Pharm GI

Question 1

A patient would do using a serotonin antagonist for her CINV, but she comes in having issues with her heart. You take a closer look and you realize she has torsades. What serotonin drug she most likely using?

Answer 1

dolasetron

Question 2

Patient is using a transdermal patch for nausea and vomiting of the serotonin family. She only takes one dose or one patch a day for her delayed CINV. You have to be cautious and we giving this to the patient because she is on anti-arrhythmic medics. Why do you need to be cautious in what is she taking?

Answer 2

Granisetron

Drug interaction, qt prolongation

Question 3

A patient is given postoperative nausea vomiting prophylaxis of PONV Three hours prior to anesthesia. The reason they’re doing this is she’s had previous nausea and vomiting in the past and had a tough time postop.

Answer 3

Aprepitant

Question 4

AG1PO patient comes in with initial nausea and vomiting because of her pregnancy. You put her on anti-histamine and she comes back two weeks later with drowsiness, urinary retention, constipation, blurred vision, and hypertension. What drug did you put on and why is she having these effects?

Answer 4

Doxylamine w b6

She is having anticholinergic side effects

Question 5

Patient comes in asking for a medication for her plane ride the train. She’s taking this fight before and she gets very nauseous and often vomits. She often feels dizzy when walking on the plane.What anti-histamine can you give her to help with this nausea and vomiting?

Answer 5

Meclizine and cyclizine

Question 6

A diabetic patient with Comes in with pain and distention in his abdomen. He has been told that he has nerve damage to his stomach and his cause dysmotility. What drug can you give him to stimulate acetylcholine in his G.I. tract and enhance G.I. motility and increase LES town.

Answer 6

Metoclpramide, d2

Question 7

In hospice care this is often given to reduce excretions for the end of life care. What is it and how is it giving?

Answer 7

Scopolamine, transdermal patch for 72 hours

Question 8

What drug minimizes five – HT3 release from vagal afferent terminals and has a large first pass metabolism? Which one is metabolized to several active metabolites so less doses are needed?

Answer 8

Dronabinol

Nabilone

Question 9

45-year-old male has been taking a drug for six months now to treat his Gerd. He has recently noticed that breast are starting to form. He also has to be careful when he takes it because he is also on warfarin. What drug Is he taking in why is he growing breast?

Answer 9

Cimetidine, h2

It decreases testosterone binding to the androgen receptor so it causes gynecomastia and men in galactorrhea and women

Question 10

A patient has been on this drug for eight weeks now for his peptic ulcer disease. He starts to notice that he is having green foul smelling diarrhea. He also needs to be careful of when he takes this medication because it interacts with other drugs via cyp450. What drug is He taking?

Answer 10

Omeprazole

Question 11

Same patient on a omeprazole with C diff infection, what would you use to treat that If they’ve never had it before? Or what do you treat when this is a recurrent infection!? Severe infection?

Answer 11

Oral vancomycin

Fidaxomicin

Oral vancomycin and metronidizole

Question 12

A patient recently gets back from a camping trip in which he ate undercooked chicken from the fire. He gets travelers diarrhea and has reactive arthritis. What do you used to treat?

Answer 12

Ciprofloxaxin, fluorquinlone allx then azithromyxin

Question 13

A lady that you have been seeing for years for chronic IBS - D,Keeps coming into the office because nothing is working for her symptoms anymore and is in growing in severity. You tell her you’re going to start her on this new medication but she needs to be careful and go through training for ischemic colitis. What medication are you about to start her on?

Answer 13

Alosetron

Question 14

And HIV patient who recently started antiviral therapy has had chronic diarrhea ever cents. They started him on a medication that inhibits chloride ion secretion by blocking cAMP simulated CFTR. What medication is he on

Answer 14

Crofelemer

Question 15

A patient is on a medication for her IBS d. It acts as an agonist to mu and kappa receptors but an antagonist to delta receptors. What warnings and adverse effects do you need to make sure the patient is aware of?

Answer 15

Liver and pancreatic toxicity, especially in patients with Out a gallbladder because it will cause pancreatitis

Eluxadoline

Question 16

A patient comes in with abdominal pain and cramping associated with IBS. How would you treat their spasms?

Answer 16

Hyoscamine and dicyclomine

Antimuscarinic

Question 17

Patient comes in with constipation due to opioids that are on. What medication do you give them to believe this kind of constipation?

Answer 17

Methylnaltrexone, naloxegol, lubiprostone

Question 18

The patient is on an opioid and is not ready to come off it. But they are having some bad side effects like constipation. You put them on a prostaglandin E derivative which increases chloride channels. What drug do you put them on?

Answer 18

Lubiprostone

Question 19

Patient is about to have a bowel resection and or given the strength to accelerate G.I. recovery following the surgery. This prevents Postop Ileus. What is the mechanism of action?

Answer 19

It is a peripheral mu opioid antagonist

Alvimopan

Question 20

A patient has chronic idiopathic constipation. She is put on guanylate cyclase c agonist by increasing cgmp to increase cftr secretion of bicarbonate and chloride. What med is she on?

Answer 20

Linaclotide

Question 21

What pre-colonoscopy bowel prep do you want to use if magnesium sulfate didn’t do the job to clean it in the first place? It accomplishes this by irritating the enterocytes causing inflammation and increasing prostaglandin and CAMP.

Answer 21

Sodium picosulfate

Question 22

What stimulant do you not want to use post surgery in case of an ileus?

Answer 22

Senna Causes urine discoloration and abd cramping

Question 23

WhatLaxative do you want to give for fast acting, 1 to 3 hours? What about in the case of non-urgency in 12 to 36 hours?

Answer 23

Osmotics, Attract and retain water in the colon

12 to 36 hours it would be a stimulant

Question 24

Patient comes into the ICU with severe liver disease. She is yellow with scleral icterus and has a really high chance of encephalopathy. What can you give her to treat her hyperammonemia?

Answer 24

Lactulose, osmotic

Question 25

What saline can you use for pre-colonoscopy bowel prep? He caution when doing this with what drug or what disease?

Answer 25

Magnesium salts (sulfates and hydroxide), be careful when giving this with diuretics renal disease CHF, and hypertension

Question 26

What laxative do you give the case that you don’t need immediate results, and can see efficacy in 2 to 4 days?

Answer 26

Bulk forming

Cellulose, calcium polycarbophil, fiber or bran, psyllium

Question 27

What are anionic surfactant that increases fluids in the G.I. tract and prevents the reabsorption? you see efficacy in 1 to 3 days. Often times it is used with opioids for prophylaxis

Answer 27

Docusate salts and mineral oil

Question 28

What osmotic drug is used in a large dose as a cathartic Pre-colonoscopy cleaning?

Answer 28

Polyethylene glycocol