GI drugs

Question 1

1st line therapy for PUD

Answer 1

Clarithromycin + amox + PPI

Question 2

2nd line therapy for puD

Answer 2

Bismuth + Flagyl + tetracycline + PPI or H2RA

Question 3

H2 RA - names

Answer 3

ranitidine, cimetidine, famotidine, and nizatidine

Question 4

H2RA MOA

Answer 4

blocking receptors reduces volume of gastric juice and it’s hydrogen ion concentration

Question 5

H2RA - uses

Answer 5

gastric and duodenal ulcers - healing takes 4-6 weeks but may take 8-12 weeks
GERD - 1st choice to relieve symptoms
Zollinger -Ellison Syndrome
heartburn, acid indigestion, sour stomach

Question 6

H2RA - pharm

Answer 6

food decreases absorption, some hepatic metabolism, excreted in urine

Question 7

H2RA - AE

Answer 7

low and usually benign, antiadrenergic effects (decreased libido, gynecomastia, impotence - reversible)
Pneumonia
CNS effects with hepatic or renal impairment

Question 8

H2RA - Interactions

Answer 8

cimetidine increases levels of warfarin, phenytoin, theophylline, and lidocaine. antacids decrease absorption of cimetidine

Question 9

PPI (omeprazole) - pharm

Answer 9

hepatic metab and renal excretion, acid labile so formulated in a capsule

Question 10

PPI (omeprazole) - uses

Answer 10

short term therapy of duodenal ulcers, gastric ulcers erosive esophagitis, and GERD - limit treatment to 4-6 weeks
long term therapy of Zollinger - Ellison

Question 11

PPI - AE

Answer 11

PNA (increased risk for a few days)
fractures
rebound acid secretion
hypomagnesemia
diarrhea

Question 12

PPI - interactions

Answer 12

clopidogrel

Question 13

Sucralfate - Uses

Answer 13

acute and maintenance of duodenal ulcers

Question 14

Sucralfate - AE

Answer 14

constipation

Question 15

Sucralfate - interactions

Answer 15

give antacids 30 in apart, may impede absorption of phenytoin, theophylline, digoxin, warfarin, and fluoroquinolones - give 2 hours apart

Question 16

Misoprostol (Cytotec) - uses

Answer 16

prevention of gastric ulcers caused by long term NSAID use

Question 17

Misoprostol (Cytotec) - AE

Answer 17

diarrhea and abd pain, spotting, dysmenorrhea

BBW - do not give in pregnancy

Question 18

Antacids - uses

Answer 18

PUD

Question 19

Antacids AE

Answer 19

constipation or diarrhea, sodium loading

Question 20

Antacids - Interactions

Answer 20

increase pH so interferes with cimetidine, ranitidine, and sucralfate, increase in pH in urine and increase or decrease secretion of certain drugs

Question 21

Bulk Forming Laxatives - names

Answer 21

methylcellulose (citrucel), psyllium (metamucil) , polycarbophil (Fibercon)

Question 22

Bulk Forming Laxatives - MOA

Answer 22

Absorb water, softens and enlarges fecal mass, promotes peristalsis - takes 1-3 days

Question 23

Bulk Forming Laxatives - Uses

Answer 23

temporary treatment of constipation

diverticulitis and IBS, pts with an ostomy

Question 24

Bulk Forming Laxatives - AE

Answer 24

minimal, should be taken with a full glass of water

Question 25

Surfactant Laxatives - names

Answer 25

Colace

Question 26

Surfactant Laxatives - MOA

Answer 26

softens stool - take with a full glass of water

Question 27

Stimulant Laxatives - names

Answer 27

Biscodyl and senna

Question 28

Stimulant Laxatives -MOA

Answer 28

stimulate intestinal motility and increasing amount of water and electrolytes in the intestine - takes 6-12 hours

Question 29

Stimulant Laxatives -use

Answer 29

opioid use constipation and slow intestinal transit

Question 30

Osmotic Laxatives - names

Answer 30

PEG (miralax), lactulose, Mg hydroxide

Question 31

Osmotic Laxatives - MOA

Answer 31

draws water into intestine to soften fecal mass, stretches intestinal wall and stimulates peristalsis
low doses - 6-12hrs
high doses (for bowel prep) - 2-6 hrs

Question 32

Osmotic Laxatives - AE

Answer 32

• dehydration, Mg toxicity in pts with renal failure, fluid retention with sodium salts