GASTROINTESTINAL PHARMACOLOGY

Question 1

Neutralize stomach acid

Answer 1

Antacids

Magnesium hydroxide
Aluminum hydroxide
Calcium carbonate
Sodium bicarbonate

Question 2

Competitve pharmacologic block of H2 receptors

Answer 2

H2-receptor antagonists

Cimetidine
Ranitine
Famotidine
Nizatine

Question 3

H2 antagonist that causes gynecomastia

Answer 3

Cimetidine

Question 4

H2 receptor antagonist that is a potent CYP450 inhibitor

Answer 4

Cimetidine

Question 5

Irreversible blockade of H+/K+ATPase in active gastric parietal cells

Answer 5

Proton-pump inhibitor

Omeprazole
Lansoprazole
Rabeprazole
Pantoprazole
Esomeprazole

Question 6

DOC for PUD

Answer 6

PPIs

Question 7

PPI with the least drug-drug interaction

Answer 7

Pantoprazole

Question 8

Binds to injured tissue and forms a protective covering over ulcer beds. Accelerate healing of peptic ulcers and reduces recurrence rate

Answer 8

Sucralfate

Question 9

Activates EP receptors causing increased HCO3 and mucus secretion in stomach. Causes uterine contraction > miscarriage (abortifacient)

Answer 9

Misoprostol

Question 10

Forms protective coating on ulcerated tissue
Stimulates mucosal protective mechanisms
Direct antimicrobial effect
Sequestrations of enterotoxin

Answer 10

BISMUTH SALICYLATE

Dual effect: mucosal protection and bactericidal effect on H. pylori
S/E: Black tarry stools and darkening of the tongue
Reduces stool frequency and liquidity in infectious diarrhea

Question 11

Prokinetic agent that blocks the D2 receptors

Answer 11

Metoclopramide
Domperidone

Question 12

Prokinetic agent that stimulates motilin receptors hence used in bowel prep during surgery to to increase gastric emptying and intestinal motility

Answer 12

Erythromycin

Question 13

DOC for diabetic gastroparesis

Answer 13

Prokinetic agents

Metoclopramide
Domperidone
Erythromycin

Question 14

Benign disorder of colonic pigmentation due to accumulation of brown lipofuscin pigments in macrophages.

Answer 14

Melanosis coli

D/t intake of Anthraquinone-containing laxatives (e.g., Senna)

Question 15

Ingestible, hydrophilic colloids that absorb water, forming a bulky, emollient gel that distend colon and promotes peristalsis

Answer 15

Bulk-forming laxative

Psyllium
Methylcellulose
Polycarbophil
Maltodextrin

Question 16

Soften stool material permitting water and lipids to penetrate

Answer 16

Stool softener

Docusate
Glycerine suppository
Mineral oil

*usually given in patients post-MI to avoid Valsalva

Question 17

Soluble but non-absorbable compounds that result in increased stool liquidity due to an obligate increase in fecal fluid

Answer 17

Osmotic laxative

Lactulose — hepatic encephalopathy
Magnesium oxide
Sorbitol
Magnesium citrate
Sodium phosphate
Polyethylene glycol — endoscopy preparation

Question 18

Directly stimulate enteric nervous system and colonic electrolyte and fluid secretion

Answer 18

Stimulant laxative

Bisacodyl
Aloe
Senna
Cascara
Castor oil

*Melanosis coli

Question 19

Opioid anti-diarrheal agents

Answer 19

Diphenoxylate
Loperamide

Question 20

Non-opioid anti-diarrheal agents

Answer 20

Kaolin + Pectin
Colloidal bismuth
Difenoxin

Question 21

Used for reversal of paralytic ileus

Answer 21

Bethanechol

Question 22

Anti-emetics that blocks chemoreceptor trigger zone and enteric nervous system 5-HT3 receptors

Answer 22

Ondansetron
Granisetron
Dolasetron
Palonosetron
Alosetron
Tropisetron

Question 23

Used in IBD that inhibits production of eicosanoid inflammatory mediators

Answer 23

Mesalamine (5-asa)
Balsalazide
Olsalazine
Sulfasalazine
Mesalazine

Question 24

Decreases the cholesterol content of bile by reducing cholesterol secretion
Used for dissolution of small cholesterol gallstones

Answer 24

Ursodiol (Ursodeoxycholic acid)

Question 25

Therapy used for kidney stones to metabolize them to bicarbonate which alkalinizes urine and raises urinary citrate.
Used in calcium oxalate nephrolithiasis and uric acid lithiasis.

Answer 25

Potassium citrate

S/e: Hyperkalemia > MI

Question 26

An amino acid derivative of quinolone used for mucosal protection, healing of gastroduodenal ulcers and treatment of gastritis. Works by enhancing mucosal defense scavenging free radicals and temporarily activating genes encoding for COX-2

Answer 26

Rebamipide

Question 27

Gastrokinetic benzamide derivative
Inhibit dopamine and Ach esterase
For functional dyspepsia and gastroparesis

Answer 27

Itopride

Question 28

Changes surface tension of gas bubbles and causes collapse of foam bubbles

Answer 28

Simethicone

Question 29

Gastroprokinetic agents
Selective 5HT4 agonist (M1)
Also acts as 5HT3 antagonist — accelerates gastric emptying
Treatment of gastritis, GERD, functional dyspepsia, and IBS

Answer 29

Mosapride

Question 30

Increases the availability if endogenous opioid by inhibiting membrane-bound enkephalinase
Has an antisecretory effect — it reduces the secretion of water and electrolyte into the intestine
Reduces both the frequency and duration of acute diarrhea

Answer 30

Racecadotril

Question 31

Probiotic, has been found to produce antimicrobial substances

Answer 31

Bacillus clausii

Question 32

Hepatoprotectant, an antioxidant, scavenger and regulator of intracellular content of glutathione as cell membrane stabilizers and permeability regulators
Stimulating liver regeneration and inhibitor of transformation of stellate hepatocyes into myofibroblasts

Answer 32

Silymarin

Question 33

Increases biliary secretion, relieves spasms of the bile ducts, enhances metabolic liver function and reduces biliary stasis

Answer 33

Rowachol

Question 34

Potent venotropic drug, treatment of venous insufficiency, increases venous tone, improves lymph drainage, and protects microcirculation

Answer 34

Daflon

Question 35

Arrest bleeding by coagulating blood protein and inducing the muscle fibers of small blood vessels to contract

Answer 35

FAKTU