Gastro - FA Pharm p392 - 394

Question 1

name 4 H2 blockers

Answer 1

cimetidine, ranitidine, famotidine, nizatidine

Question 2

what is the mech of H2 blockers?

Answer 2

reversible block of histamine H2 receptors –> dec proton secretion by parietal cells

Question 3

among H2 blockers, what is unique about cimetidine?

Answer 3

inhibitor of P450 and also has antiandrogenic effects (prolactin release, gynecomastia, impotence, dec libido in males)

Question 4

what 2 H2 blockers dec renal excretion of creatinine?

Answer 4

cimetidine, ranitidine

Question 5

mech of proton pump inhibitor?

Answer 5

irreversible inhibition of H+/K+ ATPase

Question 6

Side effects of PPI?

Answer 6

1. inc risk of C. difficle infection 2. pneumonia 3.acute interstitial nephritis 4. dec serum Mg2+ with long term use 5. dec Ca2+ absorption

Question 7

does PPI inhibit or induce P450?

Answer 7

inhibit (omeprazole)

Question 8

name 3 antacids

Answer 8

1. aluminum hydroxide 2. calcium carbonate 3. magnesium hydroxide

Question 9

which antacid can chelate and dec the effectiveness of drugs such as tetracycline, fluoroquinolones

Answer 9

calcium carbonate

Question 10

what is the common side effect of all antacid?

Answer 10

hypokalemia

Question 11

mech of bismuth, sucralfate?

Answer 11

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

Question 12

bismuth is also used is what other path?

Answer 12

H. pylori (Quadruple tx: PPI, bismuth, metronidazole, tetracycline)

Question 13

which drug is a prodrug that requires acid to be activated?

Answer 13

sucralfate - needs acid, cannot be given w/ PPI or H2B

Question 14

what is the drug that ripens cervix?

Answer 14

misoprostol (PGE1 analog)

Question 15

What is misoprostol used for ?

Answer 15

Prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production)

Question 16

4 clinical applications for octreotide

Answer 16

1. variceal bleeds 2. acromegaly 3. VIPoma 4. carcinoid tumors

Question 17

Octreotide inc risk for ______ due to _______ __________

Answer 17

Inc risk of cholelithiasis due to CCK inhibition.

Question 18

what is sulfasalazine?

Answer 18

combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)

Question 19

sulfasalazine need to be activated by

Answer 19

colonic bacteria

Question 20

3 clinical usage for sulfasalazine?

Answer 20

1. UC 2. Crohn (colitis component) 3. rheumatoid arthritis

Question 21

`Why can sulfasalazine lead to fertility problems?

Answer 21

can lead to reversible oligospermia

Question 22

MoA and use of loperamide

Answer 22

Agonist at μ-opioid receptors; slows gut motility.

Use - Diarrhea

Question 23

what is the target of ondansetron?

Answer 23

5HT3 (-)’r in CTZ, dec CN X stimulation

Question 24

side effects of ondansetron?

Answer 24

Headache, constipation, QT interval prolongation, serotonin syndrome.

Question 25

2 mechanisms of ondansetron?

Answer 25

1. dec vagal stimulation 2. powerful central acting antiemetic

Question 26

side effects of metoclopramide?

Answer 26

inc parkinsonian effects, tardive dyskinesia, restlessness, drowsiness, diarrhea

Question 27

2 conditions that are contraindicated to metoclopramide?

Answer 27

small bowel obstruction, parkinson dz

Question 28

what is the clinical app for metoclopramide?

Answer 28

diabetic and postsurgery gastroparesis, antiemetic, persistent GERD

Question 29

what is metoclopramide?

Answer 29

D2 receptor antagonist

Question 30

metoclopramide can interact with what kinds of drugs?

Answer 30

Digoxin, diabetic agents

Question 31

name of the drug that blocks gastric/pancreatic lipase

Answer 31

Orlistat

Question 32

what is the clinical app of orlistat?

Answer 32

weight loss (dec breakdown and absorption of dietary fats)

Question 33

side effects of orlistat?

Answer 33

Abdominal pain, flatulence, bowel urgency/frequent bowel movements, steatorrhea; dec absorption of fat-soluble vitamins.

Question 34

name 4 osmotic laxatives

Answer 34

1. magnesium hydroxide 2. magnesium citrate 3. polyethylene glycol (prep for colonoscopy) 4. lactulose

Question 35

the mech of osmotic laxatives?

Answer 35

provide osmotic load to draw water into the GI lumen

Question 36

Drug used for chemo induced n/v

Answer 36

Aprepitant, substance P antagonist (-) NK1 receptors in brain

Question 37

Dronabinol - mech and use?

Answer 37

cannibinoid, dec n/v post chemo (last choice)

Question 38

Mineral oil is used for? caution

Answer 38

as stool softener, (-) fat soluble vitamin absorption

Caution in elderly - risk of aspiration

Question 39

SE risk for diphenoxylate

Answer 39

rebound constipation , mild sedation

Question 40

What do u give to dec dependence to Diphenoxylate

Answer 40

Atropine - inc SE if overdose