GI Drugs

Question 1

What are the four common medical conditions affecting the gut

Answer 1

1. Gastric/peptic ulcers
2. Gastroesophegeal Reflux Disorder (GERD)
3. Diarrhea
4. Constipation

Question 2

What four things fall under gastric/peptic ulcers

Answer 2

1. excessive hydrochloric acid secretion
2. helicobacter pylori infection
3. NSAID toxicity
4. Inadequate mucosal defense against gastric acid.

Question 3

What are the excessive HCl secretion therapies

Answer 3

1. Proton Pump Inhibitors (PPIs)
2. H2 (histamine) receptor blockers
3. Antacids- treat symptoms only

Question 4

What is the suffix of proton pump inhibitors

Answer 4

“-prazole”

-starts with a P so recognize them as proton pump inhibitors

Question 5

What are the 4 proton pump inhibitors

Answer 5

1. esomeprazole
2. omeprazole
3. lansoprazole
4. pantoprazole

Question 6

what is the #3 highest selling drug in America

Answer 6

Esomeprazole –> Nexium

Question 7

What is the indication for esomeprazole

Answer 7

1. GERD
2. Gastric ulcer prophylaxis
3. Hypersecretory disorders
4. H. pylori infection

Question 8

What is the MOA of esomeprazole

Answer 8

irreversibly inhibits gastric parietal cell H+ K+ ATPase, thereby inhibiting gastric acid secretion.

Question 9

which receptors usually aid in the secretion of gastric acid

Answer 9

1. acetylcholine: activation leads to activation downstream of the proton pump.
2. histamine: drives the pump
3. prostraglandins: offer cytoprotective benefit.
4. gastrin

Question 10

What are common AE of esomeprazole

Answer 10

1. headache
2. constipation
3. diarrhea
4. xerostomia
5. flatulence

Question 11

what are serious AE of esomeprazole

Answer 11

1. SJS

2. TEN

Question 12

what are drug interactions of esomeprazole

Answer 12

1. impaired absorption of azole antifungals and certain antiviral agents.
2. azole antifungals
3. CAIs: exacerbation of hypomagnesemia

Question 13

what do esomeprazole’s depend on for their absorption? low or high pH?

Answer 13

low pH

Question 14

what are the H2 receptor blockers?

Answer 14

1. Cimetidine
2. Ranitidine
3. Famotidine
4. Nizatidine

Question 15

what is the suffix of H2 receptor blockers?

Answer 15

“tidine”

Question 16

what is the indication of cimetidine

Answer 16

1. GERD
2. Peptic ulcer
3. Dyspepsia (indigestion)

Question 17

what is the MOA of cimetidine

Answer 17

selective antagonism of gastric parietal cell H2 receptors (act more like inverse agonists though)

Question 18

what role do the Gs and Gi receptors play?

Answer 18

they are membrane proteins that mediate the stimulatory or inhibitory effect of receptor coupling to adenylyl cyclase

Question 19

what are common AE of cimetidine

Answer 19

1. headache

2. dizziness

Question 20

what are serious AE of cimetidine

Answer 20

1. food and drug allergies
2. blood dycrasias
3. psychosis, depression
4. reversible impotence, gymecomastia (enlargement of a mans breasts)

Question 21

what are drug interactions of cimetidine

Answer 21

1. impaired absorption of azole antifungals & certain antiviral agents
2. impaired metabolism of caffeine affecting NSAIDS w/ caffeine
3. impaired metabolism of cyclosporine! (know this cause its usually the other way around)