Pharmacology

Question 1

H2 blockers mechanism

Answer 1

Reversible block of H2 receptors decreasing acid secretion by parietal cells

Question 2

Indications for H2 blockers

Answer 2

Peptic ulcer, gastritis, mild esophageal reflux

Question 3

H2 blocker that causes prolactin release, gynecomastia, impotence and decreased libido in males

Answer 3

Cimetidine

Question 4

H2 blockers that decrease renal excretion of creatinine

Answer 4

Cimetidine and ranitidine

Question 5

H2 blocker that is a potent inhibitor of cytochrome P-450 causing multiple drug interactions

Answer 5

Cimetidine

Question 6

What are the H2 blockers?

Answer 6

Cimetidine, ranitidine, famotidine, nizatidine

Question 7

Irreversible inhibit H+/K+ ATPase in stomach parietal cells

Answer 7

Proton pump inhibitors

Question 8

Indicated for peptic ulcers, gastritis, esophageal reflux, Zollinger-Ellison syndrome, a part of H. pylori therapy, and stress ulcer prophylaxis

Answer 8

Proton pump inhibitors

Question 9

Drugs used for the treatment of peptic ulcers that increase the risk of C. difficile infections, pneumonia, and decrease serum magnesium with long-term use

Answer 9

Proton pump inhibitors

Question 10

What are the Proton pump inhibitors?

Answer 10

Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole

Question 11

Antacid that can chelate and decrease the effectiveness of other drugs

Answer 11

Calcium carbonate

Question 12

Antacid that is a phosphate binder, is absorbed into bones causing brittle bones

Answer 12

Aluminum hydroxide

Question 13

Antacid that causes constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy and seizures

Answer 13

Aluminum hydroxide

Question 14

Antacid that can cause diarrhea, hyporeflexia, HoTN, and cardiac arrest

Answer 14

Magnesium hydroxide

Question 15

Drugs that bind to ulcer base, providing physical protection allowing HCO3- secretion to reestablish pH gradient in the mucus layer

Answer 15

Bismuth and sucralfate

Question 16

Bismuth and sucralfate are not given with what type of acid suppressors?

Answer 16

H2 blockers and PPIs

Question 17

What type of environment is required for bismuth and sucralfate to be effective?

Answer 17

Acidic environment

Question 18

A PGE1 analog that increases production and secretion of gastric mucus barrier and decreases acid production

Answer 18

Misoprostol

Question 19

Why is misoprostol contraindicated in women of childbearing age?

Answer 19

Its an abortifacient

Question 20

Acid suppressor used off-label for ripening of cervix to induce labor

Answer 20

Misoprostol

Question 21

PGE1 analog used for the prevention of NSAID-induced ulcers

Answer 21

Misoprostol

Question 22

Long-acting somatostatin analog which inhibits secretion of various splanchnic vasodilatory hormones

Answer 22

Ocreotide

Question 23

Somatostatin analog used for the treatment of acromegaly

Answer 23

Ocreotide

Question 24

Indications for ocreotide

Answer 24

Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

Question 25

Acid suppressor indicated for VIPomas that can cause nausea, cramps, steatorrhea and increases the risk of cholelithiasis due to CCK inhibition

Answer 25

Ocreotide

Question 26

Drug indicated for ulcerative colitis and activated by colonic bacteria

Answer 26

Sulfasalazine

Question 27

Drug indicated for ulcerative colitis that causes malaise, nausea, sulfonamide toxicity and reversible oligospermia

Answer 27

Sulfasalazine

Question 28

Drug with anti-inflammatory and antibacterial properties indicated for ulcerative colitis and Crohn disease

Answer 28

Sulfasalazine

Question 29

Antidiarrheal that is an agonist at u-opioid receptors and slowing gut motility

Answer 29

Loperamide

Question 30

Patient with a history of substance abuse wants treatment for diarrhea, what drug is indicated?

Answer 30

Loperamide

Question 31

Loperamide side effects

Answer 31

Constipation and nausea

Question 32

Antidiarrheal with low addictive potential that causes constipation and nausea

Answer 32

Loperamide

Question 33

5-HT3 antagonist that decreases vagal stimulation used to control postoperative vomiting in patients undergoing cancer chemotherapy

Answer 33

Ondansetron

Question 34

Antiemetic that can cause headache, constipation, QT prolongation and serotonin syndrome

Answer 34

Ondansetron

Question 35

D2 receptor analog indicated for gastroparesis, persistent GERD and antiemesis

Answer 35

Metoclopramide

Question 36

D2 receptor analog that causes parkinsonian effects and tardive dyskinesia that is contraindicated in patients with small bowel obstruction and Parkinson disease

Answer 36

Metoclopramide

Question 37

Therapy indicated for weight loss causes steatorrhea and decreased absorption of fat soluble vitamins

Answer 37

Orlistat

Question 38

Therapy indicated for weight loss by inhibiting gastric and pancreatic lipase causing decreased breakdown and absorption of dietary fats

Answer 38

Orlistat

Question 39

Soluble fibers that draw water into gut lumen, forming a viscous fluid that promotes peristalsis

Answer 39

Psyllium and methylcellulose

Question 40

Side effect of bulk forming laxatives like psyllium and methylcellulose

Answer 40

Bloating

Question 41

Osmotic laxative indicated for the treatment of hepatic encephalopathy

Answer 41

Lactulose

Question 42

Mechanism of lactulose for the treatment of hepatic encephalopathy

Answer 42

Degraded by gut flora into lactic acid and acetic acid which promote nitrogen excretion

Question 43

Osmotic laxative that is degraded by gut flora into lactic acid and acetic acid promoting nitrogen excretion as NH4+

Answer 43

Lactulose

Question 44

Laxatives that may be abused by bulimics

Answer 44

Osmotic laxatives

Question 45

Which drugs are osmotic laxatives

Answer 45

Magnesium hydroxide, magnesium citrate, polyethylene glycol, and lactulose

Question 46

Mechanism of osmotic laxatives

Answer 46

Provide osmotic load to pull water into GI lumen

Question 47

Osmotic laxative side effects

Answer 47

Diarrhea and abuse potential by bulimics

Question 48

Patient with constipation was given a laxative which caused diarrhea and a brown pigment to be deposited in macrophages within the lamina propria of the gut wall - what is the drug?

Answer 48

Senna

Question 49

Laxative which stimulates enteric nerves to contract the colon

Answer 49

Senna

Question 50

Emollient used to osmotically draw water into gut lumen increasing water absorption by stool

Answer 50

Docusate

Question 51

Osmotic laxative which is also used as an antacid

Answer 51

Magnesium hydroxide

Question 52

Side effect of docusate

Answer 52

Diarrhea