GI - Pharmacology

Question 1

What are the components of triple therapy used to treat H. pylori?

Answer 1

1. A PPI
2. Amoxicillin
3. Clarithromycin

Question 2

What are the components of quadruple therapy used to treat H. pylori?

Answer 2

1. Bismuth
2. A tetracycline
3. Metronidazole
4. A PPI

Question 3

How long does the H. pylori triple therapy last?

Answer 3

2 weeks

Question 4

If a patient was recently exposed to a macrolide or resistance to clarithromycin is high, of what three drugs should triple therapy consist?

Answer 4

Quadruple therapy

1. A PPI
2. Metronidazole
3. Tetracycline
4. Bismuth

Question 5

If a patient has a penicillin allergy, of what three drugs should triple therapy consist?

Answer 5

1. A PPI
2. Metronidazole
3. Clarithromycin

(metronidazole inserted for amoxicillin)

Question 6

In the breath test for urea, radiolabeled _______ is ingested and radiolabeled _______ is exhaled (in patients with an active H. pylori infection).

Answer 6

In the breath test for urea, radiolabeled urea is ingested and radiolabeled CO₂ is exhaled (in patients with an active H. pylori ​infection).

Question 7

How is IBS-C treated?

Answer 7

Laxatives

Question 8

How is IBS-D treated?

Answer 8

Loperamide;

bile acid resins

(serotonin antagonists [alosetron] and/or rifaximin in refractory cases)

Question 9

How is the abdominal pain and bloating of IBS treated?

Answer 9

Antispasmodics (peppermint oil, diclycomine, hyoscyamine)

(TCAs, if refractory)

Question 10

Give the mechanism of action for the following two prescription-grade medications used to treat IBS-C:

Lubiprostone

Linaclotide

Answer 10

Give the mechanism of action for the following two prescription-grade medications used to treat IBS-C:

Lubiprostone - Activates type 2 Cl^- channels

Linaclotide - Activates CFTR

(BOTH INCREASE GUT CHLORIDE SECRETION)

Question 11

Describe the treatment chart for IBS.

Answer 11

Question 12

What medication type is often used for gram-negative GI infections?

Answer 12

Fluoroquinolones

Question 13

What medication type is often used for gram-positive GI infections?

Answer 13

Cephalosporins

(or carbapenems or monobactams)

Question 14

What medication type is often used for treating anaerobic GI infections such as Bacteriodes or C. difficile?

Answer 14

Metronidazole

Question 15

Tigecycline is reserved for _________ GI infections (Note: may be gram-negative, gram-positive, anaerobic, or atypical).

Answer 15

Tigecycline is reserved for complicated GI infections (Note: may be gram-negative, gram-positive, anaerobic, or atypical).

Question 16

Name the two major components of hepatic drug clearance.

Answer 16

The CP450 system;

P-glycoprotein