GI drugs

Question 1

H2 blockers

Answer 1

cimetidine, ranitidine, famotidine, nizatidine

Question 2

cimetidine toxicity

Answer 2

potent CYP inhibitor - multiple drug interactions
antiandrogenic effects - prolactin release, gynecomastia, impotence, decreased libido
crosses BBB - confusion, dizziness, HA
crosses placenta

Question 3

proton pump inhibitors

Answer 3

omeprazole, lansopraxole, esomeprazole, pantoprazole, dexlansoprazole

Question 4

PPI toxicity

Answer 4

increased risk of C. difficile infection and pneumonia;
hip fractures
decreased serum Mg with long term use

Question 5

bismuth moa

Answer 5

binds to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

Question 6

misoprostol moa

Answer 6

PGE1 analog; increases production and secretion of gastric mucous barrier and decreases acid production

Question 7

misoprostol toxicity

Answer 7

diarrhea; abortifacient

Question 8

octreotide moa

Answer 8

long acting somatostatin analog

Question 9

octreotide use

Answer 9

acute vatical bleeds, acromegaly, VIPoma, and carcinoid tumors

Question 10

octreotide toxicity

Answer 10

nausea, cramps, steatorrhea

Question 11

aluminum hydroxide toxicity

Answer 11

constipation and hypophosphatemia; proximal muscle weakness; osteodystrophy; seizures

Question 12

calcium carbonate toxicity

Answer 12

hypercalcemia and rebound acid increase

Question 13

magnesium hydroxide toxicity

Answer 13

diarrhea, hyporeflexia, hypotension, cardiac arrest

Question 14

osmotic laxatives

Answer 14

Mg hydroxide, Mg citrate, polyethylene glycol, lactulose

Question 15

Tx of hepatic encephalopathy

Answer 15

lactulose - metabolized by gut flora to lactic acid, which promotes nitrogen excretion as NH4

Question 16

infliximab moa

Answer 16

mAb to TNF-a

Question 17

infliximab toxicity

Answer 17

infection (including TB reactivation), fever, hypotension

Question 18

infliximab use

Answer 18

Crohn disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriasis

Question 19

sulfasalazine moa

Answer 19

combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); activated by colonic bacteria

Question 20

sulfasalazine use

Answer 20

UC and Crohns

Question 21

sulfasalazine toxicity

Answer 21

malaise, nausea, sulfonamide toxicity, reversible oligospermia

Question 22

ondansetron moa

Answer 22

5-HT3 antagonist; decreases vagal stimulation; powerful anti-emetic

Question 23

odansetron use

Answer 23

postop and chemo patients

Question 24

metoclopramide moa

Answer 24

D2 receptor antagonist; increases resting tone, contractility and motility;

Question 25

metoclopramide toxicity

Answer 25

tardive dyskinesia; parkinsonian effects; restlesness, drowsiness, fatigue, depression, nausea, diarrhea;