GI Pharma Flashcards

1
Q

What drug causes black tongue&stool?

A

Bismuth subsalicylate

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2
Q

Why is concurrent administration of antacids and some other drugs not recommended?

a. Antacids can alter the absorption of other drugs
b. Antacids can increase bicarbonate secretion
c. Antacids can inhibit CYP 450 enzymes
d. The combination can lead to increase in gastric acid secretion

A

A

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3
Q

Which of the following drugs can treat acid reflux and may cause galactorrhea and gynecomastia?

a. Dicyclomine
b. Misoprostol
c. Cimetidine
d. Omeprazole

A

C

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4
Q

Which of the following is a H/K ATPase blocker on the apical surface of parietal cells?

a. Dicyclomine
b. Misoprostol
c. Cimetidine
d. Omeprazol

A

D

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5
Q

A patient with duodenal ulcer presented with hematemesis, electrocautery was done to treat the ulcer. What will you administer at this stage?

a. Omeprazole
b. Ranitidine
c. Somatostatin
d. Sucralfate

A

A

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6
Q

Which drug is used for peptic ulcers caused by NSAIDs?

a. Misoprostol
b. Bismuth subsalicylate

A

A

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7
Q

Which of the following is contraindicated in pregnancy

a. Promethazine
b. Misoprostol

A

B

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8
Q

What is the rationale behind Quadruple therapy of peptic ulcer?

a. Reduce the cost
b. Decrease fatal adverse effects
c. Decrease emergence of resistance species
d. Decrease drug-drug interactions

A

C

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9
Q

How does famotidine reduce the effect of sucralfate?

a. Inhibition of proton pump
b. Inhibition of prostaglandin
c. Induces CYP450
d. Reduces the acidity of stomach

A

D

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10
Q

What is a drug that is considered cytoprotective for the gastric mucosa and is part of the treatment of H. Pylori?

a. Misoprostol
b. Bismuth subsalicylate
c. Dicyclomine
d. Sucralfate
e. Omeprazole

A

B

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11
Q

What is the mechanism of action of dicyclomine?

A

Muscarinic antagonist

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12
Q

A patient with epilepsy using phenytoin and he had peptic ulcer. Which drug should be avoided?

a. Omeprazole
b. Famotidine
c. Magnesium
d. Misoprostol

A

A

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13
Q

How does ranitidine reduce the efficacy of sucralfate?

A

It reduces the acidity of the stomach

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14
Q

What is the goal of triple therapy in treating peptic ulcer disease?

A

To eliminate or reduce the occurrence of drug resistance

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15
Q

What drug induces abortion?

A

Misoprostol

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16
Q

What cytoprotective drug is used for the treatment of h.pylori?

a. Bismuth chelate
b. Sucralfate

A

-

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17
Q

Why does ranitidine decrease the efficacy of sucralfate?

A

Decrease acidity

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18
Q

How do antacids affect sucralfate efficacy?

A

By altering pH in stomach

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19
Q

Why is a renal transplant patient on cyclosporine advised not to drink grape fruit juice?

a. It inhibits cyclosporine metabolism
b. The dose of cyclosporine needs to be increased
c. Increases the risk of organ rejection

A

A

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20
Q

In terms of biotransformation, a phase II reaction described as:

a. Conjugation reaction
b. Anaerobic reaction
c. Hydrolysis reaction
d. Oxidative phosphorylation

A

A

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21
Q

Which drug can cause hepatotoxicity due to immunological reaction?

a. Acetaminophen
b. Halothane

A

B

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22
Q

Co-administration of this drug with cyclosporine will lead to a decrease in cyclosporine concentration?

A

Rifampicin

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23
Q

What is the mechanism of cimetidine?

A

Inhibit CYP450 metabolism of other drugs

24
Q

Which drug interacts with cyclosporine and inhibits it’s metabolism resulting in organ rejection?

A

Rifampicin

25
Q

Which drug increases the synthesis of CYTP450 enzymes?

