GI Drugs

Question 1

Name two PPIs

Answer 1

omeprazole

lansoprazole

Question 2

Name two mucosal protectant agents

Answer 2

sucralfate

bismuth subsalicylate

Question 3

Name four histamine 2 receptor antagonists (H2 Blockers)

Answer 3

cimetidine
ranitidine
nizatidine
famotidine

Question 4

Name two antacids

Answer 4

aluminum hydroxide

calcium carbonate

Question 5

Indication for prochlorperazine

Answer 5

nausea (motion sickness)

Question 6

Indication for dronabinol

Answer 6

nausea

Question 7

Indication for metoclopramide

Answer 7

nausea
~speeds gastric emptying
~crosses BBB
~black box warning for tardive dyskinesia

Question 8

Indication for ondansetron

Answer 8

nausea (chemotherapy, hyperemesis gravidarum)

Question 9

Name two antispasmodic/promotility agents

Answer 9

dicyclomine

hyoscyamine

Question 10

Indication and MOA of:
psyllium
polycarbophil
methylcellulose

Answer 10

constipation

bulk-forming agents

Question 11

Indication and MOA of:

docusate

Answer 11

constipation

surfactants/stool softeners

Question 12

Indication and MOA of:

mineral oil, glycerin

Answer 12

constipation

lubricants

Question 13

Indication and MOA of:
milk of magnesia
phosphosoda
polyethylene glycol
magnesium citrate

Answer 13

constipation

osmotic agents

Question 14

Indication and MOA of:
bisacodyl
senna
castor oil

Answer 14

constipation

stimulants

Question 15

Indication and method of use of:

sodium phosphate

Answer 15

constipation

enema

Question 16

Indication and drug class of:
lactulose, sorbitol

Answer 16

constipation

sugar alcohol/synthetic sugar

Question 17

Indication and MOA of:
diphenoxylate
loperamide
paregoric

Answer 17

diarrhea

antiperistaltic agents

Question 18

What drug is used daily to prevent hepatic encephalopathy?

Answer 18

lactulose

Question 19

What antiemetic can be useful in stimulating appetite and reducing nausea in chemotherapy, AIDS, and anorexia patients?

Answer 19

marinol

Question 20

How can you differentiate between osmotic and secretory diarrhea?

Answer 20

osmotic (e.g. lactose intolerance): diarrhea stops when offending agent is stopped

secretory: (e.g. bacterial/viral infections): continues even if no oral food intake

Question 21

Name two bile acid sequestrants

Answer 21

cholestyramine, colestipol

Question 22

Indication for bile acid sequestrants?

Answer 22

• Diarrhea associated with excess fecal bile acids
 S/p cholecystectomy
• Bile acid malabsorption causes secretory diarrhea

Question 23

Warning when using bile acid sequestrants

Answer 23

• Can bind to other drugs (digoxin, warfarin, fat soluble vitamins)
• Therefore give other meds one hour before or four hours after

Question 24

In what situations should diarrhea NOT be treated with Imodium?

Answer 24

Avoid Imodium in those with fever and/or bloody stools
• With certain pathogens, increase risk of hemolytic-uremic syndrome
Acute flare of ulcerative colitis
• Risk of toxic megacolon

Question 25

Warnings when using milk of mag/mag citrate

Answer 25

 Warnings:
• Those with renal failure should not receive Mg (toxic from accumulation)
• Avoid in cardiac disease, pts on diuretics
• May exacerbate pre‐existing electrolyte abnormalities

Question 26

H2 blockers can be used on a PRN basis.

T/F

Answer 26

True. In contrast to PPI therapy, these drugs can be used on a prn basis.

Question 27

PPIs can be used on a PRN basis.

T/F

Answer 27

FALSE.

Take 15‐60 minutes before breakfast (empty stomach), then make sure to eat.

Question 28

How might you be able to differentiate gastric and duodenal ulcers based on how the pain timing is related to eating?

Answer 28

Gastric ulcer: usually epigastric pain is worse with eating

Duodenal ulcer: usually epigastric pain occurs 1-3 hours after a meal; pain may be relieved by eating