GI Drugs Flashcards
A 23-year-old woman with a history of type 1 diabetes since age 6 presents with nausea and vomiting associated with gastroparesis and delayed gastric emptying. Which of the following medications would be the most suitable treatment of the nausea and vomiting in this patient?
A - Dephenoxylate
B - Metoclopramide
C - Ondansetron
D - Dronabinol
E - Loperamide
B - Metoclopramide
A 64-year-old woman is receiving ondansetron for the prophylactic treatment of emesis secondary to chemotherapy. Ondansetron’s main mechanism of action is antagonism of
A - central μ opioid receptors.
B - peripheral H2 receptors.
C - central dopamine receptors.
D - central 5-HT3 receptors.
E - peripheral muscarinic receptors
D - central 5-HT3 receptors.
A 35-year-old woman has severe irritable bowel syndrome characterized by frequent and profuse diarrhea. She is being treated with alosetron because she has not responded to other forms of antidiarrheal therapy. The physician treating this patient must diligently monitor for
A - ischemic colitis.
B - congestive heart failure.
C - drug-induced hepatitis.
D - renal failure.
E - pulmonary fibrosis.
A - ischemic colitis.
A 44-year-old man has been treated for chronic back pain with opioid narcotics. He has been plagued with constipation that he has managed to treat by increasing the fiber in his diet. This is no longer effective. Which of the following medications is likely to be of benefit in this patient?
A - Naltrexone
B - Metoclopramide
C - Methylnaltrexone
D - Bisacodyl
E - Lactulose
C - Methylnaltrexone
A 53-year-old man with a long history of alcohol abuse and hepatic cirrhosis is now developing hepatic encephalopathy. Which of the following agents may be most effective in reducing the signs and symptoms of this patient’s hepatic encephalopathy?
A - Loperamide
B - Bisacodyl
C - Glycerin
D - Docusate sodium
E - Lactulose
E - Lactulose
A 27-year-old woman with ulcerative colitis is being treated with sulfasalazine. She should be closely monitored for which of the following common adverse effects with this drug?
A - Hearing loss
B - Skin rash
C - Blood in her urine
D - Heart arrhythmia
E - Onset of seizures
B - Skin rash
A 42-year-old woman with Crohn’s disease has been treated with glucocorticoid therapy. During her initial high dose therapy, she responded well and the dose was tapered over 3 months. However, she relapsed with severe symptoms during the last month of her taper. The reason for her relapse is most likely because
A - her taper was too rapid.
B - she is glucocorticoid-responsive.
C - she is glucocorticoid-unresponsive.
D - she was noncompliant with her steroid therapy.
E - she is glucocorticoid-dependent.
E - she is glucocorticoid-dependent
A 56-year-old man with ulcerative colitis is being treated with azathioprine. It is determined that his blood concentration ratio of 6-thioguanine/6-methyl-mercaptopurine is lower than normal. The most likely reason for this finding is that he has increased activity of which of following enzymes?
A - Xanthine oxidase
B - Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
C - Acetyl transferase
D - Thiopurine methyltransferase (TPMT)
E - Cytochrome P450 3A4
D - Thiopurine methyltransferase (TPMT)
A 19-year-old woman with ulcerative colitis had to stop taking sulfasalazine because of a skin rash. She is now taking olsalazine which is also converted to 5-ASA but she has experienced no side effects. The most likely reason for the lack of side effects with olsalazine in this patient is because the olsalazine
A - is absorbed in the jejunum after oral use.
B - does not contain a sulfa moiety.
C - has a pH-sensitive release formulation.
D - is given intravenously.
E - is given by enema.
B - does not contain a sulfa moiety.
A 24-year-old woman presents with symptoms of esophageal reflux. She is 6 months pregnant. Which of the following drugs is contraindicated in this patient?
A - Ranitidine
B - Lansoprazole
C - Misoprostol
D - Sucralfate
E - Aluminum hydroxide antacid
C - Misoprostol
A 48-year-old man with a duodenal ulcer disease is treated with cimetidine. After 6 weeks of treatment, he complains that his stomach pain is returning and wonders if the dose of cimetidine should be increased. The most likely reason for the decreased effectiveness of cimetidine in this patient is
A - tolerance.
B - diminished GI absorption.
C - enhanced plasma protein binding.
D - increased hepatic metabolism.
E - poor patient compliance.
A - tolerance
Esomeprazole has a plasma half-life of a few hours yet suppresses acid secretion for 24 to 48 hours. The reason for this paradox is
A - acid suppression continues until new H+,K+-ATPase molecules are synthesized.
B - gastrin depletion occurs long after esomeprazole disappears from the plasma.
C - prostaglandin synthesis is enhanced by esomeprazole.
D - H. pylori is effectively suppressed by esomeprazole for 24 to 48 hours.
E - acid suppression continues until new H2 receptors are synthesized.
A - acid suppression continues until new H+,K+-ATPase molecules are synthesized.
A 48-year-old woman has been diagnosed with a duodenal ulcer that is complicated by H. pylori infection. A suitable therapeutic regimen for this patient would be
A - a single antibiotic.
B - a single antibiotic plus a proton pump inhibitor.
C - misoprostol plus a proton pump inhibitor.
D - an H2 receptor antagonist.
E - 2 antibiotics plus a proton pump inhibitor.
E - 2 antibiotics plus a proton pump inhibitor
A 60-year-old woman has had symptoms of heartburn for 6 months. She first treated herself with antacids but as the frequency and severity of the pain increased she switched to over-the-counter omeprazole which she has been taking daily for 3 months. She now comes to your office complaining of fatigue and lethargy. Her physical examination is unusual only in that her skin is remarkably pale. An analysis of her blood reveals hypochromic, microcytic red blood cells. The most likely explanation for this finding is
A - poor absorption of calcium.
B - poor absorption of vitamin B12.
C - poor absorption of folic acid.
D - poor absorption of iron salts.
E - a direct effect of omeprazole on the bone marrow production of red blood cells.
D - poor absorption of iron salts
A woman is using a scopolamine skin patch to prevent
motion sickness while on a cruise ship. Which is the
most common adverse effect of this drug?
(A) flatulence
(B) heartburn
(C) headache
(D) diarrhea
(E) dry mouth
(E) dry mouth
