CH5 Gastrointestinal Pharmacology Flashcards
How does Peptic Ulcer Disease (PUD) occur?
It is through the breakdown in the ________________ of the stomach by stomach acid.
prostaglandin-based protective lining
Peptic Ulcer Disease (PUD) can be treated in what three ways?
- Lifestyle changes
- Eradicate the bacteria (H. pylori)
- Decrease the acid production
Gastroesophageal Reflux Disease (GERD) caused when contents of the stomach “______” into the esophagus leading to _______ tissue damge.
reflux (spill); esophageal
Gastroesophageal Reflux Disease can be treated by what three lifestyle changes?
- Change in diet
- Stress reduction
- Elevation of the head during sleep
Peptic Ulcer Disease (PUD) and Gastroesophageal Reflux Disease (GERD) can be treated by lifestyle choices and _______ production.
decreased acid
______ cells in the stomach create acid.
parietal
Gastric Pathologies are treated by either blocking ________ receptors in the stomach wall, inhibiting _______ at the parietal cell in the stomach wall, or by simply taking an ______.
histamine-2; proton-pump; antacid
When treating gastric pathologies proton pump inhibitors are more effective than histamine-2 inhibitors. This does not mean that this is always the better choice.
True
False
True
Claratin is NOT and histamine-2 blocker.
True
False
True
Cimetidine (Tagamet) is the only drug that interacts with lidocaine.
True
False
True
Tagamet slows dow the processes of the liver.
True
False
True
Histamine-2 receptor antagonists are used for
A) Short-term treatment of active duodenal ulcer or benign gastric ulcer
B) Treatment of gastroesophageal reflux
C) Treatment of pathological hypersecretory conditions
D) All of the above
E) None of the above
D) All of the above
Which of the following reactions is not the result of a Histamine-2 receptor antagonists.
A) Headache, dizziness
B) Xerostomia
C) Halitosis
D) skin rash
E) Nausea & diarrhea
B) Xerostomia
You need stomach acid to absorb _____ in your diet, this is one of the falacies in antacids.
?? Verify the second sentence.
calcium
H+/K+ ATPase is in reference to what system?
Proton Pump inhibitor system
Abilify is used to treat schitzophrenia
The mechanism of action of the Proton-Pump inhibitor is to inhibit the action of the “proton pump” at the ______ in the stomach wall.
parietal cell
Name four main adverse reactions to treatment of gastric pathologies.
1) headache
2) constipation or diarrhea
3) flatulence
4) halitosis
(vitamin deficiency is another advese reaction)
Which of the following is the most common gastrointestinal disease in the United States population?
A) Peptic ulcers
B) Gastroesophageal reflux disease (GERD)
C) Diarrhea
D) Constipation
E) Ulcerative colitis
B) Gastroesophageal reflux disease (GERD)
GERD is the prevalent gastrointestinal disease in the United States. In this condition, the stomach contents, including the acid, reflux, or flow backward through the cardiac sphincter, up into the esophagus. Ulcers may occur in the stomach or the small intestine. Diarrhea is treated with antidiarrheals and laxatives are used for constipation. An autoimmune response is thought to be associated with ulcerative colitis.
Which of the following is the main problem causing gastroesophageal reflux disease (GERD)?
A) Excess stomach acid
B) A diet that is too high in saturated fat
C) Lack of adequate function of the cardiac sphincter
D) Being overweight
C) Lack of adequate function of the cardiac sphincter
The main problem is the lack of adequate function of the cardiac sphincter, allowing backflow to occur. The symptoms are exacerbated by eating large meals and by assuming a supine position. In this condition, the stomach contents flow up into the esophagus. Because the esophagus is not designed to endure the stomach’s acid irritation, inflammation and erosion can occur.
Which histamine-2 (H2)-blocking agent has been associated with dry mouth and taste alterations?
A) Cimetidine (Tagamet)
B) Ranitidine (Zantac)
C) Famotidine (Pepcid)
D) Meclizine (Bonine)
C) Famotidine (Pepcid)
Famotidine has been associated with dry mouth and taste alterations. Cimetidine and ranitidine are H2-blockers that do not cause xerostomia or taste alterations. Meclizine does cause xerostomia, but is an anticholinergic rather than H2-blocker. It is used to prevent vomiting, vertigo, and motion sickness.
Which of the following adverse reactions is common to all of the currently marketed H2-blocking agents?
