First Aid GI pharm - First Aid GI pharm (1)

Question 1

4 H2 blockers

Answer 1

cimetidine, ranitidine, famotidine, nizatidine

Question 2

MOA of H2 blockers

Answer 2

reversibly block H2 receptors which causes decreased H+ secretion by gastric parietal cells

Question 3

cimetidine toxicities

Answer 3

P450 inhibitor; antiandrogenic; crosses BBB (confusion, HAs, dizziness) and placenta

Question 4

2 proton pump inhibitors

Answer 4

omeprazole, lansoprazole

Question 5

MOA of PPIs

Answer 5

irreversibly bind H+/K+ ATPase in gastric parietal cells

Question 6

MOA of bismuth, sucralfate

Answer 6

bind to ulcer base and provide physical protection, allow bicarb secretion to reestablish pH gradient in mucous layer

Question 7

triple tx of H. pylori?

Answer 7

metronidazole + bismuth + amoxicilin/tetracycline

Question 8

MOA of misoprostol

Answer 8

PGE1 analog, that increases production and secretion of gastric mucous barrier and decreases acid production

Question 9

toxicity/contraindications for misoprostol

Answer 9

(PGE1 analog) diarrhea, not for women of childbearing potential

Question 10

which 2 muscarinic antagonists used for treatment of peptic ulcer?

Answer 10

pirenzepine, propantheline

Question 11

toxicities of pirenzepine and propantheline?

Answer 11

tachycardia, dry mouth, difficulty focusing eyes

Question 12

overuse of aluminum hydroxide can cause what problems?

Answer 12

(antacid) constipation, hypophosphatemia, proximal mm weakness, osteodystrophy, seizures

Question 13

overuse of magnesium hydroxide can cause what problems?

Answer 13

(antacid) diarrhea, hyporeflexia, hypotension, cardiac arrest

Question 14

overuse of calcium carbonate can cause what problems?

Answer 14

(antacid)hypercalcemia, rebound acid increase

Question 15

MOA of infliximab

Answer 15

monoclonal TNF-alpha ab

Question 16

clinical use of infliximab

Answer 16

Crohn’s dz, rheumatoid arthritis

Question 17

infliximab toxicity

Answer 17

respiratory infection, fever, hypotension

Question 18

MOA sulfasalazine

Answer 18

combo antibacterial (sulfapyridine) and anti-inflammatory (mesalamine); activated by colonic bacteria

Question 19

clinical use of sulfasalazine

Answer 19

UC, Crohn’s disease

Question 20

toxicity of sulfasalazine (5)

Answer 20

malaise, nausea, sulfonamide toxicity, reversible oligospermia

Question 21

MOA of ondansetron

Answer 21

5-HT3 antagonist (powerful central acting anti emetic)

Question 22

clinical use of ondansetron

Answer 22

antiemetic; to control vomiting post-op and in pts undergoing chemotherapy

Question 23

toxicity of ondansetron

Answer 23

headache, constipation

Question 24

MOA of cisapride

Answer 24

acts thru serotoni R to increase Ach release at myenteric plexus; increases esophageal tone; increases gastric and duodenal contracitlity and improves transit time (prokinetic)

Question 25

Clinical use of cisapride

Answer 25

prokinetic (on GIT) but no longer used because of serious interactions with erythromycin, ketoconazole, nefazodone, fluconazole (–>torsades de pointes!)

Question 26

MOA of metoclopramide

Answer 26

D2 R antagonist; increases resting tone, contractility, LES tone, motility but does not increase transit time thru colon. (pro-kinetic)

Question 27

clinical use of metoclopramide

Answer 27

diabetic and post-surgery gastroparesis

Question 28

toxicity of metoclopramide

Answer 28

(D2 R antag). Increased Parkinsonian effects; restlessness, drowsiness, fatigue, depression, nausea, constipation.

Question 29

drug interactions of metoclopramide

Answer 29

digoxin and diabetic agents

Question 30

contraindications for metoclopramide?

Answer 30

(D2 R antag) pts with small bowel obstruction