Block 1

Question 1

Antacids

Answer 1

aluminium hydroxide and magnesium hydroxide, calcium carbonate and magnesium carbonate

Gastric acid neutralisation

Question 2

Antacids + alginates

Answer 2

sodium alginate with sodium bicarbonate and calcium carbonate

Gastric acid neutralisation and increasing viscosity of stomach contents.

Question 3

H2 receptor antagonists

Answer 3

Ranitidine

Blockade of gastric H2 histamine receptors

Question 4

Proton pump inhibitors

Answer 4

omeprazole, lansoprazole

Blockade of parietal cell proton transporters

Question 5

Bulk laxatives

Answer 5

methylcellulose, ispaghula husk

Water retention in intestinal lumen to soften & bulk stools

Question 6

Osmotic laxatives

Answer 6

magnesium sulphate and magnesium hydroxide (saline purgatives), macrogol, lactulose

Promote movement of fluid across the wall into the GI lumen, which accelerates transit and causes colonic distension, simulating purgation

Question 7

Faecal softeners

Answer 7

docusate, arachis oil

Lower surface tension - allowing water and fat to enter stool, softening stool consistency & increasing bulk to aid transit

Question 8

Stimulant purgatives

Answer 8

bisacodyl, senna

Increase intestinal motility

Question 9

Oral rehydration therapy

Answer 9

isotonic/hypotonic solution of glucose and sodium chloride

Promotes uptake of Na+ and water by intestines, restoring
hydration levels following fluid loss from diarrhoea

Question 10

Opioid anti-motility agents

Answer 10

loperamide, codeine

Agonist for µ-opioid receptors in myenteric plexus.

Question 11

Aminosalicylate (for inflammatory bowel disease)

Answer 11

mesalazine

Suppresses immune system in gut to reduce inflammation and tissue damage

Question 12

Loop diuretics

Answer 12

furosemide

Inhibits Na+/K+/2Cl- transporter in loop of Henle

Question 13

Thiazides (& related diuretics)

Answer 13

indapamide, bendroflumethiazide, hydrochlorothiazide, chlortalidone

Inhibits Na+/Cl- co-transporter in early distal tubule

Question 14

Potassium sparing diuretics

Answer 14

spironolactone, eplerenone (mineralocorticoid receptor (aldosterone) antagonists), amiloride (epithelial sodium channel (ENaC) antagonist)

Mineralocorticoid receptor blockade (spironolactone, eplerenone)

Blockade of sodium reabsorption via ENaC channel (amiloride)

Question 15

Carbonic anhydrase inhibitors

Answer 15

acetazolamide

Prevent renal reabsorption of bicarbonate

Question 16

Osmotic diuretics

Answer 16

Mannitol

Increases osmolarity of glomerular filtrate

Question 17

ACE inhibitors

Answer 17

ramipril

Inhibits conversion of angiotensin I to angiotensin II. Reduces vasoconstriction

Question 18

Angiotensin-II receptor antagonists

Answer 18

losartan

Blockade of cell signalling induced by angiotensin II

Question 19

Aldosterone antagonist

Answer 19

spironolactone

Blockade of mineralocorticoid activation

Question 20

thyroid hormones

Answer 20

levothyroxine, liothyronine

Activation of thyroid hormone receptors

Question 21

Alpha-adrenergic blocker (for urinary retention)

Answer 21

Tamsulosin

Smooth muscle relaxant affecting neck of bladder

Question 22

Urinary anti-spasmodic; anticholinergic (for urinary incontinence)

Answer 22

Oxybutinin

Blockade of muscarinic receptors leading to reduction of bladder detrusor activity