GI

Question 1

Reversible H2-receptor block

Decreases H+ secretion by parietal cells

Peptic ulcer, gastritis, mild esophageal reflux

Answer 1

H2 blockers:

Cimetidine, rantidine, famotidine, nizatidine

Question 2

P450 inhibitor

Antiandrogenic effects

(prolactin release, gynecomastia, impotence, decreased libido in males)

Confusion, dizziness, headaches (cross BBB)

Crosses placenta

Decreases renal excretion of creatinine

Answer 2

Side effects of: Cimetidine

Question 3

Decreases H+ secretion by parietal cells

Decreases renal excretion of creatinine

(2)

Answer 3

Cimetidine, ranitidine

(H2 receptor blockers)

Question 4

Irreversibly inhibit H+/K+ ATPase in parietal cells

Peptic ulcer, gastritis, esophageal reflux,

Zollinger-Ellison syndrome

Increased risk of C. diff infection, pneumonia,

long-term use: hip fractures, low serum Mg2+

Answer 4

Proton pump inhibitors

Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole

Question 5

Physically protects ulcer,

allows HCO3- secretion to restore pH

Ulcer healing, traveler’s diarrhea

Answer 5

Bismuth, sucralfate

Question 6

PGE1 analog

Increased production of gatric mucous barrier

Decreases acid production

Prevents NSAID-induced peptic ulcers

Maintains patent ductus arteriosus, induces labor

Diarrhea, contraindicated for fertile women

Answer 6

Misoprostol

Question 7

Somatostatin analog

Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

Nausea, cramps, steatorrhea

Answer 7

Ocreotide

Question 8

Can cause hypokalemia

Can affect absorption, bioavailability, urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying

Answer 8

Antacid use

Question 9

Overuse of which antacid causes:

Constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures

Answer 9

Aluminum hydroxide

(Aluminimum amout of feces)

Question 10

Overuse of which antacid causes:

Diarrhea, hyporeflexia, hypotension, cardiac arrest

Answer 10

Magnesium hydroxide

(Mg = must go to bathroom)

Question 11

Overuse of which antacid causes:

hypercalcemia, rebound acid secretion

Can chelate and decrease effectiveness of other drugs (i.e. tetracycline)

Answer 11

Calcium carbonate

Question 12

Draws water out by osmosis…

(4)

Constipation

SE: diarrhea, abuse by bulimics

Answer 12

Osmotic laxatives

Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

Question 13

Treats hepatic encephalopathy

Promotes gut excretion of NH4+

Lactic acid and acetic acid metabolites

Answer 13

Lactulose

Gut flora degrades into metabolites, promotes ammonium excretion

Question 14

TNF-alpha antibody

Crohn’s, ulcerative colitis, rheumatoid arthritis

SE: infection, reactivation of latent TB, fever, hypotension

Answer 14

Infliximab

Question 15

Activated by colonic bacteria

Sulfapyridine + 5-ASA

Ulcerative colitis, Crohn’s

SE: malaise, nausea, sulfonamide toxicity, reversible oligospermia

Answer 15

Sulfasalazine

Question 16

5-HT3 antagonist

Centrally acting antiemetic

Control postoperative vomiting and in chemo

SE: headache, constipation

Answer 16

Ondansetron

Question 17

D2 receptor antagonist

Increases:

Resting tone, contractility, LES tone, motility (except colon)

Diabetic and post-surgery gastroparesis, antiemetic

Parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrhea.

Contra: small bowel obstruction or Parkinson’s

Answer 17

Metoclopramide

Interactions with digoxin, diabetic agents