GI Pharmacology

Question 1

Cimetidine, ranitidine, famotidine, nizatidine are all in the class of medications called _____.

Answer 1

H2 blockers

Question 2

H2 blockers irrversibly/reversibly blocks H2 receptors which leads to inc/dec H+ secretion by ______ cells.

Answer 2

Reversibly; dec; parietal

Question 3

Name 3 clinical uses of H2 blockers.

Answer 3

Peptic ulcer, gastritis, mild esophageal reflux

Question 4

Cimetidine is a potent inhibitor of _____; also has anti_____ effects; can/cannot cross the BBB and placenta.

Answer 4

Cytochrome P-450; androgenic; can

Question 5

Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole are all in the class of medications called _____.

Answer 5

Proton pump inhibitors

Question 6

Proton pump inhibitors irreversibly/reversibly inhibits _____ ATPase in stomach _____ cells.

Answer 6

Irreversibly; H+/K+; parietal

Question 7

Name 4 clinical uses of proton pump inhibitors.

Answer 7

Peptic ulcer, gastritis, mild esophageal reflux, Zollinger-Ellison syndrome

Question 8

Name 4 potential toxicities of proton pump inhibitors.

Answer 8

Increased risk of C. difficile infection, pneumonia. Hip fractures, dec serum Mg2+ with long-term use

Question 9

How do bismuth and sucralfate aid in ulcer healing?

Answer 9

Binds to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer.

Question 10

T/F: Misoprostol is used to prevent NSAID-induced peptic ulcers, maintain PDA, and induce labor.

Answer 10

TRUE

Question 11

Name the medication used to treat acute variceal bleeding, acromegaly, VIPoma, and carcinoid tumors.

Answer 11

Octreotide

Question 12

T/F: Antacids can cause hyperkalemia.

Answer 12

FALSE: HYPOkalemia

Question 13

Name the toxicities associated with aluminum hydroxide.

Answer 13

Constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures

Question 14

Name the toxicities associated with magnesium hydroxide.

Answer 14

Diarrhea, hyporeflexia, hypotension, cardiac arrest

Question 15

Name the toxicities associated with calcium carbonate.

Answer 15

Hypercalcemia, inc rebound acid

Question 16

Name 4 osmotic laxatives

Answer 16

Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

Question 17

How does lactulose treat hepatic encephalopathy?

Answer 17

Gut flora degrades it into metabolites (lactic acid and acetic acid) that promotes nitrogen excretion as NH4+

Question 18

What is infliximab?

Answer 18

Monoclonal antibody to TNF-alpha

Question 19

Name 3 clinical uses of infliximab.

Answer 19

Crohn’s disease, ulcerative colitis, rheumatoid arthritis

Question 20

Name 3 toxicities associated with infliximab.

Answer 20

Infection (including reactivation of latent TB), fever, hypotension

Question 21

Name 2 clinical uses of sulfasalazine.

Answer 21

Ulcerative colitis, Crohn’s disease

Question 22

What are 4 toxicities of sulfasalazine?

Answer 22

Malaise, nausea, sulfonamide toxicity, reversible oligospermia

Question 23

What is ondansetron?

Answer 23

5-HT3 antagonist, powerful central-acting antiemetic

Question 24

What is metoclopramide?

Answer 24

D2-receptor antagonist; increases resting tone, contractility, LES tone, motility

Question 25

T/F: Metoclopramide does NOT influence colon transport time.

Answer 25

TRUE

Question 26

What medication should be used for diabetic and post-surgery gastroparesis?

Answer 26

Metoclopramide

Question 27

Metoclopramide has a drug indication with which 2 medications?

Answer 27

Digoxin and diabetic agents

Question 28

Metoclopramide is contraindicated in which 2 medical conditions?

Answer 28

Patients with small bowel obstruction or Parkinson's disease