pharm 1

Question 1

mechanism of antacids

Answer 1

local neutralization of acid

Question 2

common components of antacids

Answer 2

mix of a neutralizing agents and an element

Question 3

side effects of antacids (3)

Answer 3

1. diarrhea due to magnesium
2. constipation due to aluminum
3. abdominal distension due to calcium

Question 4

why do we need caution with antacids? (2)

Answer 4

1. kidney insufficieny- elements a re removed by the kidney

2. drug interactions- chelation type of interactions for impaired absorption

Question 5

variability between antiacids is high

Answer 5

yep

Question 6

cytoprotectants (1)

Answer 6

1. bismuth compounds
2. sucralfate- carafate
3. misoprostol- cytotec

Question 7

bind to base of ulcers promoting mucin and bicarb production, it has antibacterial effects but there is low bioavailability

Answer 7

bismuth compounds like pepto-bismol

Question 8

side effects of bismuth compounds

Answer 8

1. constipation

2. darkening of stool and toungue due to the dulfate

Question 9

we should avoid _____ when taking bismuth subsalicylate

Answer 9

aspirin if there is an allergy bismuth contain aspirin already

Question 10

drug interaction os bismuth

Answer 10

can bind to other drugs and change the absorption

Question 11

preferentially binds to damaged GI mucosa and activated by acidic environment. low bioavailability

used with acid-peptic disease or stress ulcer prophylaxis

Answer 11

sucralfate

Question 12

what is a good thing about sucralfate?

Answer 12

does not change the gastric pH and thus keeps the flora

Question 13

side effects of sucralfate

Answer 13

1. consitpation

2. accumulation of aluminum leading to problems with kindey

Question 14

prostaglandin E analog that stimulates secretion of mucin and bicarb, increases mucosal blood flow and suppresses acid production in parietal cell by binding to EP3 receptor

Answer 14

misoprostol

Question 15

misoprostol leads to smooth muscle contractions and thus some adverse effects include:

Answer 15

1. diarrhea

2. increased uterine contractility; can either induce labor or medical termination

Question 16

meds ending in tidine and they compete with histamine for binding on parietal cells

Answer 16

H2 receptor antagonist

Question 17

H2 receptor antagonists are more potent, longer lasting effects than traditional antacids

Answer 17

yep

Question 18

H2As should be dose adjusted for

Answer 18

kidney insufficiency

Question 19

H2As side effects (2)

cimetidine side effect

Answer 19

1. general; diarrhea, constipation, drowsiness, fatigue,headache
2. CNS- sedation
3. cimetidine- gynecomastia in men and galactorrhea in women because it blocks p450 and thus no estrogen

Question 20

H2As drug interactions

Answer 20

1. changes in pH leads to issues of absorption with drugs requiring an acidic environment
2. inhibitor of CYP-450- effects on drugs with a narrow therapeutic margin

Question 21

NMDA is a known carcinogen that can be found in

Answer 21

ranitidine nad nizatidine

Question 22

ends in prazole and it is a prodrug that requires activation in acidic environment and irreveribly binds to and inactivates H+, K+ ATPase

Answer 22

proton pump inhibitors

Question 23

adverse effects of PPI

Answer 23

1. GI- Nausea, diarrhea, abd. pain, constipation
2. altered vitamin and mineral absorption
3. skin rashes, myopathy, ECL cell hyperplasia
4. infections?

Question 24

you need multiple antimicrobials and a high dose of acid suppressive therapy to eradicate H.pylori

Answer 24

yep

Question 25

H. pylori treatment

Answer 25

typically 10-14 days on antibiotics and acid suppressive therapy continued for additional 2 weeks at lower dose