FA GI Pharm

Question 1

Reversible block of histamine H2-receptors –> decreased H+ secretion by parietal cells

Answer 1

H2 blockers

Question 2

Irreversibly inhibit H+/K+ ATPase in stomach parietal cells

Answer 2

Proton pump inhibitors

Question 3

Bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

Answer 3

Bismuth, sucralfate

Question 4

A PGE1 analog. Increased production and secretion of gastric mucous barrier, decreased acid production

Answer 4

Misoprostol

Question 5

Long-acting somatostatin analog

Answer 5

Octreotide

Question 6

Provide osmotic load to draw water out

Answer 6

Osmotic laxatives

Question 7

treats hepatic encephalopathy since gut flora degrade it into metabolites (lactic acid and acetic acid) that promote nitrogen excretion as NH4+

Answer 7

Lactulose

Question 8

Monoclonal antibody to TNF-alpha

Answer 8

Infliximab

Question 9

A combination of sulfapyridine (antibacterial) and 5-aminosalicyclic acid (anti-inflammatory). Activated by colonic bacteria.

Answer 9

Sulfasalazine

Question 10

5-HT3 antagonist; decreased vagal stimulation. Powerful central-acting antiemetic

Answer 10

Ondansetron

Question 11

D2 receptor antagonist. Increased resting tone, contractility, LES tone, motility. Does not influence colonic transport time

Answer 11

Metoclopramide

Question 12

CU: peptic ulcer, gastritis, mild esophageal reflux

Answer 12

H2 blockers

Question 13

Ex: cimetidine, ranitidine, famotidine, nizatidine

Answer 13

H2 blockers

Question 14

Ex: omeprazole, lanzoprazole, esmoeprazole, pantoprazole, dexlansoprazole

Answer 14

PPIs

Question 15

CU: peptic ulcer, gastritis, esophageal reflux, ZES

Answer 15

PPIs

Question 16

Tox: increased risk of C diff infxn, pneumonia, hip fractures, decreased serum Mg with long term use

Answer 16

PPIs

Question 17

CU: increased ulcer healing, traveler’s diarrhea

Answer 17

Bismuth, sucralfate

Question 18

Potent inhibitor of cytochrome P450; anti androgen effects; can cross BBB and placenta, decreases renal excretion of creatinine

Answer 18

Cimetidine

Question 19

CU: prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production); maintenance of a PDA; also used to induce labor (“ripens cervix”).

Answer 19

Misoprostol

Question 20

Tox: Diarrhea, abortifacient

Answer 20

Misoprostol

Question 21

CU: acute variceal bleeds, acromegaly, VIPoma, carcinoid

Answer 21

Octreotide

Question 22

Tox: nausea, cramps, steatorrhea

Answer 22

Octreotide

Question 23

Tox (group): can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying; hypokalemia

Answer 23

Antacids

Question 24

Tox: Constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures

Answer 24

Aluminum hydroxide

Question 25

Tox: Hypercalcemia, rebound acid increase, can chelate and decrease effectiveness of other drugs (tetracycline)

Answer 25

Calcium carbonate

Question 26

Tox: diarrhea, hyporeflexia, hypotension, cardiac arrest

Answer 26

Magnesium hydroxide

Question 27

Cu: constipation

Answer 27

osmotic laxatives

Question 28

Ex: Mg hydroxide, Mg citrate, polyethylene glycol, lactulose

Answer 28

osmotic laxatives

Question 29

CU: Crohn's, UC, RA, ankylosing spondylitis, psoriasis

Answer 29

Infliximab

Question 30

CU: UC, Crohn's

Answer 30

Sulfasalazine

Question 31

CU: control vomiting postoperatively and in pts undergoing cancer chemotherapy

Answer 31

Ondansetron

Question 32

CU: diabetic and post-surgery gastroparesis, antiemetic

Answer 32

Metoclopramide

Question 33

Tox: diarrhea, dehydration; may be abused by bulimics

Answer 33

osmotic laxatives

Question 34

Tox: infection, reactivation of latent TB, fever, hypotension

Answer 34

Infliximab

Question 35

Tox: malaise, nausea, sulfonamide toxicity, reversible oligospermia

Answer 35

Sulfasalazine

Question 36

Tox: headache, constipation

Answer 36

Ondansetron

Question 37

Tox: increased parkinsonian effects. restlessness, drowsiness, fatigue, depression, nausea, diarrhea.

Answer 37

Metoclopramide

Question 38

Metoclopramide is notable for drug interactions with what types of meds?

Answer 38

Digoxin, diabetic agents

Question 39

Metoclopramide is contraindicated in what conditions?

Answer 39

Small bowel obstruction or Parkinson dz (D1-receptor blockade)