GI Pharmacology

Question 1

Cimetidine MOA, AE?

Answer 1

MOA: Competitive inhibition of H2
AE: CYP 450 Inhibitor=>Antiandrogenic effects, confusion

Question 2

Omeprazole DOC? MOA? AE?

Answer 2

MOA: Irreversibly inhibits H+/K+ ATPase in stomach parietal cells
Use: DOC for Peptic Ulcer, gastritis, ZES, Reflux

AE: Increased risk of C diff infection and

Question 3

Bismuth/Sucralfate MOA? What is Bismuth mainly used for? What is unique about Sucralfate? AE? of bismuth

Answer 3

MOA: Binds to Ulcer base and protects it from further acid damage
Bismuth=>4 drug combo for H pylori
AE: Black tongue

Sucralfate=>prodrug that converts with acid (don’t use with antacids)

Question 4

Misoprostol MOA? Use? AE?

Answer 4

MOA: PGE1 analog=>increases mucus secretion
Use: Prevention of NSAID induced ulcers

AE: abortion pill; don’t give it to pregos

Question 5

Ocretotide MOA? Use?

Answer 5

MOA: Somatostatin analog
Use: DOC for Acute variceal bleeds, Aromegaly, VIPoma, carcinoid tumors

Question 6

Antacids affect weak bases in what way? weak acids? TCAs?

Answer 6

Increase absorption of weak bases

Decreases absorption of weak acids and TCAs

Question 7

AE of Aluminum hydroxide antacid? Magnesium hydroxide antacid? Calcium Carbonate?

Answer 7

AluMINIMUM amount of feces
CC=>Chelates!
Mg=> Must Go to the bathroom

Question 8

What is lactulose used for? MOA? AE?

Answer 8

DOC=>Hepatic encephalopathy=>promotes nitrogen excretion as NH4 by lowering the pH of the bowel
AE: bloating like lactose

Question 9

Sulfasalazine/Mesalamine MOA? Use? AE?

Answer 9

MOA: delivers 5-ASA to the entire bowel
Use: DOC for initial Crohns/UC
AE: Rash, hemolysis and renal tox (sulfasalazine)

Question 10

Ondansetron (-Setron) MOA? Use? AE?

Answer 10

MOA: 5-HT3 antagonist
Use: Antivomiting in patients with chemo (esp. Cisplatin)
AE: QT interval prolongation

Question 11

Metoclopramide+ (-azine)

Answer 11

MOA: D2 receptor antagonist=>increases motility and LES tone
AE: EPS

Question 12

Orlistat MOA? Use? AE?

Answer 12

MOA: inhibits Gastric and pancreatic lipase=>decreases breakdown
Use: Weight Loss
AE: Steatorrhea, and decreased absorption of fat soluble vitamins

Question 13

3 drug regimen for H pylori? 4 drug regimen?

Answer 13

PPI, Clarithromycin and Amoxicillin

PPI, Bismuth, Tetracycline and metronidazole

Question 14

If Ocretide does not work, what procedure can you do to stop acute variceal bleeding?

Answer 14

endoscopic band ligation