GI Drugs

Question 1

examples of antacids

Answer 1

• sodium bicarbonate
• calcium carbonate
• magnesium hydroxide
• aluminum hydroxide

Question 2

moa of antacids

Answer 2

• weak bases react with gastric hcl to form salt and water (neutralizing)
• inhibit peptic activity
• can increase acid production
• liquids > chewables
• onset 5-15 mins, duration 2 hrs

Question 3

clinical use of antacids

Answer 3

• fast relief of gastric discomfort
• dyspepsia
• peptic ulcer and ger

Question 4

side effect of antacids

Answer 4

• less absorption of other medications

- dont give with tetracyclines, fluoroquinolones, itraconazole, and iron

Question 5

moa to h2 receptor antagonists

Answer 5

• histamine from enterochromaffin like cells is blocked
• decreased acid secretion
• bid or at bedtime

Question 6

clinical use of h2 receptor antagonists

Answer 6

• pud
• gerd
• erosive esophagitis
• non0ulcer dyspepsia

Question 7

side effects of h2 receptor antagonists

Answer 7

• most seen in elderly: constipation, mental status change
• cimetidine: most adverse effects, drug interactions
• avoid in pregnant and breastfeeding

Question 8

moa of protein pump inhibitors

Answer 8

• inhibit h+ secretion by irreversible inhibition of k/h proton pumps in parietal cells
• inhibit meal stimulated acid and basal acid
• give 30 mins to 1 hour before meals

Question 9

examples of ppis

Answer 9

omeprazole, lansoprazole, pantoprazole, esomeprazole

“prazole”

Question 10

clinical uses of ppis

Answer 10

• pud (h pylori, nsaid-related, stress, gastrinoma)

- gerd

Question 11

moa of mucosal resistance enhancers

Answer 11

• provide physical barrier over ulcer

- increase secretion of protectants (mucus, prostaglandin, bicarbonate)

Question 12

examples of mucosal resistance enhancers

Answer 12

• sucralfate
• bismuth chelate
• carbenoxolone
• misoprostol

Question 13

moa of sucralfate

Answer 13

• stimulates mucus, bicarbonate, and prostaglandin

- for gastric, duodenal, and oral ulcers, gi bleed, and stress ulcer

Question 14

moa of bismuth

Answer 14

• increases mucus
• reduces peptic activity
• eliminates h pylori

Question 15

moa of misoprostol

Answer 15

• stable analog of pge1
• augments secretion of mucus and bicarbonate
• prevention and treatment of nsaid ulcers

Question 16

___ can blacken the tongue and feces

Answer 16

bismuth chelate

Question 17

____ can cause uterine contraction

Answer 17

misoprostol

- contra in pregnancy

Question 18

treatment for h pylori

Answer 18

• triple therapy: 1 ppi + 2 antibiotics
• first line: omeprazole, amoxicillin, clarithromycin (oca)
• penicillin sensitive: omeprazole, clarithromycin, metronidazole (ocm)
• macrolide resistant: omeprazole, metronidazole, amoxicillin (oma)
• quadrule therapy: 1 ppi + 1 bismuth + 2 antibiotics
• omeprazole, tetracycline, metronidazole, bismuth
• otmb