A

Rifampicin

26
Q

A patient taking OCP, what do you advise her not to take with it?

A

St. John’s worts

27
Q

If diazepam and cimetidine are given together, what must be done?

A

Reduce diazepam dose

28
Q

What is the major oxidant in the liver?

A

Cytochrome P450

29
Q

What is a prodrug?

A

converted to active metabolite

30
Q

What drug is an H1 antagonist that causes motion sickness

a. Cyclizine
b. Hyoscine (scopolamine)

A

A

31
Q

Which of the following drugs is a 5-HT3 receptor antagonist?

a. Ondansetron
b. Metoclopramide
c. Hyoscine
d. Cyclizine

A

A

32
Q

What is the mechanism of action of lactulose?

a. Forms a bulky hydrated mass in the gut
b. Retains fluid in the bowel lumen by osmosis

A

B

33
Q

What is a dopamine receptor antagonist?

A

Metoclopramide

34
Q

What is the mechanism of action of scopolamine?

A

Antagonism of muscarinic receptors

35
Q

Which of the following drugs decreases the motility of GIT?

A

Codeine

36
Q

Which of the following drugs is a stimulant purgative?

a. Senna
b. Bisacodyl

A

-

37
Q

How does senna exert its laxative effects?

A

Stimulates the colonic activity and increases peristalsis

38
Q

Which drug is used to treat postoperative nausea
and vomiting by inhibiting the 5HT3
receptor?

A

Ondansetron

39
Q

What is antagonist for muscarinic receptors used for motion sickness?

A

Hyoscine

40
Q

Which laxative increases peristalsis by stimulating the enteric nerves?

A

Senna

41
Q

Which drug is a D2 receptor antagonist with central and GI effect?

A

Metoclopramide

42
Q

Which drug is a serotonin antagonist used with chemotherapy?

A

Ondansetron

43
Q

What is the mechanism of action of senna?

A

Stimulates contraction of the colon

44
Q

What shows more toxicity in children than adults?

a. Acetaminophen
b. Isoniazid
c. Halothane
d. Salicylate

A

D

45
Q

What is the mechanism of halothane drug induced hepatotoxicity?

a. Idiosyncratic toxicity
b. Intrinsic toxicity

A

A

46
Q

Which drug can result in hepatotoxicity in both fast and slow acetylators?

a. Acetaminophen
b. Isoniazid

A

B

47
Q

Hepatoxicity to which drug can be treated with N-acetylcysteine?

a. Acetaminophen
b. Rifampicin
c. Halothane
d. Isoniazid

A

A

48
Q

Pruritus and jaundice are common features of the cholestatic effect of which drug? (hepatocanalicular injury)?

a. Valproicacid
b. Tetracycline
c. Acetaminophen
d. Methotrexate
e. Chlorpromazine

A

E

49
Q

Toxic doses of which drug causes a centrilobular pattern of necrosis in the liver?

a. Valproic acid
b. Tetracycline
c. Acetaminophen
d. Methotrexate
e. Chlorpromazine

A

C

50
Q

What is the most likely cause of acetaminophen hepatotoxicity?

A

Accumulation of electrophilic metabolites

51
Q

Which drug can cause hepatotoxicity in children less than 3 years old?

A

Valproic acid

52
Q

Which of the following conditions is associated with liver steatosis without inflammation or fibrosis?

A

Methotrexate hepatotoxicity

53
Q

Which drug causes hepatotoxicity due to genetic variation on acetyltransferase?

A

Isoniazid

54
Q

A 70 year old patient on isoniazid treatment, presented with elevated liver enzymes. What most likely would be the cause?

A

accumulation of active metabolites in liver

55
Q

Which drug causes microvesicular steatosis?

a. amiodarone
b. steroids
c. methotrexate
d. Valproic acid

A

D

56
Q

How does Acetaminophen cause hepatocellular necrosis?

A

Depletion of glutathione