Drugs for GERD and PUD

Question 1

Goals of antiulcer therapy

Answer 1

Relief of pain
Ulcer healing
Prevent complications
Prevent relapse

Question 2

Receptor for gastrin on parietal cells

Answer 2

CCK-B

Question 3

Drug class of Ranitidine

Answer 3

H2 antagonist

Question 3

Drug class of cimetidine

Answer 3

H2 antagonist

Question 4

Drug class of famotidine

Answer 4

H2 antagonist

Question 5

Drug class of nizatidine

Answer 5

H2 antagonist

Question 6

H2 antagonist with weak antiandrogenic activity, that may cause gynecomastia in men or galactorrhea in women

Answer 6

Cimetidine

Question 7

H2 antagonist that inhibits cytochrome P450 isozymes

Answer 7

Cimetidine

Question 8

Lipophilic weak bases that diffuse into the parietal cell canaliculi to irreversibly inhibit proton pumps

Answer 8

PPIs

Question 9

Drug class that forms a covalent disulfide link with a cysteinyl residue in the proton pump

Answer 9

PPIs

Question 10

Drug class of choice in Zollinger-Ellison syndrome, GERD, and PUD.

Answer 10

PPIs

Question 11

Drug class that may decrease oral bioavailability of vit B12 and some drugs that require acidity for absorption

Answer 11

PPIs

Question 12

Omeprazole may inhibit the metabolism of what drugs?

Answer 12

Clopidogrel
Warfarin
Diazepam
Phenytoin

Question 13

PGE1 analogue used to treat GERD and PUD

Answer 13

Misoprostol

Question 14

Primary indication for use of misoprostol

Answer 14

Prevention and treatment of NSAID associated GI injury and blood loss

Question 15

Side effects of misoprostol

Answer 15

Diarrhea
Abdominal cramps
Uterine bleeding and abortion

Question 16

Systemic antacids

Answer 16

Sodium bicarbonate
Sodium citrate

Question 17

Non-systemic antacids

Answer 17

Magnesium hydroxide
Aluminum hydroxide
Calcium carbonate

Question 18

Side effect of magnesium hydroxide

Answer 18

Strong laxative effect (diarrhea)

Question 19

Side effect of aluminum hydroxide

Answer 19

Constipating action

Question 20

Possible side effect of calcium carbonate

Answer 20

Constipation

Question 21

Ulcer protective drugs

Answer 21

Sucralfate
Bismuth compounds
Misoprostol

Question 22

Small molecule that polymerizes in the stomach acid to bind to injured tissue and form a protective layer

Answer 22

Sucralfate

Question 23

Drug that accelerates peptic ulcer healing and reduces recurrence. Needs to be taken Q4D

Answer 23

Sucralfate

Question 24

Side effect of sucralfate

Answer 24

Constipation
Contains aluminum –> avoid in renal disease
Impairs absorption of other drugs

Question 25

Types of bismuth compounds

Answer 25

Bismuth subsalicylate
Bismuth subcitrate potassium

Question 26

Drug class that forms a protective coating on ulcerated tissue and has direct antimicrobial effects

Answer 26

Bismuth compounds

Question 27

Side effects of bismuth compounds

Answer 27

Black stools
Avoid in renal disease
Bismuth toxicity in prolonged use

Question 28

Signs of bismuth toxicity

Answer 28

Encephalopathy
Salicylate toxicity

Question 29

Drug class of pirenzepine

Answer 29

Anticholinergic

Question 30

Antimicrobials effective in treating H pylori infection

Answer 30

Amoxicillin
Clarithromycin
Tetracycline
Metronidazole
Tinidazole

Question 31

Standard of care in treating H pylori

Answer 31

PPI
Two or more of the effective antimicrobials

Question 32

Alternative regimen for treating H pylori

Answer 32

PPI
Bismuth subsalicylate
Metronidazole
Tetracycline

Take for 14 days, or until eradication confirmed

Question 33

Short course sequential therapy for H pylori

Answer 33

5 days of PPI plus amoxicillin
Followed by 5 day of PPI plus clarithromycin plus metronidazole/tinidazole