GI Rx

Question 1

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Cimetidine

Answer 1

1) peptic ulcer, gastritis, mild esophageal reflux
2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell
3) potent cyt P450 inhibitor (Rx interactions); anti-androgenic effects (prolactin release, gynecomastia, impotence, decr libido in males); can X BBB (confusion, dizziness, HA) + placenta; decr renal exretion of Cr
4) N/A

Question 2

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Ranitidine

Answer 2

1) peptic ulcer, gastritis, mild esophageal reflux
2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell
3) decr renal exretion of Cr
4) N/A

Question 3

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Famotidine

Answer 3

1) peptic ulcer, gastritis, mild esophageal reflux
2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell
3) decr renal exretion of Cr
4) N/A

Question 4

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Nizatidine

Answer 4

1) peptic ulcer, gastritis, mild esophageal reflux
2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell
3) decr renal exretion of Cr
4) N/A

Question 5

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Omeprazole

Answer 5

1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn
2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells
3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use
4) N/A

Question 6

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Lansoprazole

Answer 6

1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn
2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells
3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use
4) N/A

Question 7

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Esomeprazole

Answer 7

1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn
2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells
3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use
4) N/A

Question 8

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Pantoprazole

Answer 8

1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn
2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells
3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use
4) N/A

Question 9

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Dexlansoprazole

Answer 9

1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn
2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells
3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use
4) N/A

Question 10

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Bismuth

Answer 10

1) incr ulcer healing, traveler’s diarrhea
2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer
3) N/A
4) N/A

Question 11

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Sucrafate

Answer 11

1) incr ulcer healing, traveler’s diarrhea
2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer
3) N/A
4) N/A

Question 12

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Misoprostol

Answer 12

1) prevent NSAID-induced peptic ulcers; maintenance of patent ductus arteriosus; also induce labor (ripens cervix)
2) PEG1 analog: incr production + secretion of gastric mucus barrier; decr acid production
3) diarrhea; contraindicated in women of childbearing age (abortifacient)
4) N/A

Question 13

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Octreotide

Answer 13

1) acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
2) long-acting somatostatin analog
3) nausea, cramps, steatorrhea
4) N/A

Question 14

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Aluminum hydroxide

Answer 14

1) esophageal reflux dz’s
2) antacid
3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; constipation + hypophosphatemia; proximal musc weakness; osteodystrophy; seizures
4) N/A

Question 15

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Magnesium hydroxide

Answer 15

1) esophageal reflux dz’s, constipation
2) antacid; osmotic laxative: provide osmotic load to draw out H2O
3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; diarrhea; hyporeflexia; hypotension; cardiac arrest; diarrhea, dehydration
4) may be abused by bulimics

Question 16

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Calcium carbonate

Answer 16

1) esophageal reflux dz’s
2) antacid
3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; hypercalcemia; rebound incr in acid
4) can chelate + decr effectiveness of other Rx (ie, tetracycline)

Question 17

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Magnesium citrate

Answer 17

1) constipation
2) osmotic laxative: provide osmotic load to draw out H2O
3) diarrhea, dehyration
4) may be abused by bulimics

Question 18

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Polyethylene glycol

Answer 18

1) constipation
2) osmotic laxative: provide osmotic load to draw out H2O
3) diarrhea, dehyration
4) may be abused by bulimics

Question 19

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Lactulose

Answer 19

1) constipation; hepatic encephalopathy
2) osmotic laxative: provide osmotic load to draw out H2O; gut flora degrades this Rx into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4+
3) diarrhea, dehyration
4) may be abused by bulimics

Question 20

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Infliximab

Answer 20

1) Crohn’s dz, ulcerative colitis, rheumatoid arthritis
2) monoclonal ab to TNF-alpha
3) infct (including reactivation of latent TB); fever; hypotension
4) N/A

Question 21

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Sulfasalazine

Answer 21

1) ulcerative colitis, Crohn’s dz
2) combo of sulfapyridine (antibacterial) + 5-aminosalicylic acid (5-ASA, anti-inflammatory); activated by colonic bacteria (cleaves bond)
3) malaise; nausea; sulfonamide toxicity; reversible oligospermia
4) N/A

Question 22

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Ondansetron

Answer 22

1) control vomiting postoperatively + in pts undergoing CA chemo
2) 5-HT3 antagonist; powerful central-acting antiemetic
3) HA, constipation
4) N/A

Question 23

1) uses 2) class/ MOA 3) ADE 4)Fun fact/note

Metoclopramide

Answer 23

1) DM, post-sx gastroparesis, antiemetic
2) D2 receptor antagonist: incr resting tone, contractility, LES tone, motility; doesn’t influence colon transport time
3) incr parkinsonian effects; restlessness; drowsiness; fatigue; depression; nausea; diarrhea; contraindicated in pts w/ small bowel obstruction or Parkinson’s dz
4) Rx interaction w/ digoxin + DM agents