Ulcer Treatment

Question 1

Cimetidine- Classification

Answer 1

Histamine H2 Receptor Antagonist

Question 2

Cimetidine- Mech of Action

Answer 2

blocks histamine H2 receptors,

decreases gastric acid secretion

Question 3

Cimetidine- Routes of administration

Answer 3

1. oral
2. i.v.
3. injection

Question 4

Cimetidine- Therapeutic Use

Answer 4

1. duodenal ulcers
2. gastric ulcers
3. erosive gastroesophageal reflux disease (GERD)
4. prevention of upper GI bleeding
5. hypersecretory conditions (Zollinger-Ellison Syndrome)

Question 5

Cimetidine- Side effects

Answer 5

gynecomastica w/ long-term use

impotence in some cases

Question 6

Cimetidine- comments

Answer 6

• i.v. bolus can cause cardiac arrythmias and hypotension (rare)
• H2 antagonists can be added to PPIs to stop nocturnal acid breathrough, but may reduce efficacy of PPIs

Question 7

Ranitidine- Classification

Answer 7

Histamine H2 receptor antagonist

Question 8

Ranitidine- Mech of Action

Answer 8

blocks histamine H2 receptors,

decreases gastric acid secretion

Question 9

Ranitidine- Routes of Administration

Answer 9

1. oral

2. i.v.

Question 10

Ranitidine- Therapeutic Use

Answer 10

(same as cimetidine)

1. duodenal ulcers
2. gastric ulcers
3. GERD
4. prevention of upper GI bleeding
5. hypersecretory conditions

Question 11

Ranitidine- Side Effects

Answer 11

rare, but include:
agitation
anemia
confusion
depression

Question 12

Ranitidine- comments

Answer 12

• may increase risk of developing pneumonia

- H2 antagonists can be added to PPIs to stop nocturnal acid breakthough but may decrease efficacy of PPIs

Question 13

Omeprazole- Classification

Answer 13

PPI

Question 14

Omeprazole- Mech of Action

Answer 14

Inhibits H+/K+ pump (proton pump) in the gastric parietal cells

Question 15

Omeprazole- Route of Administration

Answer 15

oral

Question 16

Omeprazole- Therapeutic use

Answer 16

1. Zollinger-Ellison Syndrome
2. GERD
3. short term treatment of duodenal ulcers
4. Rx of H. Pylori in combination with antibiotics

Question 17

Omeprazole- Contraindications

Answer 17

1. can increase concentrations of WARFARIN, DIAZEPAM, AND PHENYTOIN by decreasing their clearance by the liver
2. PPIs can reduce absorption of KETOCONAZOLE and increase absorption of DIGOXIN

Question 18

Omeprazole- Side Effects

Answer 18

diarrhea
nausea
skin rash
dizziness

Question 19

Omeprazole- comments

Answer 19

Not normally used with H2 antagonists- reduced efficacy of PPIs

Question 20

Sucralfate- Classification

Answer 20

Mucosal Protective Agent

Question 21

Sucralfate- Mech of Action

Answer 21

binds selectively to necrotic tissue to form a barrier against gastric acid

Question 22

Sucralfate- Route of administration

Answer 22

1. oral

Question 23

Sucralfate- Type of Therapeutic use

Answer 23

1. duodenal ulcers

2. suppresses H. pylori infection

Question 24

Sucralfate- Contraindications

Answer 24

1. can decrease absorption of cimetidine, ciproflaxacin, digoxin, ofloxacin, ranitidine if given simultaneously with sucralfate
2. Grapefruit promotes absorption of Al in sucralfate- problems in patients with renal inssufficiency/failure

Question 25

Sucralfate- side effects

Answer 25

Minor:constipation, flatulence, dry mouth, diarhhea, nausea

Question 26

Sucralfate- comments

Answer 26

colloidal bismuth works in same manner as sucralfate