Peptic Ulcer Disease

Question 1

Triple therapy for H. pylori infection is composed of?

Answer 1

PPI (omeprazole) + clarithromycin + amoxicillin

Question 2

Omeprazole is a proton pump inhibitor (PPI) that blocks gastric acid secretion by directly inhibiting _________

Answer 2

H/K ATPase

Question 3

__________ is useful in NSAID induced ulcers

Answer 3

Misoprostol

Question 4

Ranitidine and cimetidine are both ___________, useful in PUD

Answer 4

H2 antagonists

Question 5

Side effect of cimetidine??

Answer 5

Gynecomastia

Galactorrhea

Question 6

Which antibiotic is central to H pylori treatment?

Answer 6

Clarithromycin

Question 7

NaHCO3 and CaCO3 are systemic antacids because

Answer 7

They get absorbed from the gut

Question 8

Magnesium hydroxide and aluminum hydroxide are not absorbed from the bowel and don’t cause systemic side-effects such as __________

Answer 8

Alkalosis

Question 9

_________ are used for immediate symptomatic relief of heartburn

Answer 9

Antacids

Question 10

Which vitamin deficiency is associated with the use of PPIs?

Answer 10

B12

Question 11

Antacids decrease absorption of oral __________ via chelation

Answer 11

Tetracyclines

Question 12

A patient who regularly takes antacids for his heart burn develops pneumonia and is put on an antibiotic course for 5 days. The absorption of which of the following antibiotics would decrease due to his antacid use?

Answer 12

Tetracycline

Question 13

________ are not recommended for treatment of active peptic ulcer

Answer 13

Antacids

Question 14

____________ is a surface acting agent added with antacids to disperse the foam

Answer 14

Simethicone

Question 15

__________ has no antacid or ulcer healing properties

Answer 15

Simethicone

Question 16

Antacids increases the rate of elimination of _________ and ___________

Answer 16

phenobarbitone and salicylates

Question 17

Antacids decreases the elimination of four drugs. Name them.

Answer 17

amphetamine
ephedrine
mecamylamine
quinidine

Question 18

What are the functions of misoprostol?

Answer 18

modest acid inhibition
stimulates mucus and bicarbonate ions secretion
enhances mucosal blood flow

Question 19

20% of patients have _________ (diarrhea/constipation) and cramping abdominal pain using misoprostol however, this is dose-dependent

Answer 19

Diarrhea

Question 20

All H2 receptor antagonist except __________ inhibit gastric first pass metabolism of ethanol and increase its bioavailibility

Answer 20

famotidine

Question 21

__________ cause hypergastrinemia that leads to carcinoid tumors in rats

Answer 21

PPIs

Question 22

__________ inhibit the cytochrome p450 metabolism of warfarin and phenytoin.

Answer 22

PPIs

Question 23

Antacids are weak bases that are taken _________

Answer 23

orally

Question 24

What are the functions of antacids?

Answer 24

partially neutralize gastric acid
reduce pepsin activity
stimulate prostaglandin production

Question 25

__________are still used commonly by patients as nonprescription remedies for dyspepsia

Answer 25

Antacids

Question 26

Why pepsin activity is reduced by using antacids?

Answer 26

pepsin is inactive at a gastric pH of greater than 4 and antacids increase the pHq

Question 27

________ antacids should not be used for long-term treatment

Answer 27

Sodium bicarbonate

Question 28

Sodium bicarbonate is contraindicated in three conditions?

Answer 28

HTN Heart failure Renal failure

Question 29

Why can't we give sodium bicarbonate to hypertensive patient?

Answer 29

because its high sodium content can increase fluid retention

Question 30

What does sodium bicarbonate do in the body?

Answer 30

Produces transient metabolic alkalosis | Increases sodium load

Question 31

__________ antacid may stimulate gastrin release and thereby cause rebound acid production

Answer 31

Calcium carbonate

Question 32

Adverse effect of magnesium hydroxide?

Answer 32

diarrhea

Question 33

MgOH2 is a ________ (rapid/slow) acting antacid

Answer 33

rapid

Question 34

Aluminium hydroxide is a __________ (rapid/slow) acting antacid

Answer 34

slow

Question 35

Adverse effect of aluminium hydroxide?

Answer 35

Constipation | Encephalopathy

Question 36

Food _______ (shortens/prolongs) the duration of action of antacids.

Answer 36

prolongs

Question 37

Do not use antacids w/i 2hrs of administration of ?

Answer 37

Iron Tetracyclines Fluoroquinolones Itraconazole

Question 38

__________ has a particular affinity for exposed proteins in the crater of duodenal ulcers

Answer 38

Sucralfate

Question 39

Whats in sucralfate?

Answer 39

Aluminium hydroxide | Sulfated sucrose

Question 40

Sucralfate produce _________ and nausea

Answer 40

constipation

Question 41

Sucralfate is used in critical care settings to prevent ___________ bleeding

Answer 41

stress-related