Lecture 4: Gastrointestinal

Question 0

Gastric defense may be harmed by three things?

Answer 0

-EtOH, NSAIDs, and prednisone(long term)

Question 1

What is the treatment goal of GERD? (2)

Answer 1

(1) complete resolution if symptoms

(2) healing of the esophagitis

Question 2

Proton pump inhibitors reduce stomach acid production by what percentage?

Answer 2

90%

Question 3

Assuming equivalent dosage, what would be equivalent to omeprazole?

Answer 3

Pantoprazole (because all PPIs are equivalent)

Question 4

What is the stem for PPIs?

Answer 4

-prazole

Question 5

You can use PPIs to treat peptic ulcer disease (including ulceration causes by H. pylori). What medication class do you need to use in combination with the PPI?

Answer 5

Antibiotic

Question 6

Are PPIs for immediate relief?

Answer 6

No. They take 2-5 days to achieve maximum benefit.

Question 7

When in the patients’ day is it ideal to take their PPIs?

Answer 7

30 minutes before a meal?

Question 8

What is a major side effect of log term use of PPIs?

Answer 8

Osteoporosis and fracture (due to decrease in vitamin B12)- takes 3-5 years to get these effects.

Question 9

what is the stem for Histamine 2 receptor antagonists (H2RA)?

Answer 9

-tidine

Question 10

Cimetidine (Tagamet) has a major side effect if it is taken along with drugs like warfarin. What worse saw scenario could occur?

Answer 10

Death

Question 11

What can happen when either H2RAs or PPIs are discontinued (like a patient forgets to take their meds for a week)?

Answer 11

Rebound acid increase (thus, gradual tapering is required)

Question 12

How many antibiotics (approximately) should be taken when combating H. pylori?

Answer 12

2 or 3 antibiotics plus a PPI.

Why so many? It has a high resistance

Question 13

How long (in days) is the antibiotic regimen taken for when combating H. pylori?

Answer 13

10-14 days .

Question 14

What is a possible side effects of bismuth?

Answer 14

Black stool and blackening of the tongue

Question 15

What is a possible side effect if a patient is taking immunosuppressants (such as TNF-alpha blockers)

Answer 15

Reactivate latent TB

Question 16

What is the BRAT diet?

Answer 16

You know this shit Steven.

Question 17

What is the most commonly used medication for Treatment of Emesis?

Answer 17

(5HT3 receptor antagonists)
-setron’s
ondansetron (Zofran)

Question 18

Can a pregnant person take 5HT3 receptor antagonist safely?

Answer 18

Eh. It’s class B. Animal testing was safe. It has been proven safe in 2nd and 3rd trimester. But the 1st trimester studies are inconclusive. Mauriana wouldn’t trust it

Question 19

What is a major side effect of long term use of dopamine antagonists?

Answer 19

tardive dyskinesia

Question 20

What is a short term side effect of dopamine antagonists? (Phenothiazine)

Answer 20

Severe drowsiness

Question 21

If a patient is found to have a GI bleed from ulceration (or any other GI bleed for that matter)… What medication should they immediately stop taking?

Answer 21

Anti platelets and anticoagulants

Question 22

PPIs are relatively safe in the short term treatment if GERD. However, due to the reduction in acid, which mineral absorption is effected?

Answer 22

Calcium