Pharmacology of Acid-Peptic Disease

Question 1

What class of drugs is most effective in increasing gastric pH?

Answer 1

Proton Pump Inhibitors

Question 2

A patient comes to the ER with an actively bleeding gastric ulcer. What are the likely treatment steps that will be taken by the attending physician?

Answer 2

Cimetidine - fast-acting

Sucralfate - must be administered 2 hours after H2 blockers and PPIs

Omeprazole - longterm therapy

Question 3

What is the MOA of misoprostol?

Answer 3

Prostaglandin analog that increases mucus production

Question 4

What are the preferred class of drugs to treat GERD?

Answer 4

PPIs

Question 5

What class of drugs is indicated to treat Zollinger-Ellison Syndrome?

Answer 5

PPIs - decrease H+ production

Question 6

H2 blockers are most effective in treating (duodenal/gastric) ulcers.

Answer 6

Duodenal ulcers

Question 7

This PPI is a P450 inhibitor.

Answer 7

Omeprazole

Question 8

This class of drugs has the fastest onset in treating heartburn symptoms, but the effects are short-lived.

Answer 8

Antacids

Question 9

This drug is indicated for diarrhea, coats and protects the GI tract, and is bactericidal to H. pylori.

Answer 9

Bismuth subsalicylate

Question 10

What potentially severe ADRs are associated with PPIs?

Answer 10

Cell hyperplasia, polyps, carcinoma

Question 11

H2 blockers are indicated to treat what GI disorders?

Answer 11

Stress-induced GI ulcers

Question 12

What ADRs are associated with Cimetidine?

Answer 12

Impotence, gynecomastia, galactorrhea

Question 13

True/False. PPIs take effect nearly immediately.

Answer 13

False - effects take 12-36 hours

Question 14

What is the most potent H2 blocker to treat GI ulcers?

Answer 14

Famotidine

Question 15

What is the treatment for H. pylori infection?

Answer 15

PPI, Clarithromycin, Amoxicillin (or metronidazole if allergic to penicillin)

Question 16

This drug that reduced H+ production is most associated with antagonism of androgen receptors.

Answer 16

Cimetidine (H2 blocker)

Question 17

What is the primary ADR associated with antacid toxicity?

Answer 17

Metabolic alkalosis (milk-alkali syndrome)

Question 18

What is the MOA of sucralfate?

Answer 18

Binds to proteins in ulcers to promote direct healing

Question 19

What is the MOA of H2 blockers in acid production?

Answer 19

Decrease H+ secretion by inhibiting production of cAMP