GI Pharm

Question 1

A. Gastroesophageal reflux disease (GERD) is _______; “acid reflux” is ________(isolated incidents)

Answer 1

chronic

acute

*“heartburn” occurs in 7% of population daily

Question 2

What are 8 aggravating factors of Acid reflux/GERD?

Answer 2

1-empty stomach
2-reclined, 
3-increased age, 
4-obesity, 
5-fatty foods, 
6-caffeine/alcohol/smoking,
7-large meals, 
8-some drugs

Question 3

What are 6 ways to help relieve GERD/Acid reflux?

Answer 3

1-small meals 
2-reduced fat 
3-reduced weight 
4-elevate head of bed 
5-avoid aspirin/NSAIDs
6-Stop smoking/drinking alcohol

Question 4

What are the three main groups of medications used for GERD?

Answer 4

1-Antacids
2-H2 receptor blockers
3-Proton pump inhibitors (PPIs)

Question 5

What are 4 types of antacids that neutralize gastric HCl?

Answer 5

1-magnesium salts (can cause diarrhea)
2-bicarbonate (causes gas)
3-calcium carbonate (chalky and constipation)
4-aluminum salts (not very effective)

Question 6

What are the three H2 receptor drugs that block H2 receptors in the gut?

Answer 6

1-Cimetidine (Tagamet)
2-Ranitidine (Zantac)
3-Famotidine (Pepcid)

*Headaches, diarrhea, drowsiness

Question 7

Which drugs act by disrupting hydrogen exchange for K in parietal cells, which blocks production and release of HCl into gut?

Answer 7

Proton Pump Inhibitors (PPIs)

*diarrhea, interferes with digestion, increases food allerges, oral sores/ulcers

Question 8

What are 4 PPI drugs?

Answer 8

1-Omeprazole (Prilosec)
2-Omeprazole + sodium bicarbonate for fast release
3-Lamsoprazole (Prevocid)
4-Esomeprazole (Nexium)

Question 9

What are three causes of Peptic ulcers (both gastric and duodenal)?

Answer 9

1-Inflammation of epithelium
2-Errosion
3-Infection by H. pylori (70-80% incidence)

Question 10

What are 3 main symptoms of an Ulcer?

Answer 10

1-Epigastric burning (alleviated by eating or antacids)
2-Pain worse on empty stomach and at night
3-Pain often mistaken for a heart attack and vice versa

Question 11

What are 3 drugs that can suppress the acidity to heal sores but not cure ulcers?

Answer 11

1-Antacids
2-PPIs
3-H2 Blockers

Question 12

What are two treatments used to cure ulcers if they are caused by H. Pylori?

Answer 12

1-Prevpac (combo Iansoprazole, amoxicillin and clarithromycin)
2-Milk of magnesia

*especially contagious within family

Question 13

Where are water and alcohol absorbed?

Answer 13

Stomach

Question 14

Where are Fe, Ca, Mg, Na, Fats, water, proteins, and vitamins absorbed?

Answer 14

Duodenum

Question 15

Where are carbohydrates and proteins absorbed?

Answer 15

Jejunum

Question 16

Where are bile salts, B12 and Cl absorbed?

Answer 16

Ileum

Question 17

Where are water and electrolytes absorbed?

Answer 17

Colon

Question 18

Which laxative drug stimulates smooth muscle, is fast acting and is an OTC suppository/oral?

Answer 18

Bisacodyl

*Causes cramps

Question 19

Which laxative acts by retaining more water in stools to soften them?

Answer 19

Docusate

*Dulcelax is an OTC version

Question 20

What are three medications used for Diarrhea?

Answer 20

1-Loperamine (imodium, mild opioid agonist, can go strong if sever)
2-Bismuth subsalicylate (pepto-bismol)
3-Anti-cholinergics (atropine)

Question 21

What syndrome has no structural defect, typically episodic pain and bloating in young adults-50 yr olds and is the most common GI disorder?

Answer 21

Irritable Bowel Syndrome (IBS)

*could be 5HT dependent neuromuscular disorder. affects 20%

Question 22

What is the only FDA approved drug for IBS with constipation that is a guanylate cyclase-C agonist??

Answer 22

Linaclotide (Linzess)

*increase bowel movement, fluid secretion and reduce pain. Can cause diarrhea and gas

Question 23

What chronic diarrheal disease affects mostly ileum and colon with intermittent strictures with swelling, scarring and ulcerations?

Answer 23

Crohn’s disease

*Perianal fissures/fistules

Question 24

What are 3 conditions that are associated with Crohn’s disease?

Answer 24

1-Arthritis
2-Fatty liver
3-Colon Cancer

Question 25

What are two anti-inflammatory drugs used for Crohns disease?

Answer 25

1-Mesalamine (topical anti-inflammatory)
2-Corticosteroids-act systemically

*Metronidazole also used

Question 26

What disease is similar to Crohns disease but is limited to colon and is more generalized without strictures?

Answer 26

Ulcerative colitis

*treated with similar drugs to Crohns disease

Question 27

Where is HBV virus most concentrated in the mouth?

Answer 27

Gingival sulcus