Exam 1 Pharm: PUD and GERD

Question 1

Suffix for H2 receptor agonists

Answer 1

-tidine

Cimitidine
Famotidine
Nizatidine

Question 2

Suffix for Proton Pump Inhibitors

Answer 2

-prazole

Lansoprazole (Dexlansoprazole)
Omeprazole (Esomeprazome)
Pantoprazole
Rabeprazole

Question 3

Isomer of Lansoprazole

Answer 3

Dexlansoprozole

Question 4

Isomer of Omeprazole

Answer 4

Esomeprazole

Question 5

Surface acting agent

Answer 5

Sucralfate

Question 6

PGE1 Analog

Answer 6

Misoprostol

Question 7

Bismuth Compound

Answer 7

bismuth subsalicylate

Question 8

H2 blocker MOA

Answer 8

reversibly binds H2 receptor on parietal cell, decreases intracellular cAMP, decreased acid release

Question 9

Cimitidine adverse effect

Answer 9

decreases testosterone binding to androgen receptor

gynecomastia in men
galactorrhea (milky nip discharge) in women

Question 10

Which two PUD/GERD drugs are CYP450 inhibitors

Answer 10

Cimetidine, Omeprazole

increase toxicity of other drugs metabolized by CYP450

Question 11

PUD/GERD drugs relatively contraindicated in pregnancy

Answer 11

H2 blockers, PPIs, Misoprostol (induces labor)

Question 12

PPI MOA

Answer 12

covalently bind to H+/K+ ATPase on parietal cell, irreversibly inhibiting gastric acid secretion

Question 13

Rare PPI adverse effect

Answer 13

C. Diff associated diarrhea

Question 14

Sucralfate MOA

Answer 14

Surface acting agent

Undergoes cross linking due to stomach acid interactions, polymer adheres to epithelial cells around ulcer’s crater

Question 15

Sucralfate adverse effect

Answer 15

constipation

Question 16

Sucralfate contraindications

Answer 16

avoid in pts with severe renal failure

drug interactions possible, plan doses around other drugs

Question 17

Misoprostol MOA

Answer 17

PGE1 analog

Stimulates mucus production from gastric mucose

Inhibits cAMP pathway in parietal cell, decreasing acid release (weaker than PPI or H2 blocker)

Question 18

Misoprostol indication

Answer 18

Porphylaxis of NSAID-induced gastric ulceration (i.e. chronic pain pt.)

Question 19

Bismuth subsalicylate MOA

Answer 19

Antimicrobial, prevents H. Pylori attachment to gastric mucosa, inactivates enterotoxin, disrupts cell wall

Question 20

Bismuth subsalicylate adverse effects

Answer 20

Black/dark regularly formed stools (may alarm pt. dont get tricked into thinking GI bleed)

Drug interactions

Question 21

Bismuth subsalicylate contraindications

Answer 21

-salicylate (similar to aspirin NSAID)

Do not use in pt on anticoagulants or renal failure

Salicylate hypersensitivity