L22- GIT Drugs I (mucosal protective agents)

Question 1

Misoprostol = (1):

• binds (2) in stomach to induce (3) effect
• also has effects to increase (4) and enhance (5)

Answer 1

1- PG-E1
2- EP3 receptor, Gi (dec cAMP)
3- dec gastric acid secretion
4- stimulates mucus and bicarb. secretion
5- gastric / mucosal blood flow

Question 2

Misoprostol:

• (1) is the main use
• (2) occurs in 30% of users
• (3) contraindication

Answer 2

1- prevention of NSAID induced ulcers (in high-risk patients)

2- diarrhea, abdominal pain / cramps

3- pregnancy (abortifacient)

Question 3

Sulcrafate:

• (1) formulation
• (2) MOA
• (3) contraindication

Answer 3

1- salt of sucrose + sulfated aluminum hydroxide

2-
viscous paste selectively binds ulcers
–> neg charge of sucrose sulfate binds pos charge of proteins
–> physical barrier

3- other acid suppressors, it only functions in an acid environment

Question 4

discuss the main therapy goals of Sulcrafate

Answer 4

• restricts further caustic damage

- stimulates PG and bicarb secretion

Question 5

Sulcrafate uses

Answer 5

GERD in pregnancy

Question 6

BSS = (1)

• (2) is its main use in combination
• (3) are its common uses alone

Answer 6

1- bismuth subsalicylate (Pepto)

2- H. pylori suppression / ulcers (no neutralizing action on gastric acid) in Quadruple therapy

3- dyspepsia, acute diarrhea

Question 7

BSS = (1):

• toxicity is (common/rare)
• (3) is a harmless effect
• (4) contraindication

Answer 7

1- bismuth subsalicyclate

2- bismuth is rare // salicyclate toxicity in combination with other salicylate products

3- blackening of stool (confused for melena)

4- renal failure