GI

Question 1

cimetidine (famotidine, ranitidine, -dine)

Answer 1

• H2-antagonist, CYP450 inhibitor, used for peptic ulcers

- increased prolactin leads to decreased libido, impotence, gynecomastia

Question 2

bismuth

Answer 2

binds ulcers creating physical barrier

Question 3

omeprazole

Answer 3

PPI, binds irreversibly to H+ pumps

Question 4

misoprostol

Answer 4

• prostaglandin E1 analog, used specifically to treat NSAID ulcers, contraindicated in pregnant women
• used as medically induced abortive agent

Question 5

ondansetron

Answer 5

5HT-3 antagonist, side effects: headache, constipation, urinary retention

Question 6

statins (side effects)

Answer 6

myopathy, metabolized by CYP450 - interactions can lead to severe muscle pain

Question 7

D-penicillamine

Answer 7

copper chelator - Tx for wilson’s disease

Question 8

deferoxamine

Answer 8

iron chelator - Tx for hemochromatosis (bronze diabetes)

Question 9

metronidazole

Answer 9

• tx for c. diff
• induces DNA damage in anaerobes
• combined with alcohol, disulfram reaction!

Question 10

milk of magnesia

Answer 10

antacid that causes diarrhea

Question 11

aluminum hydroxide

Answer 11

antacid that causes constipation

Question 12

infliximab

Answer 12

• antibody directed at TNF-alpha

- Tx: refractory chrons

Question 13

metocloprimide

Answer 13

• D2 receptor antagonist
• used to treat gastroparesis
• SE: extrapyramidal symptoms, parkinsonism, akasthesia

Question 14

octreotide

Answer 14

• antagonizes serotonin at level of the receptor (Tx carcinoid)
• basically a synthetic somatostatin, decrease GI acid, motility, inhibit hypothalamus
• inhibits growth hormone at level of hypothalamus

Question 15

gemfibrizole

Answer 15

• increase activity of lipoprotein lipase
• large decrease in triglycerides, small decrease in LDL, small increase in HDL
• contraindicated in Tx of high cholesterol with gallstones

Question 16

azathiopine

Answer 16

• immuno suppressive, works by inhibiting purine synthesis

Question 17

sulfasalazine

Answer 17

• combination of anti-bacterial/anti-inflammatory

- used in Tx of UC

Question 18

rifaximin

Answer 18

• not systemically available antibiotic

- used to treat GI infections, especially E. coli (not 0157:H7)

Question 19

ezetimibe

Answer 19

• prevents cholesterol absorption at brush border, mild reduction in LDL
• NOT helpful in decreasing CV events
• appropriate Tx for LDL w/concern for gall stones, PROTECTIVE

Question 20

itraconozole

Answer 20

• anti-fungal

- potent CYP450 inhibitor

Question 21

macrolides

Answer 21

-erythromycin: more side effects, acute liver tox possible inhibits 50s subunit of ribosome

Question 22

pegylated interferon

Answer 22

• used in tx of HCV

- SE: flu like symptoms (fever/chills) and severe depression

Question 23

NAC (N-Acetylcystine) - MOA

Answer 23

-reducing agent, promotes formation of glutathione

Question 24

ketoconazole

Answer 24

• antifungal, MOA: inhibit fungal CYP450
• some cross reactivity with liver CYP450
• gynecomastia due to hormone synthesis inhibition

Question 25

infliximab

Answer 25

• monoclonal chimeric antibody
• tx for autoimmune (refractory chron’s, but also other autoimmute)
• MOA: binds and inactivates free TNF-alpha

Question 26

nystatin

Answer 26

• antifungal, tx for candida albicans

- binds ergosterol and forms pores in membranes

Question 27

tetracyclines

Answer 27

• inhibit 30s subunit of ribosomes

- tx: mycoplasma pneumonia, rickettsia rickettsii, chlamydia, borellia burgdorferi

Question 28

floroquinolones

Answer 28

• inhibit toposiomerase II
• tx: shigella
• SE: prolong QT interval

Question 29

penicillamine

Answer 29

-tx: for copper overload, Wilson’s Dz

Question 30

orlistat

Answer 30

• inhibits pancreatic lipase

- leads to intentional malabsorption of fats (and fat soluble vitamins)…steatorrhea