GI drugs

Question 1

Name a motilin receptor agonist that can stimulate intestinal peristalsis

Answer 1

erythromycin

Question 2

Treatment of hereditary hemachromatosis

Answer 2

Phlebotomy
deferasirox
deferoxamine

Question 3

Treatment of wilson’s disease and MOA

Answer 3

D-Penicilliamine

chelation of copper

Question 4

List the H2 blockers

Answer 4

Cimetidine
ranitidine
famotidine
nizatidine
Hint: DINE with histamine

Question 5

MOA of the H2 blockers

Answer 5

reversible block of histamine receptor leading to decreased acid secretion from parietal cells

Question 6

H2 blocker clinical use

Answer 6

Peptic ulcer disease
mild esophageal reflux
gastritis

Question 7

Cimentidine side effect

Answer 7

potent P450 inhibitor
antiandrogenic effect: Prolactin release, gynecomastia, impotence and decrease libido in males
crosses BB to cause confusion, dizziness and HA

Question 8

Common toxicity shared by cimentidine and ranitidine

Answer 8

decrease serum excretion of creatinine

Question 9

List the proton pump inhibitors

Answer 9

Omeprazole
lansoprazole
esomeprazole
pantoprazole
dexlansoprazole

Question 10

Proton pump inhibitor MOA

Answer 10

irreversibly inhibit the H+/K+ ATPasse in the stomach parietal cells

Question 11

Proton pump inhibitor uses

Answer 11

Peptic ulcer
gastritis
esophageal reflux
zollinger-ellison syndrome

Question 12

Proton pump inhibitor toxicity

Answer 12

Increased risk of
 C.diff
f vibreo cholera
pneumonia
hip fxs
decreased Mg2+

Question 13

Bismuth and sucralfate clinical use

Answer 13

increase ulcer healing

traveler’s diarrhea

Question 14

Bismuth and sucrafate MOA

Answer 14

bind to ulcer base providing physical protection and allows HCO3- secretion to reestablish pH gradient in mucous layer

Question 15

Misoprostol MOA

Answer 15

PGE1 analog that increases the production and secretion of gastric mucous barrier
Decrease acid production

Question 16

Misoprostol uses

Answer 16

Prevention of NSAID induced peptic ulcers
PDA maintainance
Ripen the cervix to induce labor

Question 17

Misoprostol toxicity

Answer 17

Diarrhea

Question 18

Misoprostol is contraindicated in

Answer 18

women of childbearing potention–abortifacient

Question 19

octreotide uses

Answer 19

Acute variceal bleeds
acromegaly
VIPoma
carcinoid tumor

Question 20

Octreotide MOA

Answer 20

a Long acting Somatostatin analog

Question 21

Octreodie toxicity

Answer 21

Nausea
cramps
steatorrhea

Question 22

List the antiacids

Answer 22

Aluminum hydroxide
magnesium hydroxide
calcium carbonate

Question 23

Clinical consequences of antacids

Answer 23

hypokalemia
affect the absorption , urinary excretion, bioavailabilty of other durgs by delaying gastric empty and lowering pH of urine

Question 24

Aluminum hydroxide toxicity

Answer 24

constipation
hypophosphatemia
proximal muscle weakness
osteodystrophy
seizures

Question 25

Magnesium OH toxicity

Answer 25

Diarrhea hyporeflexia Hypotension cardiac arrest

Question 26

Calcium carbonate toxicity

Answer 26

Hypercalcemia rebound acid can chelate and decrease effectiveness of other drugs like tetracycline

Question 27

List and describe MOA of the osmotic laxatives

Answer 27

``` Provide osmotic load to draw out water Magnesium hydroxide Magnesium citrate polyethylene glycol lactulose ```

Question 28

In addition to being an osmotic laxative, Lactulose also: | what is the MOA of this action

Answer 28

treats hepatic encephalopathy | Gut flora metabolize it to lactic and acetic acid which binds NH3 to be excreted as NH4+

Question 29

Osmotic laxative toxicity and abuse

Answer 29

Diarrhea dehydration abuse by bullemics

Question 30

Infliximab MOA

Answer 30

Monoclonal AB to TNF-alpha

Question 31

Infliximab uses

Answer 31

Crohn's UC RA

Question 32

Infliximab toxicity

Answer 32

Risk of infection--TB reactivation Fever HypoTn

Question 33

Sulfasalazine is a combination of

Answer 33

Sulfapyridine--a antibacterial | 5-aminosalicylic acid--anti inflammatory

Question 34

Sulfasalazine has to be

Answer 34

activated by colonic bacteria

Question 35

Sulfasalazine uses and toxicity

Answer 35

``` UC and Chrohn's Malaise nausea sulfonamide toxicity? reversible oligospermia ```

Question 36

Ondansteron MOa and toxicity

Answer 36

5-HT3 antagonist--central acting antiemetic | HA and constipation

Question 37

Ondansteron use

Answer 37

postoperative vomiting | chemotherapy vomiting

Question 38

Metoclopramide MOa

Answer 38

D2 receptor antagonist---increases resting tone, LES tone and motility but no effect on colon transit time

Question 39

Metoclopramide use

Answer 39

DM and post-surg gastroparesis | antiemetic

Question 40

Metoclopramide toxicity

Answer 40

Increase parkinsonian effects Restlessness/dizziness/fatigue/depression N/D drug interaction with digoxin and DM drugs

Question 41

Metoclopramide is contraindicated in

Answer 41

Small bowel obstruction | parkinson's disease