A) Abnormal liver function tests
B) Thrombocytopenia
C) Slurred speech
D) Gynecomastia
A) Abnormal liver function tests
Reversible hepatitis and abnormal liver function tests have been reported with all H2-blockers. Cimetidine’s hematologic effects include granulocytopenia, thrombocytopenia, and neutropenia. Slurred speech, delusions, confusion, and headache are associated with cimetidine. Because cimetidine binds with the androgen receptors, it produces antiandrogenic effects such as gynecomastia, reduction in sperm count, and sexual dysfunction. Neither ranitidine nor famotidine has been found to possess antiandrogenic activity.
Which agent inhibits the hydrogen/potassium adenosine triphosphate (H+/K+ ATPase) enzyme system found at the surface of the gastric parietal cell?
a. Ketoconazole
b. Lansoprazole
c. Misoprostol
d. Famotidine
e. Metronidazole
b. Lansoprazole (Prevacid)
Proton-pump inhibitors, such as lansoprazole, inhibit gastric H+/K+ ATPase as their mechanism of action. Ketoconazole is an antifungal agent. Misoprostol is prostaglandin E2-alpha PGE2. Famotidine is a histamine-2 receptor antagonist. Metronidazole is an antibacterial agent.
Newer types of combination therapy for treating ulcers often combine an antibiotic with a(n)
A) hyperosmotic laxative.
B) proton-pump inhibitor.
C) antacid.
D) prostaglandin.
B) proton-pump inhibitor.
Newer combinations often use one antibiotic and a PPI such as clarithromycin and esomeprazole (Nexium). These agents are used for 2 weeks and often result in a cure. There are several types of regimens for treating ulcers caused by Helicobacter pylori. A combination of two antiinfective agents, an H2-blocker or a PPI, and bismuth subsalicylate (Pepto-Bismol) may be used.
Antacids are the best treatment for peptic ulcers.
True
False
False
Acute gastritis and symptoms of ulcers are sometimes managed with antacids; however, ulcers are closely related to Helicobacter pylori and are treated with antibiotics.
Gastroesophageal reflux disease is characterized by the backward flow of stomach acid up into the esophagus.
True
False
True
Peptic ulcer disease (PUD) is characterized by an erosion of the protective mucosal lining of the stomach.
True
False
True
Histamine-2 receptors are responsible for which bodily function?
Stimulating gastric acid secretion
Which of the following is a proton pump inhibitor?
A) Omeprazole
B) Cimetidine
C) Sucralfate
D) Misoprostol
E) Lisinopril
A) Omeprazole
What can PUD lead to?
erosion, uleration, and perforation
Gastric pathologies are realated to the presence of ________
Helicobacter pylori (H. Pylori)
Gastric pathologies can lead to ______ damage.
esophageal
GERD is related to the position of the stomach and the cardiac sphincher? In a __________ the upper portion of the stomach protrudes into the chest cavity through the esopageal hiatus.
Hiatal hernia
The mechanism of action for the histamine-2 receptor antagonist is to block _______ receptors in stomach wall and decrease acid production.
histamine-2
______end with ‘prazole.
Proton-Pump Inhibitors
______ end with ‘ine.
Histamine-2 receptors
Tums is an example of an ____ that neutralizes stomach acid preventing the absorption of Ca. In excess, this can cause kidney stones.
antacid
Antacids provide temporary symptomatic relief of hyperacidity, but their use can cause constipation, diarrhea and _________.
rebound hyperacidity
Good to know.
A dental consideration for the dental hygienist is to be congnizant that excessive use of antacids can negatively impact calcium uptake in teeth resulting in implant failure and weakened tooth stucture.
Good to know
Pepcid AC has been found to be beneficial in thiis COVID pandemic.
________ are used for short-term treatment of active duodenal ulcer or bennign gastric ulcer.
Histamine-2 Receptor Antagonists
____ is the only drug that interacts with Lidocaine. It slows down the metabolism of lidocaine, causing it to last longer than it should.
Tagament
Good to know
If you have a choice to use a proton pump inhibitor or a H2 antagonist, the PPI will be more effective. It is important to note that that is not always a good thing.
The mechanism of action for the PPI is inhibition of action of the “proton pump” at the parietal cell in the stomach wall. This leads to a decrease in ____ production.
acid
What are some examples of PPI?
omeprazole (Prilosec)
lansoprazole (Prevacid)
esomeprazole (Nexium)
The ___ is used for short-term treatment of active duodenal ulcers, GERD, and erosice esophagitis.
PPI
___ neutralize the gastric acid by rasing stomach pH.
Antacids
