Pharmacology

Question 1

Misoprostol

Answer 1

Type: synthetic prostaglandin analog; protects mucosal barrier
MOA: inhibits basal acid secretion, increases mucus and bicarbonate secretion
Indications: prevention of ulcers when using NSAIDs
Toxicities: uterine contractions, diarrhea, nausea

Question 2

Sulfated polysaccharides (Sucralfate)

Answer 2

Type: protects mucosal barrier
MOA: activated by acid, forms viscous gel that binds to ulcer craters and epithelial cells; inhibits pepsin, absorbs bile salts
Indications: ulcer treatment/prevention, treatment of bile-reflux diseases
Toxicities: constipation, reduces bioavailability of other drugs

Question 3

Dexlansoprazole

Answer 3

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 4

Esomeprazole

Answer 4

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 5

Pantoprazole

Answer 5

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 6

Rabeprazole

Answer 6

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 7

Lansoprazole

Answer 7

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 8

Omeprazole

Answer 8

Type: PPI, anti-secretory
MOA: irreversibly binds H+/K+ system (proton pump) in parietal cells
Indications: ulcers, GERD, Zollinger-Ellison
Toxicities: low magnesium/B12, SIBO, P450 inhibitor, increased risk of pneumonia, osteoporosis, dementia, C. Diff, interstitial nephritis

Question 9

Nizatidine

Answer 9

Type: H2 Blocker, anti-secretory
MOA: competitive inhibition of H2 receptors, inhibits gastric acid secretion stimulated by histamine
Indications: ulcer treatment/prevention, GERD treatment
Toxicities:
B12 deficiencies, inhibition of P450, CNS effects in elderly, gynecomastia

Question 10

Famotidine

Answer 10

Type: H2 Blocker, anti-secretory
MOA: competitive inhibition of H2 receptors, inhibits gastric acid secretion stimulated by histamine
Indications: ulcer treatment/prevention, GERD treatment
Toxicities:
B12 deficiencies, inhibition of P450, CNS effects in elderly, gynecomastia

Question 11

Ranitidine

Answer 11

Type: H2 Blocker, anti-secretory
MOA: competitive inhibition of H2 receptors, inhibits gastric acid secretion stimulated by histamine
Indications: ulcer treatment/prevention, GERD treatment
Toxicities:
B12 deficiencies, inhibition of P450, CNS effects in elderly, gynecomastia

Question 12

Cimetidine

Answer 12

Type: H2 Blocker, anti-secretory
MOA: competitive inhibition of H2 receptors, inhibits gastric acid secretion stimulated by histamine
Indications: ulcer treatment/prevention, GERD treatment
Toxicities:
B12 deficiencies, inhibition of P450, CNS effects in elderly, gynecomastia

Question 13

Antacids

Answer 13

Type: Acid-neutralizing
MOA: basic compounds neutralize HCl, inactivates pepsin, binds bile salts
Indications: dyspepsia, intermittent symptoms
Toxicities: reduce absorption, bioavailability, alter gut motility, bad for renal patients