Chapter 20 -G.I.

Question 1

Name medications associated with gastric mucosal damage and ulcer formation

Answer 1

NSAIDS
Steroids
NSAIDS With anticoagulants

Question 2

Name two agents used to treat or prevent ulcer formation

Answer 2

Sucralfate (Carafate)

Misoprostal (Cytotec)

Question 3

—

Answer 3

Sucralfate

Question 4

__________ is a methyl analog of prostaglandin E1.

Analog equals what does analog mean? A compound with the molecular structure closely similar to that of another.

Answer 4

Misoprostol

Question 5

Name two Cytoprotective agents

Answer 5

Sucralfate

Misoprostol

Question 6

Which cytoprotective agent binds to necrotic tissue, covers the ulcer site, and acts as a barrier to acid, pepsin, and bile salts

Answer 6

Sucralfate

Question 7

Which ulcer medication has no acid neutralizer activity?

Answer 7

Sulcralfate

Question 8

Which ulcer medication inhibits gastric secretion through the inhibition of histamine Stimulated cyclic adenosin monophosphate production?

Answer 8

Misoprostol

Question 9

Inhibits basil and nocturnal gastric acid secretion and acid secretion in response to meals, histamine, and coffee

Answer 9

Misoprostol

Question 10

Has no effect on fasting or post prandial gastrin, or on intrinsic factor out put

Answer 10

Misoprostol

Question 11

Produces a moderate decrease in pepsin concentration during basal conditions.

Answer 11

Misoprostol

Question 12

Can be taken with food

Answer 12

Misoprostol

Question 13

Produces uterine contractions they can in danger pregnancy

Answer 13

Misoprostol

Question 14

Which ulcer medication is minimally absorbed and largely topical

Answer 14

Sucralfate

Question 15

Which ulcer medication is rapidly and extensively absorbed after oral administration

Answer 15

Misoprostol

Question 16

More than 90% of this ulcer medication is excreted in the feces

Answer 16

Sucralfate

Question 17

Rapidly converted to its free acid, is not affected by cytochrome P4 50, half-life is 20 to 40 minutes, is excreted in the urine—which ulcer medication is this?

Answer 17

Misoprostol

Question 18

Which ulcer medication is pregnancy category B with a few contra indications

Answer 18

Sucralfate

Question 19

Which ulcer medication is pregnancy category X may cause abortion, premature birth, or birth defects

Answer 19

Misoprostol

Question 20

Can cause uterine rupture when administered to induce labor

Answer 20

Misoprostol

Question 21

Do not treat NSAID induced ulcers with this medication

Answer 21

Misoprostol

Question 22

Metabolized into misoprostol acid And excreted in breastmilk

Answer 22

Misoprostol

Question 23

Adverse reactions with his this ulcer medication are rare

Answer 23

Sucralfate

Question 24

The most common adverse reaction to Sucralfate is

Answer 24

Constipation, dizziness, gastric discomfort

Question 25

Misoprostol Most common side effect is

Answer 25

Diarrhea

Question 26

Misoprostol may cause side effects related to

Answer 26

Menstrual irregularities

Question 27

Sucralfate May decrease the _______ Of many drugs when given concurrently are before their administration

Answer 27

Absorption

Question 28

Misoprostol has very few drug interactions. The risk for_—

Answer 28

Diarrhea

Magnesium based and acids

Question 29

Many patients self medicate with antacids. Which patients should be council to not take calcium carbonate antacids without discussing it with their provider or pharmacist first?

Answer 29

Patients with kidney stones

Question 30

Patients taking antacids should be educated regarding these drugs, including letting them know that:

Answer 30

They may cause constipation and diarrhea
Many are high in sodium
They should separate and acids from other medications by one hour
Answer: all of the above

Question 31

Kelly has diarrhea and is wondering if she can take loperamide for the diarrhea. Loperamide:

Answer 31

Slows gastric motility and reduces fluid and electrolyte loss from diarrhea

Question 32

Bismuth subsalicylate is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:

Answer 32

May lead to toxicity if taken with aspirin
Is contra indicated in children with flu like illness
Has antimicrobial affects against bacterial and viral enteropathogens
Answer: all of the above

Question 33

Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop travelers diarrhea. Advice includes following normal food and water precautions as well as taking:

Answer 33

Bismuth subsalicylate with each meal and at bedtime

Question 34

Josie is a five-year-old patient who presents to the clinic with a 48 hour history of nausea, vomiting, and some diarrhea. She is an able to keep fluids down and her weight is 4 pounds less then her last recorded wait. Besides IV fluids, Her exam warrants the use of an anti-nausea medication. Which of the following would be the appropriate drug to order for Joseph?

Answer 34

Ondansetron

Question 35

Jim presents with complaints of heartburn that is minimally relieved with tums Calcium carbonate and is diagnosed with gastroesophageal reflux disease GERD. An appropriate first step therapy would be

Answer 35

Ranitidine Zantac twice a day

Question 36

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for

Answer 36

Iron deficiency anemia, vitamin B 12 and calcium deficiency

Question 37

Sadie is a 72-year-old patient it takes oMeprazole for her chronic GERD. Chronic long-term omeprazole use places her at risk for :

Answer 37

Megaloblastic anemia

Question 38

Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. And appropriate choice of medication for a 10-year-old child would be:

Answer 38

Bisacodyl dulcolax Suppository

Question 39

Methylnaltrexone is used to treat constipation in:

Answer 39

Opioid associated constipation

Question 40

An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include

Answer 40

Electrolytes, including potassium and chloride