Pharm- GI

Question 1

Phases of Digestion:

Answer 1

1) Cephalic- anticipation, parietal cells secrete acid (pH 1-4)
2) Gastric-gastrin release when antrum stretched, more gastric acid
3) Intestinal- chyme enters duodenum, neg feedback reduces stomach secretions, release HCO₃^- and pancreatic enzymes

Question 2

Which portion of the autonomic ns has an excitatory effect, ↑GI motility?

Answer 2

Parasympathetic

Question 3

What can block the proton pump

Answer 3

Histamine blockers, anticholinergic agents, proton pump inhibitors, some prostaglandins

Question 4

Antacids with calcium/aluminum or magnesium will increase/decrease motility in different ways:

Answer 4

Mg= diarrhea

Ca= constipation

Question 5

The ↑pH from antacids will effect absorption:

Answer 5

↓absorption of other drugs

electrolyte imbalance

take 2 hours before meds

Question 6

which antacid class is associated with AE of muscle pain, taken HS (bedtime), and is a P450 inhibitor (might cause gynecomastia)

Answer 6

H2 receptor antagonist

cimetidine (Tagamet)

ranitidine (Zantac)

Question 7

which antacid class inhibits the H+/K+ pump on parietal cell membranes, and long-term use is associated with altered Calcium metabolism (decreased bone mineralization)

Answer 7

Proton Pump Inhibitors

omeprazole (Prilosec) -not on our list but really common

Question 8

What mucosal protector is used for NSAID induced ulcers

Answer 8

Misoprostol

Question 9

What Aluminum salt and mucosal protector is used for high risk cases (trauma, burns, ARDS, major surgery, etc)

Answer 9

sucralfate

Question 10

Treatment of H Pylori is a combination using (broad class):

Answer 10

an antacid and antibiotic

(mucosal protector: bismuth chelate)

Question 11

Hypoxia leads to vomiting by triggering which sensor in the brain:

Answer 11

Vomiting center

(dorsal reticular formation of Medulla)

Question 12

Which patch (and generic name) prevents motion sickness by binding to ACh receptors on vestibular nuclei

Answer 12

transderm Scop patch

(scopolamine)

AE: dizzy, drowzy, dry mouth, dilate, difficult urinating, blurred vision

Question 13

meclizine is an H2 blocker that inhibits vestibular input to the Chemoreceptor Trigger Zone (CTZ) to prevent:

Answer 13

motion sickness

Question 14

haloperidol blocks dopamine receptors in the CTZ for chemo-induced vomiting. It’s what class of antiemetic:

Answer 14

Neuroleptic

Question 15

metoclopramide blocks dopamine in CTZ with central and peripheral entiemetic effects, in which class of antiemetic

Answer 15

Prokinetic

Question 16

Which class of antiemetic is associated with long term extrapyramidal symptoms (akinesia, tardive dyskinesia), and includes haloperidol

Answer 16

Neuroleptic

Question 17

Which antiemetic class blocks substance P binding in central and peripheral vomit centers, and includes rolapitant, aprepitant

Answer 17

Neruokinin-1 receptor blocker

Question 18

Which antiemetic class is associated with AE Steven Johnsons syndrome (painful spreading rash in reaction to meds), and includes rolapitant, and aprepitant

Answer 18

Neurokinin-1 receptor blocker

Question 19

Which class of anti-nausea treatments works directly on the smooth muscle of the GI tract walls for intestinal flu or food-borne causes

Answer 19

Phosphorated Carbohydrate Solution (Emetrol)

Question 20

Which class of antidiarrheal agents binds to bacteria to carry them out, and includes bismuth subsalicylate and attapulgite

Answer 20

Absorbent

bismuth subsalicylate (Pepto-Bismol)

attapulgite (Kaopectate)

Question 21

Which class of antidiarrheal slows GI motility but is rarely a first choice treatment due to it’s adverse effects

Answer 21

Anticholinergics

Question 22

Which antidiarrheal agents help to restore balance and suppress harmful organisms

Answer 22

Intestinal flora modifiers

Question 23

diphenoxylate has atrophine added to prevent recreational use, and slows GI motility in which antidiarrheal class:

Answer 23

Opiate

diphenoxylate (Lomotil)

Question 24

methycellulose increases water absorption, causes distension of the colon to cause peristalsis, but is not for a pt with abdominal pain or N/V, and is in the laxative class:

Answer 24

Bulk Forming Laxative

methycellulose (Citrucel)

Question 25

lactulose and polyethylene glycol draw fluid into the colon, may cause abdominal bloating, and are in the laxative class:

Answer 25

Hyperosmotic

AE: abdominal bloating, rectal irritation, electrolyte imbalance

Question 26

What class of laxative are called “fecal softeners” and “lubricant laxatives”, and include docusate sodium

Answer 26

Emollient laxatives

docusate sodium (Colace)

AE: ↓vitamin absorption, electrolyte imbalance, skin rash, usually well tolerated

Question 27

Which class of laxative stimulates the enteric ns to increase peristalsis, includes senna glycoside, but can lead to dependence and damage to the intestinal wall with long term use?

Answer 27

Stimulant laxatives

senna glycoside (Senna)