GASTROINTESTINAL

Question 1

Which H2 blocker is the most potent blocker of the CYP450 system?

Answer 1

cimetidine

Question 1

What are the AE of misoprostol? In whom is it contraindicated?

Answer 1

diarrhea; CI in pregnant because abortifacient

Question 1

What effect does metoclopromide have on colon transport time?

Answer 1

NONE, it only affects the stomach and LES

Question 2

Cimetidine can cause the release of what anterior pituitary hormone?

Answer 2

prolactin i.e. causes gynecomastia

Question 2

Which receptor is antagonized by PPI’s?

Answer 2

H/K ATPase on parietal cells

Question 2

Which GI drug is a D2 receptor antagonist?

Answer 2

metoclopromide

Question 4

Misoprostol is a PG__1 analog

Answer 4

E

Question 4

What other disorder aside from constipation can lactulose be used to treat, why?

Answer 4

hepatic encephalopathy because gut flora degrade it into lactic and acetic acid which help to draw out ammonia, thus decreasing their hyperammonemia

Question 5

What electrolyte imbalance may be caused by ALL antacids?

Answer 5

hypokalemia

Question 6

3 indications for H2 blockers?

Answer 6

PUD, gastritis, and MILD esophageal reflux

Question 6

Which osmotic laxative is also an antacid?

Answer 6

Magnesium hydroxide – this explains diarrhea being an AE

Question 7

People on PPI’s are at increased risk of what infection?

Answer 7

Clostridium difficile (contrarily, these drugs are used to treat infections with H pylori)

Question 9

Which osmotic laxative is also used to Tx hepatic encephalopathy?

Answer 9

lactulose

Question 10

All H2 blockers end in _____ while all PPI’s end in ________

Answer 10

dine; prazole

Question 10

What are 4 osmotic laxatives?

Answer 10

Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

Question 12

Sulfasalazine would be contraindicated in treating a patient with an allergy to what?

Answer 12

sulfa drugs i.e. it contains sulfapyridine

Question 12

What ist he black box warning on metoclopromide?

Answer 12

tardive dyskinesia

Question 13

What is the toxicity of octreotide?

Answer 13

can cause steatorrhea, and nausea/cramping

Question 14

Which antacids can chelate and decrease absorption of tetracyclines?

Answer 14

CaCO3 or just Ca containing antacids

Question 16

Which antacids cause constipation and which cause diarrhea?

Answer 16

Aluminum containing ones cause constipation and Mg containing ones cause diarrhea (Mg = Must Go)

Question 17

Why would metoclopromide possibly work for GERD (it isnt indicated for it, just asking about a concept)

Answer 17

it increases LES tone

Question 19

What are 3 clinical indications for misoprostol?

Answer 19

prevent NSAID-induced ulcers, maintain patent ductus arteriosus, induce labor by ripening cervix

Question 19

What are 4 clinical indications for octreotide?

Answer 19

ACUTE variceal bleeding, VIPoma, carcinoid syndrome, and acromegaly

Question 19

What are the major AE of infliximab?

Answer 19

infection and reactivation of latent TB, fever, hypotension

Question 20

A man with ulcerative colitis is receiving treatment but finds that he and his wife cannot conceive, why?

Answer 20

sulfasalazine causes reversible oligospermia

Question 21

How do PPI’s inhibit the receptor?

Answer 21

IRREVERSIBLY

Question 23

Which antacid is most likely to cause cardiac arrest?

Answer 23

Magnesium hydroxide

Question 25

In which way do H2 blockers antagonize the receptor?

Answer 25

REVERSIBLY

Question 27

Which H2 blockers decrease renal secretion of creatinine?

Answer 27

cimetidine and ranitidine

Question 29

Which cells are affected by H2 blockers and PPI’s?

Answer 29

parietal cells (secrete H and IF)

Question 30

Which antacids can cause a rebound increase in acid and hypercalcemia?

Answer 30

Calcium Carbonate

Question 31

Infliximab is a monoclonal antibody against ______. What 3 diseases can it Tx?

Answer 31

TNF alpha; Crohn’s, UC, and Rheumatoid arthritis

Question 33

What are the indications for metoclopromide?

Answer 33

Diabetic and Post-Surgery Gastroparesis and it is used as an anti-emetic

Question 34

What is the MOA of ondansetron?

Answer 34

centrally acting 5-HT3 antagonist, prevents emesis in chemotherapy

Question 35

What antibiotic can be used to Tx gastroparesis? MOA?

Answer 35

erythromycin; motilin analog

Question 36

Which antacids can cause proximal muscle weakness, osteodystrophy, and seizures

Answer 36

Aluminum containing ones, in addition to constipation

Question 37

Which drugs are used to bind to the base of ulcers and promote healing and can also be used to Tx travelers diarrhea?

Answer 37

Bismuth and Sucralfate

Question 38

Who might abuse osmotic laxatives? And the Tx for their disorder is?

Answer 38

Bulimics; SSRI’s

Question 39

In whom is metoclopromide contraindicated?

Answer 39

patients with small bowel obstruction or Parkinson’s disease

Question 40

In addition to PUD, GERD and gastritis (which are indications for H2 blockers), PPI’s can additionally Tx what disease?

Answer 40

Zollinger Ellison Syndrome

Question 41

What is sulfasalazine a combination of?

Answer 41

Sulfapyridine ( a sulfa drug) and 5 aminosalycylic acid

Question 42

What drug is given in the treatment of acute variceal bleeding? MOA?

Answer 42

octreotide; long acting somatostatin analog

Question 43

If a man was given a drug for “stomach problems” and developed gyncecomastia, what was he most likely given?

Answer 43

cimetidine it has antiandrogenic effects