GI Pharm

Question 1

Pt with peptic ulcer comes in with gynecomastia, confusion. MoA of these side effects?

Answer 1

Cimetidine (H2-blocker). Has antiandrogen effects (prolactin release, impotence etc) and can cross BBB (confusion, dizziness)

Question 2

Pregnant woman with acid reflux. Better not give?

Answer 2

Cimetidine (can cross placenta). Use other H2 blockers

Question 3

Pt taking these drugs may have a low renal excretion of creatinine?

Answer 3

Cimetidine and Rantidine

Question 4

-tidine? MoA?

Answer 4

H2 Blockers. Reversibly Block H2 receptors on parietal cells.

Question 5

-prazole? MoA?

Answer 5

PPIs. Irreversibly ATPase in parietal cells.

Question 6

Pt on drug comes in with decreased serum Mg and C. difficle. Increased risk for?

Answer 6

PPI toxicities. Hip fracture

Question 7

Pt with ulcer or traveller’s diarrhea. Can give? (2). MoA?

Answer 7

Bismuth, sucralfate. Bind to ulcer base, providing physical protection and allowing HCO3 secretion.

Question 8

Used to induce labor but contraindicated in women of childbearing age because can cause abortion. Other uses?

Answer 8

Misoprostol. PGE analog. Also used to prevent NSAID-induced ulcers and maintain the PDA.

Question 9

Pt with acute variceal bleeds. Drug can also be used to treat what?

Answer 9

Octreotide. Somatostatin analog. VIPoma, carcinoid tumors

Question 10

Pt with acomegaly. Side effects of drug?

Answer 10

Octreotide. Nausea, Steatorrhea

Question 11

Pt with reflux. Tx causes hypoK.

Answer 11

Antacids

Question 12

Pt with reflux. Tx causes muscle weakness and constipation. At risk for?

Answer 12

Aluminum hydroxide antacid (aluMINIUM amount of feces). Risk for seizure.

Question 13

Pt with reflux. Tx causes complaints of diarrhea. PD shows hyporeflexia and hypotension. Pt may get?

Answer 13

Mg hydroxide. Cardiac arrest.

Question 14

Pt with reflux. Taking antibiotics but they dont seem to be working. What drug/what antibiotic?

Answer 14

Ca carbonate can chelate tetracyclines

Question 15

Pt with hepatic encephalopathy. Can give what osmotic laxative? MoA?

Answer 15

Lactulose. Gut flora break it down into lactic and acetic acid. Promotes excretion as NH4.

Question 16

Drug that is both a laxative and an antacid?

Answer 16

Mg hydroxide

Question 17

Osmotic Laxatives?

Answer 17

Mg hydroxide
Mg Citrate
polyethylene glycol
lactulose

Question 18

RA/Crohn’s/UC Pt comes in with cough. Tests positive for caseating granulomas? Drug?

Answer 18

infliximab. TNFa inhibitior. increased risk of infection like TB reactivation

Question 19

Male pt comes in with Oligospermia after being put on a drug.

Where is the drug activated?

Answer 19

Sulfasalazine. Activated by colonic bacteria

Question 20

Sulfasalazine: Use and MoA?

Answer 20

Sulfasalazine. Combo of sulfapyridine (anti-bacterial) and 5-ASA (antiinflam). Used in UC and crohn’s

Question 21

Ondansetron?

Answer 21

Antiemetic. 5HT3 antagonist.

“Feeling queasy? Keep ON-DANCing with Ondansetron”

Question 22

Diabetic with gastroparesis. MoA of drug?

Answer 22

Metaclopromide. D2 receptor antag. Increases tone of LES.

Question 23

Drug that is used as antiemetic and for gastroparesis but has no effect on colonic transport time.

Do not give to pts with?

Answer 23

Metoclopramide. PD pts and pts with small bowel obstruction.