Antacid Pharm

Question 1

Regarding Parietal cell acid secretion, Ach and Gastrin action occurs through raising the levels of what>

Answer 1

IP3 and Calcium

Question 2

Histamine stimulates acid production through?

Answer 2

Adenylyl cyclate (raising cAMP levels)

Question 3

Somatostatin and Prostaglandins lower acid secretion via?

Answer 3

Lowering cAMP levels….cut off the histamine pathway

Question 4

pH goal of antacid tx is?

Answer 4

pH greater than 4

Question 5

Antacids can significantly impact the absorption of other drugs!!! worth knowing….do not have pts take antacids within hrs of other meds.

Answer 5

ok

Question 6

H2 blockers mechanism

Answer 6

Block the binding of histamine to the histamine receptor.
H2 blockers inhibit the basal, cephalic, and nocturnal Gastric Acid Secretion!!!!
Reduce volume and acidity of GA secretions.

Question 7

Potency of Cimetidine?

Answer 7

1x

Question 8

Potency of Ranitodine and Nizatidine?

Answer 8

4-10x

Question 9

Famotidine potency?

Answer 9

20-50

Question 10

Cimetidine has what effect on CYPs?

Answer 10

inhibits them

Question 11

Famotidine leads to low clearance of ?

Answer 11

Theophylline

Question 12

Proton Pump Inhibitors mechanism>

Answer 12

Inhibit the proton pump (Hydrogen Potassium ATPase) at the apical membrane of the parietal cells. Most effective form of gastric acid relief/

Question 13

PPI’s are absorbed into the bloodstream in the small intestine as lipid soluble prodrugs. Carried in teh blood to parietal cells and diffuse to canaliculi where the acid pH ionizes them. The ionized form of the drug then binds irreversibly to H/K ATPase and achlorhydria results. Because the binding is irreversible, the parietal cell must make new PP.

Answer 13

KNOW this mech

Question 14

All PPIs are CYP— substrates?

Answer 14

CYP219

Question 15

Which of the PPIs is the weakest of the CYP219 substrates?

Answer 15

Pantoprazole….rabeprozole is also right there with it

Question 16

PPIs lower the bioavailability of what types of drugs?

Answer 16

Anti-retrovirals

Question 17

What the hell is bismuth subsalicylate?

Answer 17

Pepto Bismol.

Question 18

How does the pink stuff work?

Answer 18

Increases Mucous and bicarb secretion. Lowers Pepsin activity. Chelates protein at the base of the ulcer and forms a protective barrier inside it from GA and Pepsin. Inhibits H Pylori as well.

Question 19

Sucralfate

Answer 19

Forms a sticky gel that adheres to the gastric epithelium and protects it from gastric acid and pepsin.

Question 20

What type of pH does Sucralfate require for activity>

Answer 20

Acidic pH

Question 21

What ABs can be used to eradicate H Pylori which is the most common cause of ulcers

Answer 21

Clarithromycin
Amoxicillin
Metronidazole
Furazolidine

F Cam

Question 22

Furazolidine mechanism

Answer 22

Nitrofuran antibacterial and anti-protozoal

Question 23

Clarithromycin mech

Answer 23

Macrolide

Question 24

Amoxicillin mech

Answer 24

Beta lactamase resistant

Question 25

Metronidazole mech?

Answer 25

synthetic antibiotic for obligate anaerobes

Question 26

What is the drug regimen for H pylori?

Answer 26

Give a PPI or H2 blocker, pepto bismol, and 1-2 antibiotics for 10-14 days.