GI Drugs

Question 1

What are the 4 defenses of peptic ulcer disease (PUD)?

Answer 1

Mucous secretion, bicarbonate, good blood flow, prostaglandin

Question 2

How does mucous secretion defend against PUD?

Answer 2

Barrier to protect from acid and pepsin

Question 3

How does bicarbonate protect against PUD?

Answer 3

Neutralize H+, trap in mucus

Question 4

How does good blood flow protect from PUD?

Answer 4

Increase mucosal integrity, decrease blood flow =local ischemia-> cell injury->acid and pepsin attack

Question 5

How does prostaglandin protect from PUD?

Answer 5

Increase mucous secretion, bicarbonate, good blood flow (vasodilation), (not answer just fact about it : pro inflammatory)

Question 6

Where are the five aggressor of PUD?

Answer 6

H. pylori, nonsteroidal, anti-inflammatory, gastric acid, pepsin, smoking

Question 7

Why is H. Pylori a aggressor of PUD?

Answer 7

It’s a bacteria that causes PUD, carcinogen (gastric cancer), resistance to stomach acid, errode gut wall

Question 8

How is nonsteroidal anti-inflammatory and aggressor of PUD?

Answer 8

Inhibit biosynthesis of prostaglandin

Question 9

How is pepsin an aggressor , of PUD??

Answer 9

Natural enzyme that break down proteins, pH dependent, increase with acid inactivates, when pH is greater than five

Question 10

How is smoking aggressor of PUD?

Answer 10

Sphincter tone weaken -> esophageal, acid, reflux, delay, healing, lower efficiency of drug, lower secretion of by carbonate, increase, gastric, emptying meaning there is more acid that moves to the duodenum

Question 11

How do you prevent PUD?

Answer 11

Avoid NSAID, corticosteroid(prednisone & dexatextmethasone), etho, diet of six small meals and avoid acid and space, decrease stress

Question 12

What are the three things that you need to do for an antibiotic regimen for PUD?

Answer 12

Do you have to use 2 to 3 antibiotics this is to decrease resistance, decreased stomach acid with antisecretory agent, use antibiotic long enough to kill H pylori

Question 13

Where are the three main antibiotics to treat H. pylori?

Answer 13

Amoxicillin (Amoxil)
Bismuth( Pepto-Bismol)
Metronidazole ( flagyl)

Question 14

How does amoxicillin (Amoxil) kill H. pylori? Best condition? Side effects?

Answer 14

bind to bacterial cell wall and cause cell death, is best with neutral pH, most affective, if gastric acid is lower, side effect: rash, diarrhea

Question 15

How does bismuth (Pepto-Bismol) kill H. pylori? Side effect?

Answer 15

Acts topically lysis cell equals death, SE: black tongue, black stool

Question 16

What type of H. Pylori does metronidazole ( Flagyl) kill? Why would you avoid? side effect?

Answer 16

Affective against sensitive strain, avoid with pregnancy, avoid alcohol because disulfiram like rxn, side effect: nausea, headache

Question 17

What does a histamine H2 receptor antagonist do? Uses? What should you avoid with use? ADR

Answer 17

Inhibit gastric acid secretion, uses: H. pylori, decrease pain, symptoms, and prevent complication PUD, NSAID, ulcer, prophylaxis, decreased heartburn, GERD, gastroesophageal, reflux, disease, Zollinger Ellison syndrome. Avoid anti-acid one hour before meds. ADR: pleading DYSCRASIAS abnormality

Question 18

Where are the three drug of histamine H2 receptor antagonist?

Answer 18

Cimetidine ( Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)

Question 19

Where are H1 receptor for?

Answer 19

Allergy symptom

Question 20

What are H2 receptor for?

Answer 20

Increase gastric acid secretion

Question 21

Cimetidine (Tagamet)
Action
Pharmacokinetics (route, food eff, BBB)
ADR
Drug interaction

Answer 21

Action: decrease gastric acid secretion
Pharmacokinetics: (route-oral solution or tablet,food= Decrease, absorption, equal, prolong effect, cross BBB)
ADR:
Antiandrogenic eff(gynecimastia, lower libido,impotence, reversible)
CNS eff(older adult with renal and hepatic problem, confusion, hallucination, CNS depression/excitation
Pneumonia(decrease gastric activity leads to increase bacterial colony in stomach, second to increase colony in lung)
Drug interaction
Inhibit, hepatic, drug metabolism
Anti-acid decrease absorption of cimetidine take one hour