GI Drugs

Question 1

What histamine blockers reduce the amount of acid secreted in the stomach? What secondary G protein mechanism do they work by?

Answer 1

1) H2 receptor blockers

2) Gs protein

Question 2

Cimetidine
Ranitidine
Famotidine
Nizatidine

Answer 2

Think: take H2 blockers before you DINE. table for two (H2)

H2 blockers

Question 3

What are side effects of cimetidine?

Answer 3

1) Inhibits p450 system
2) Can cause gynecomastia (antiandrogenic effects)
3) Decrease renal excretion of creatinine

Question 4

Omeprazole
Lansprazole
Esomeprazole
Pantoprazole
Dexlansoprazole

Answer 4

Proton pump inhibitors

Question 5

Long acting somatostatin analog

Answer 5

Octreotide

Question 6

What are the clinical uses of octreotide?

Answer 6

1) VIPoma
2) Carcinoid tumor
3) Variceal bleeds
4) Acromegaly

Question 7

Side effect of aluminum hydroxide

Answer 7

Constipation

Question 8

Magnesium hydroxide

Answer 8

Diarrhea

Question 9

5-HT3 antagonist with powerful central acting antiemetic effects

Answer 9

Ondansetron

Question 10

D2 receptor antagonist. Increases resting tone, contractility, LES tone, motility; used as an antiemetic

Answer 10

Metclopramide

Question 11

MOA of Metformin

Answer 11

1) Act on AMP depedent protein kinase causing decreased gluconeogenesis, increased glycolysis, and increased peripheral glucose uptake

Question 12

Adverse effects of metformin

Answer 12

1) Lactic acidosis (contraindicated in renal failure)

Question 13

Tolbutamide
Chlorpropamide
Glyburide
Glimepiride
Glipizide

Answer 13

Sulfonylureas

Question 14

MOA of sulfonylureas

Answer 14

1) Closes K channel in beta cell membrane
2) Depolarization occurs triggering insulin release via Ca influx
3) Stimulates the release of insulin in type 2 DM

Question 15

Pioglitazone

Rosiglitazone

Answer 15

Glitazones/thiazolidinediones

Question 16

MOA of Glitazones

Answer 16

1) Increase insulin sensitivity in peripheral tissue
2) Binds to PPAR-gamma nuclear transcription regulator (regulates fatty acid storage and glucose metabolism)
3) Used as monotherapy for DM2

Question 17

Pramlintide

Answer 17

Amylin analog

Question 18

MOA of Pramlintide

Answer 18

1) Decreases glucagon

2) Increases satiety

Question 19

Acarbose

Miglitol

Answer 19

Alpha-glucosidase inhibitors

Question 20

MOA of alpha glucosidase inhibitors

Answer 20

Inhibit intestinal brush border alpha glucosidases; delayed sugar hydrolysis and glucose absorption

Question 21

Exenatide

Liraglutide

Answer 21

GLP-1 analogs

Question 22

MOA of GLP-1 analogs

Answer 22

1) Given by injection

2) Increase insulin and decrease glucagon release

Question 23

Linaglipitin
Saxagliptin
Sitaglipitin

Answer 23

DPP-4 inhibitors

Question 24

MOA of DPP-4 inhibitors

Answer 24

1) Increase insulin and decrease glucagon

Question 25

Adverse effects of GLP-1 analogs?

Answer 25

Acute pancreatitis

Question 26

What is the adverse effect of thiazolidinediones

Answer 26

1) Contraindicated in patients with CHF
2) Weight gain
3) Edema
4) Hepato and cardiovascular toxicity