Gastrointestinal

Question 1

Examples of Antacids

Answer 1

Magnesium oxide, magnesium hydroxide, aluminum oxide and calcium carbonate

Question 2

MOA of antacids

Answer 2

buffers neutralize gastric acids and decrease pH-dependent conversion of pepsinogen to pepsin (increasing gastric pH to above 3.5 reduces proteolysis catalyzed by pepsin); reduces gastric damage to mucosal lining

Question 3

Therapeutic effects of antacids

Answer 3

Reduces gastritis and peptic ulcer disease

Question 4

Examples of antimicrobials and antibiotics

Answer 4

amoxicillin and/or tetracycline

Question 5

MOA of bismuth

Answer 5

bismuth increases mucus secretion and disrupts bacterial cell wall adhesion to gastric mucosa, reduces bacterial damage

Question 6

MOA of antibiotics in gastric pharmacology

Answer 6

antibiotics inhibit bacterial cell growth and eliminate infection by H. Pylori

Question 7

Therapeutic effect of antimicrobials and antibiotics

Answer 7

to treat peptic ulcer disease, gastritis and H. Pylori

Question 8

Examples of histamine receptor antagonists

Answer 8

cimetidine and rantidine

Question 9

MOA of histamine receptor antagonists

Answer 9

parietal cell H2 histamine receptor antagonist; blocks activation of proton pump

Question 10

therapeutic effect of histamine receptor antagonists

Answer 10

treatment of peptic ulcer disease, gastritis and GERD

Question 11

examples of proton pump inhibitors

Answer 11

omeprazole and esomeprazole

Question 12

MOA of proton pump inhibitors

Answer 12

drugs directly inhibit proton pump on parietal cells; slow onset of action

Question 13

therapeutic effects of proton pump inhibitors

Answer 13

treatment of GERD, peptic ulcer disease, gastritis, esophagitis and esophageal bleeding

Question 14

Examples of synthetic prostaglandins

Answer 14

misoprostol

Question 15

MOA of synthetic prostaglandins

Answer 15

prostaglandin receptor agonist along GI tract; mimics the inhibitory effects of prostaglandins on parietal cells

Question 16

therapeutic effect of synthetic prostaglandins

Answer 16

treat gastritis, peptic ulcer disease caused by steroid and other drugs (NSAIDs)

Question 17

Example of anti-diarrheal agents

Answer 17

loperamide

Question 18

MOA of anti-diarrheal agents

Answer 18

opioid receptor agonist along GI tract; mimics inhibitory effects of endorphins

Question 19

therapeutic effects of anti-diarrheal

Answer 19

treating diarrhea

Question 20

examples of prokinetic medications

Answer 20

metoclopramide and erythromycin

Question 21

MOA of metoclopramide

Answer 21

a D2 receptor antagonist that suppresses the inhibitory effects of dopamine on cholinergic smooth muscle contractions along the GI tract.

Question 22

MOA of erythromycin

Answer 22

Erythromycin is a motilin receptor agonist that triggers smooth muscle contractions on the GI tract

Question 23

therapeutic effect of prokinetic medications, specifically metoclopramide

Answer 23

metoclopramide is used in the treatment of delayed gastric emptying due to diabetic gastroparesis and GERD.

Question 24

therapeutic effect of prokinetic medications, specifically erythromycin

Answer 24

Erythromycin is used before endoscopies for emptying

Question 25

Example of a human guanylin and uroguanylin agonist

Answer 25

linaclotide

Question 26

MOA of human guanylin and uroguanylin agonists

Answer 26

guanylin acts as an agonist of the guanylyl cyclase receptor that regulates electrolyte and water transport into the lumen of the intestine. Linacotide is a guanylin/guanylate cyclase-c agonist. Draws more water into the stool by bringing more sodium and bicarb into the lumen. Water follows.

Question 27

Therapeutic effect of linaclotide

Answer 27

Linaclotide is used in the treatment of Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation

Question 28

things to consider to educate the patient when taking linaclotide

Answer 28

Linzess should be taken on an empty stomach at least 30 minutes before the first meal of the day. Taking linaclotide (Linzess) immediately after the high fat breakfast results in looser stools and a higher stool frequency compared with taking it in the fasted state.

Question 29

true or false: patients with cystic fibrosis do NOT have the cystic fibrosis transmembrane conductance regulator (CFTR)

Answer 29

true

Question 30

What are proton pumps?

Answer 30

Proton pumps are found in parietal cells. When stimulated by histamine 2 proton pumps will pump H+ into the stomach which will contribute to hydrochloric acid. When prostaglandins are present in a parietal cell, the proton pumps are turned off.

Question 31

What are gastric endocrine cells?

Answer 31

extrachromaffin-like cells that are located near parietal cells, contain receptors for gastrin and ACh that when activated trigger the release of histamine that then interacts with parietal cells.

Question 32

what pH does the gastric content need to be, to convert pepsinogen to pepsin?

Answer 32

less than 3.5

Question 33

what does pepsin break down?

Answer 33

proteins

Question 34

What neurotransmitter inhibits cholinergic control of peristalsis?

Answer 34

dopamine

Question 35

What hormone enhances gastric motility?

Answer 35

motilin

Question 36

Why should a pt not take metoclopramide for prolonged periods of time?

Answer 36

it may cause tardive dyskinesia d/t its persistent dopamine antagonistic effect

Question 37

MOA of dicyclomine (bentyl)

Answer 37

cholinergic receptor antagonist in the GI system; suppresses peristalsis and spasms

Question 38

Treatment of inflammatory bowel disease (could also be used for RA)

Answer 38

Infliximab; it is an IV infusion. Antibody to tumor necrosis factor. Immune system suppressant. Must test for latent TB before administering