Test # 4 GI disorders

Question 1

What is when there is a backflow of stomach acid into the esophagus - leads to scaring, heartburn

Answer 1

GERD - gastroesophageal reflux disease

Question 2

When the lining of the esophagus is replaced with abnormal tissue. 10% of GERD pt - there had been a link to cancer in the esophagus

Answer 2

Barrett’s Esophagus

Question 3

What are the two main causes of Peptic ulcer disease - 95%

Answer 3

Increased bacteria and NSAID use

Question 4

One type of Antacid that is systemic and increases the pH of the blood

Answer 4

Sodium Bicarbonate

Question 5

Two Antacids that do not cross into the blood - it stays orally

They are both more potent that Ca++

Answer 5

Aluminum Hydroxide + Mg Hydroxide

Maalox and Mylanta

Question 6

What is an antacid that stays orally (does not cross into the blood) and may cause some consitpation

Answer 6

Ca Carbonate (Tums)

Question 7

What are 3 H2 (histamine) receptor blockers that inhibit gastric acid secretion

Answer 7

Famotidine
Ranitidine
Nizatidine

Question 8

What is one H2 (histamine) receptor blocker that inhibits gastric acid secretion
It also effects other drugs through the p450
and also inhibits metabolism of estrogen (men will get breast)!!!

Answer 8

Cimetidine

Question 9

what are 5 proton pump inhibitors that inhibit secretion of gastric acid - they prevent “pumping” or releasing of acid.

works in 24hours but takes about 4-8wks for the stomach to heal back up

Answer 9

Omeprazole - NEIL Prilosec
Esomeprazole - nexium
Rebeprazole
Lansoprazole - prevacid
Pantoprazole

Question 10

What is one drug that is a prostagladin and is used for the tx of NSAID induced injury (ulcer formation)

can cause birth defects and premature births

Answer 10

Misoprostol - cytotec

Question 11

What is the last resort for tx of increase acid production in stomach - and Anticholinergic (muscarinic antagonist)

SE: burry vision, constipation, dry mouth, sedation (anti-slude)

Answer 11

Pirenzipine

Question 12

a mucosal protectant - needs low pH to activate

forms a barrier around ulcer and allows it to heal

give 2 hrs before or after meals and other drugs

Answer 12

Sucralfate (carafate)

Question 13

a mucosal protectant that protects ulcer to allow to heal.

Helps some with H.Pylori

use for less than 2 months - BLACK STOOLS

Answer 13

Chelated bismuth - Pepto Bismol

Question 14

what are two meds to treat H. Pylori

they disrupt the bacteria cell wall

Answer 14

Bismuth

Amoxicillin

Question 15

what are 2 drugs to tx H. Pylori

they inhibit protein synthesis

Answer 15

Clarithromycin

Tetracycline

Question 16

What is one drug used to tx H. pylori that is given when there is a bacterial resistance or intolerance to other drugs

Answer 16

Metronidazone

Question 17

what drugs are defined in the TRIPLE therapy use to treat H.Pylori.

It is a 7 day treatment

and is a tx of choice for people who have an ulcer and are positive for H. Pylori

Answer 17

Proton pump inhibitior + amoxicillin/tetraccycline + metronidazone/clarithomycin

Question 18

What is in the QUADRUPLE therapy to tx H.Pylori

it is a 7 day course treatment

Answer 18

Proton pump inhibitior + amoxicillin/tetraccycline + metronidazone/clarithomycin

PLUS bismuth!!

Question 19

What is the #1 cause of constipation?

Answer 19

laxative use!

always try diet first

Question 20

what are 3 Bulk laxatives

they increase bowel content which causes a peristalsis reflex

indigestible - few days to work

Answer 20

Psyllium

Bran

Methycellulose

Question 21

What laxatives work in1-3 hours (purge intestines)

the fluid is drawn into the bowel

Answer 21

saline and osmotic laxatives

Lactulose, prunes
milk of magnesia
epsom salt
polyethylene - saposatory

Question 22

What are 3 stool softeners

lub the stool so it can slide out

Answer 22

Docusate sodium
Liquid paraffin
glycerin suppositories

Question 23

what are 3 irritants that stimulate GI peristalsis

works in 6-8 hours for severe constipation

Answer 23

Bisacodyl - Dulcolax

Senna

Lubiprostone

Question 24

An anti-diarrheal agent that is 50x more potent than morphine

decreases peristalsis - stimulates opioid receptor in bowel

NO CNS effect - does not cross BBB

Answer 24

Loperamide - Imodium

Question 25

what are three other anti-diarrheal agents that stimulate opioid receptors to slow GI

What for increase in toxic effects bc drugs can get trapped in the system

Answer 25

Morphine

Codeine

Diphenoxylate

Question 26

what is the # 1 cause in clinic setting diarrhea.

It secretes an enzyme and can perm. damage lining of GI

Answer 26

C. Diff

Question 27

what is an antiflatulant that alters the mucous bubble

clinical only effectiveness is when used with loperamide (gas associated with diarrhea)

Answer 27

Simethicone

Question 28

What drug induces emesis

only give if more than 30-60mins away from hospital

Answer 28

Syrup of Ipecac emetic

Question 29

an antiemetic (M1 receptor antagonist)

ANTI-SLUDE Side effects

give only 1 bc extra may cause hallucinations

Answer 29

Scopolamine

Question 30

what are two H2/D2 antagonists that are used for antiemetics

SE: blurred vision, dry mouth, extrapyramidal effects, seizures

Answer 30

Promethazine - phenergan

Prochlorperazine - Compazine

Question 31

What are two antiemetic drugs that block the 5-HT2 receptor

HE and constipation

newest drug - safe -, effective, rapid

Answer 31

Ondansetron - Zofran

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