Peptic ulcer disease

Question 1

Which groups of drugs can be used for peptic ulcer disease? (5 groups)

Answer 1

Histamine H2 antagonists
Proton pump inhibitors
Antacids
Cytoprotective drugs
Antibiotics

Question 2

H2 blockers (4 drugs)

Answer 2

Cimetidine
Famotidine
Ranitidine
Nizatidine

Question 3

H2 blockers - MOA

Answer 3

Inhibition of gastric acid and pepsin secretion

Question 4

H2 blockers - indications

Answer 4

PUD, GERD, dyspepsia.

Allergy (combo with H1 blocker)

Question 5

Cimetidine - adverse effects, and why

Answer 5

Gynecomastia in men because of antiandrogenic activity

Question 6

Cimetidine - interactions (10 drugs)

Answer 6

Decreased metabolism of alprazolam, carbamazepine, cisapride, disopyramide, felodipine, lovastatin, phenytoin, saquinavir, triazolam, warfarin

Question 7

PPIs - MOA

Answer 7

Irreversible inhibition of proton pumps.

Question 8

PPIs (5 drugs)

Answer 8

Esomeprazole
Omeprazole
Pantoprazole
Rabeprazole
Lanzoprazole

Question 9

PPIs - indications

Answer 9

PUD, GERD, Zollinger-Ellison syndrome. NSAID treatment

Question 10

Drug of choice for Zollinger-Ellison syndrome (group)

Answer 10

PPIs

Question 11

PPIs - adverse effects

Answer 11

Hypomagnesemia (long treatment)

Question 12

Antacids (3 drugs)

Answer 12

Aluminum hydroxide
Magnesium hydroxide
Calcium bicarbonate

Question 13

Which antacids are usually combined, and why?

Answer 13

Aluminum hydroxide + magnesium hydroxide.

Prevents side effects

Question 14

Aluminum hydroxide - adverse effect

Answer 14

Constipation

Question 15

Magnesium hydroxide - adverse effects

Answer 15

Diarrhea

Question 16

Which group of drugs are seldom used for PUD?

a) H2 blockes
b) PPIs
c) antacids
d) cytoprotecitve drugs
e) antibiotics

Answer 16

Antacids

Question 17

Cytoprotective drugs (2 drugs)

Answer 17

Sucralfate

Misoprostol

Question 18

Sucralfate - MOA

Answer 18

Forms cytoprotective barrier by inhibiting pepsin catalyzed hydrolysis and stimulation of prostaglandin synthesis.

Question 19

When is sucralfate used for PUD?

Answer 19

When H2 blockers or PPIs are not tolerated

Question 20

Sucralfate - Adverse effects

Answer 20

Laryngospasm

Question 21

Misoprostol - MOA as GI drug

Answer 21

Inh acid secretion. Stimulates mucus and bicarbonate secretion

Question 22

Misoprostol (as GI drug) is espesically used for

Answer 22

NSAID treatment: prevention of ulcers

Question 23

Misoprostol - adverse effects

Answer 23

Uterine contractions

Question 24

Drugs against H. pylori

Answer 24

Amoxicillin, clarithromycin, metronidazole, tinidazole, bismuth subsalicylate, tetracycline