psyllium, Methylcellulose, Polycarbophil (TOPNOTCH)

Question 20

Soften stool material, Permitting water and lipids to penetrate

Answer 20

Stool-softener: Docusate, Glycerine, Suppository, Mineral oil (TOPNOTCH)

Question 21

Soluble but nonabsorbable compound that result in increased stool liquidity due to an obligate increase in fecal fluid

Answer 21

Osmotic Laxatives: Lactulose, Magnesium oxide, Sorbitol, Magnesium citrate, Sodium phosphate, Polyethylene Glycol (TOPNOTCH)

Question 22

Directly stimulate enteric nervous system and colonic electrolyte and fluid secretion

Answer 22

Stimulant Laxatives: Bisacodyl, Aloe, Senna, Cascara, Castor oil (TOPNOTCH)

Question 23

Activates opioid receptors in enteric nervous system. Slows motility with negligible CNS effects

Answer 23

Diphenoxylate, Loperamide, Kaolin+Pectin, Colloidal Bismuth (TOPNOTCH)

Question 24

Blocks chemoreceptor trigger zone and enteric nervous system 5-HT3 receptors ; For Vomiting (Post chemothereaphy, postoperative)

Answer 24

Ondansetron, Granisetron, Dolasetron, Palonosetron (TOPNOTCH)

Question 25

Probably inhibits production of eicosanoid inflammatory mediators ; for Inflammatory bowel disease (mild to moderate)

Answer 25

Mesalamine, Balsalazide, Olsalazine, Sulfasalazine (TOPNOTCH)

Question 26

Contraindication to administration of magnesium-aluminum hydroxide:

Answer 26

patients with impaired renal function

Question 27

SE of magnesium hydroxide:

Answer 27

diarrhea MAGtatae ka!

Question 28

SE of aluminum hydroxide:

Answer 28

constipation Ayaw LUMabas! = ALUMinum

Question 29

DOC for peptic ulcer disease

Answer 29

omeprazole (PPIs)

Question 30

Metoclopramide is the DOC for \_\_\_\_\_\_\_\_:

Answer 30

diabetic gastroparesis

Question 31

SE of senna:

Answer 31

melanosis coli (for anthraquinone-containing laxatives)

Question 33

SE of diphenoxylate: What subgroup of the population are more susceptible to this SE? What drug can be given to reverse this SE?

Answer 33

* paralytic ileus * children less than 4 years old * bethanechol

Question 34

* This drug blocks chemoreceptor trigger zone and enteric nervous system 5-HT3 receptors: * What is the drug class?

Answer 34

* odansetron * 5-HT3 receptor antagonist

Question 35

What 5-HT3 receptor antagonist can cause QRS and QT prolongation?

Answer 35

dolasetron

Question 36

* Identify: immunomodulator that can be used in treatment of inflammatory bowel disease: * what is the MOA?

Answer 36

* mesalamine * unknown; probably inhibits production of eicosanoid inflammatory mediators

Question 37

* drug used for medical therapy of gallstone: * drug class? * MOA?

Answer 37

* ursodiol * bile acid * decreases the cholesterol content of bile by reducing cholesterol secretions

Question 38

Identify: this drug change surface tension of gas bubbles and causes collapse of foam bubbles, thus allowing easier passage of gas and preventing gas pockets in the GI tract

Answer 38

simethicone

Question 39

This drug increases the availability of endogenous opioids (enkephalins) by inhibiting membrane-bound enkephalinase -\> induces selective increase in chloride absorption by inhibiting adenylate cyclase -\> reduces secretion of water and electrolyte into the intestine -\> reduces both the frequency and duration of diarrhea

Answer 39

racecadotrol

Question 40

Identify: probiotic that has been found to produce antimicrobial substances that are active against gram-positive bacteria, e.g. Staphylococcus aureus, Enterococcus faecium, and Clostridium difficile

Answer 40

*Bacillus clausii*

Question 41

this drug can be usd for hepatic encephalopathy:

Answer 41

L-ornithine aspartate