Drugs Peptic Ulcers/Acidity

Question 1

Antacid Mech

Answer 1

• Binding H+

- Stimulating EP3 -> INC PGE

Question 2

Antacid AE

Answer 2

• distention/belching
• NaCl -> Fluid absorption
• NaHCO3 -> Metabolic alkalosis

Question 3

Milk-Alkali syndrome

Answer 3

Milk + Tums –> Hypercalcemia, renal insufficiency, hyperphosphatemia, Nephrolithiasis

Question 4

Antacids containing Mg or Al can lead to?

Answer 4

Diahrrea or Constipation

Question 5

Antracid Drug interactions

Answer 5

• tetracycline
• fluoroquinolones
• itraconazole
• Fe

Question 6

H2 Receptore antagonist

Answer 6

• “-tidine”
• T1/2: 1-4 H
• Hepatic + Renal elimination -> Dose reduction in Dx

Question 7

Other indication for Cimetidine (besids GI)

Answer 7

Warts

Question 8

H2 antagonist AE

Answer 8

• CNS effects in rapidly infused elderly
• High dose/ long period -> Gynecomastia or Galactorrhea
• B12 deficiency
• Heart problems

Question 9

H2 antagonist interactions

Answer 9

• antacids reduce absorption
• Cimetidine inhibitis CYP450
• ALL compete w/ procainamide for renal tube secretion

Question 10

PPI Pk

Answer 10

• 50% reduced availabilioty w/ food
• T1/2 1.5 H
• 3-4 days for maximum effectiveness

Question 11

PPI AE

Answer 11

• Diahhrea, HEadache, abdominal pain

- DEC Clopidogrel effectiveness (CYP2C19)

Question 12

PPI interactions

Answer 12

• reduced absoprtion of ketoconazole + Digoxin

Question 13

Misoprostol

Answer 13

• PGE analogue
• Stimulats intestinal secretions, motility, + Uterine contractions
• Uses: NSAID Ulcers, abortion

Question 14

Sucralfate

Answer 14

• covers ulcer site to protect against further damage
• No change in pH
• Take on empty stomach and avoid antacids

Question 15

Bismuth salicylate Mech

Answer 15

• Coats ulcers, stimulates PGE + HCO3 secretion

- antimicrobial

Question 16

Bismuth Salicylate AE

Answer 16

• Blackening of stool;
• Darkening of tongue
• CNS prolonged use
• Salicylate toxicity