GI Drugs Flashcards
A 55-year-old woman with type 1 diabetes of 40 yrs’ duration complains of severe bloating and abdominal distress, especially after meals. Evaluation is consistent with diabetic gastroparesis. Which of the following is a prokinetic drug that could be used in this situation?
(A) Alosetron (B) Cimetidine (C) Loperamide (D) Metoclopramide (E) Sucralfate
Of the drugs listed , only metoclopramide is considered a prokinetic agent (ie, one that increases propulsive motility in the gut). The answer is D.
A patient who is taking verapamil for hypertension and angina has become constipated. Which of the following drugs is an osmotic laxative that could be used to treat the patient’s constipation?
(A) Aluminum hydroxide (B) Diphenoxylate (C) Magnesium hydroxide (D) Metoclopramide (E) Ranitidine
A laxative that mildly stimulates the gut would be most suitable in a patient taking a smooth muscle relaxant drug such as verapamil. By holding water in the intestine, magnesium hydroxide provides additional bulk and stimulates increased contractions. The answer is C.
Which drug accumulates in parietal cell canaliculi and undergoes conversion to a derivative that irreversibly inhibits H+/ K+ ATPase?
(A) Cimetidine (B) Diphenoxylate (C) Esomeprazole (D) Metoclopramide (E) Sulfasalazine
Esomeprazole, the (S) isomer of omeprazole, is a prodrug converting spontaneously in the parietal cell canaliculus to a sulfonamide that irreversibly inactivates the proton pump. The answer is C.
Which drug is most likely to be useful in the treatment of inflammatory bowel disease?
(A) Diphenhydramine (B) Diphenoxylate (C) Mesalamine (D) Ondansetron (E) Ursodiol
Mesalamine is a form of aminosalicylate that releases 5-aminosalicyclic acid in the large intestine and thereby provides a local anti-inflammatory effect that is useful in inflammatory bowel disease. The answer is C.
A 34-year-old woman has irritable bowel syndrome with diarrhea that is not responsive to conventional therapies . Despite the small risk of severe constipation and ischemic colitis, the patient decides to begin therapy with alosetron. Alosetron has which of the following receptor actions?
(A) 5-HT 3 receptor antagonist (B) 5-HT 4 receptor agonist (C) D2 receptor antagonist (D) NK1 receptor antagonist (E) Muscarinic receptor antagonist
Serotonin plays a major regulatory role in the enteric nervous system, and the potent 5-HT 3 receptor antagonist alosetron has shown efficacy in treating women with IBS that is accompanied by diarrhea. The answer is A
On your way to an examination, you experience the vulnerable feeling that an attack of diarrhea is imminent. If you stopped at a drugstore, which one of the following antidiarrheal drugs could you buy without a prescription even though it is related chemically to the strong opioid analgesic meperidine?
(A) Aluminum hydroxide (B) Diphenoxylate (C) Loperamide (D) Magnesium hydroxide (E) Metoclopramide
Aluminum hydroxide is constipating but is not related chemically to meperidine; magnesium hydroxide is a strong laxative . The 2 antidiarrheal drugs that are structurally related to opioids are diphenoxylate and loperamide. Loperamide is available over-the-counter; diphenoxylate is mixed with atropine alkaloids, and the product (Lomotil, others) requires a prescription. The answer is C
A 45-year-old man with a duodenal ulcer was treated with a combination of drugs intended to heal the mucosal damage and to eradicate Helicobacter pylori. Which of the following antibacterial drugs is used commonly to eradicate intestinal Helicobacter pylori?
(A) Cefazolin (B) Ciprofloxacin (C) Clarithromycin (D) Clindamycin (E) Vancomycin
The macrolide antibiotic clarithromycin is commonly used in antibiotic regimens designed to treat duodenal ulcers caused by H pylori. The other antibiotics that are used include amoxicillin, tetracycline, and metronidazole. Bismuth also has an antibacterial action. The answer is C
A patient is receiving highly emetogenic chemotherapy for metastatic carcinoma. To prevent chemotherapy -induced nausea and vomiting, she is likely to be treated with which of the following?
(A) Levodopa (B) Methotrexate (C) Misoprostol (D) Ondansetron (E) Sucralfate
The 5-HT 3 receptor antagonists are highly effective at preventing chemotherapy -induced nausea and vomiting, which can be a dose-limiting toxicity of anticancer drugs. The answer is D
Management of steatorrhea is best accomplished by the use of this agent.
(A) Mineral oil (B) Omeprazole (C) Ondansetron (D) Pancrelipase (E) Sucralfate
Steatorrhea is due to decreased fat absorption as a result of inadequate pancreatic secretion of lipase. The answer is D
This is a small molecule that polymerizes in stomach acid and coats the ulcer bed, resulting in accelerated healing and reduction of symptoms.
(A) Mineral oil (B) Omeprazole (C) Ondansetron (D) Pancrelipase (E) Sucralfate
Sucralfate is a small molecule that polymerizes in stomach acid and forms a protective coat over the ulcer bed. The answer is E
A 45-year-old male who is obese presents to his primary care physician complaining of postprandial epigastric pain. The pain does not appear after every meal. He has noticed the pain especially after eating spicy food and oatmeal. He is not currently taking any medications. Which of the following drugs prevents acid secretion by antagonizing a receptor?
Aluminum hydroxide Fexofenadine Misoprostol Omeprazole Ranitidine
The answer is E: Ranitidine
A 37-year-old man complains of chest pain after meals. He says this pain has gone on for a few months and gets only minimal relief from antacid tablets. The physician prescribes a drug that will decrease the amount of acid secreted by binding to and inhibiting an ATPase on the luminal surface of parietal cells. Which of the following drugs works by this mechanism?
Atropine Cimetidine Misoprostol Octreotide Omeprazole
The answer is E: Omeprazole
A 27-year-old man complains of occasional heartburn. His physician makes a few suggestions of diet and lifestyle changes he could make as well as some medications he can take for symptom management. The patient decides to try a magnesium hydroxide (MgOH) preparation. Which of the following is a side effect of MgOH that the physician should warn him about?
Constipation Diarrhea Headache Impotence Seizures
The answer is B: Diarrhea
A 42-year-old woman with irritable bowel syndrome with diarrhea predominance presents to her primary care physician for treatment. The physician suggests an exercise regimen, dietary modifications, and a bulk laxative. The likely mechanism of action of this agent would involve which of the following?
Gel formation in the intestine Neuromodulation of the S3 nerve root Nonabsorbable salt Osmotic laxative Stimulation of the cholinergic nervous system
The answer is A: Gel formation in the intestine
A 49-year-old man with a history of peptic ulcer disease and gastroesophageal reflux disorder is being treated with cimetidine for approximately 20 years. He now complains of breast swelling and breast discharge. What is the most likely explanation for these findings?
Abscess Antiandrogenic effect Inflammatory response Neoplastic process Overwhelming edema
The answer is B: Antiandrogenic effect
