VII - GI DRUGS

Question 1

Neutralize stomach acid by reacting with protons in the lumen

Answer 1

Antacids (TOPNOTCH)

Question 2

Impairs absorption of tetracyclines, flouroquinolones,itraconazole and iron

Answer 2

Antacids (TOPNOTCH)

Question 3

Antacids

Answer 3

Magnesium-Aluminum Hydroxide, Calcium carbonate, Sodium bicarbonate (TOPNOTCH)

Question 4

Competitive pharmacologic block of H2 receptors ; for peptic ulcer disease, Zollinger-Ellison syndrome, Gastroesophagal reflux, dyspepsia

Answer 4

H2 Receptor Blockers
RANITIDINE, CIMETIDINE, FAMOTIDINE

(TOPNOTCH)

Question 5

H2 Receptor Blockers

Answer 5

Cimetidine, Ranitidine, Famotidine, Nizatidine (TOPNOTCH)

Question 6

Highly effective in suppressing nocturnal acid secretion but only modest effect on meal- stimulated secretion

Answer 6

H2 Receptor Blockers (TOPNOTCH)

Question 7

Irreversible blockade of H/K ATPase in active gastric panetal cells. Long lasting reduction of meal stimulated and nocturnal acid secretion

Answer 7

Proton Pump Inhibitors (TOPNOTCH)

Question 8

Proton Pump Inhibitors

Answer 8

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 9

usually enetric coated, needs 3-4 days treatment to achieve full effectiveness

Answer 9

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 10

SE: Diarrhea, headache, abdominal pain, Malaabsorption (Vit B12, Ca, Fe, Zn), Infections (respiratory, enteric), Hypergastrinemia, Atrophic gastritis

Answer 10

Omeprazole, Lansopraole, Rabeprazole, Pantoprazole, Esomeprazole (TOPNOTCH)

Question 11

Binds to injured tissue and forms a protective covering with ulcer beds. Accelerates healing of peptic ulcers and reduces recurrence rate

Answer 11

Sucralfate - Mucosal protective agent (TOPNOTCH)

Question 12

Forms a protective coating on ulcerated tissue. Stimulates mucosal protective mechanisms, direct antimicrobial effects and sequestration of enterotoxins

Answer 12

Bismuth Salicylate
*This drug has dual activity. It acts as mucosal protective agent. And due to its heavy metal component (Bismuth), it has a direct bactericidal effect on H. pylori J
(TOPNOTCH)

Question 13

SE: Abdominal pain, Diarrhea, Uterine cramping, Miscarriage

Answer 13

Misoprostol (TOPNOTCH)

Question 14

Activates EP receptors. Causes incresed HCO3 and mucus secretion in stomach. Uterine contraction

Answer 14

Misoprostol

* Activates PGE 1 receptor which decreases acid secretion and increases mucus secretion in the stomach

Question 15

SE: Black stools, darkening of tongue, Encephalopathy (Atraxia, headaches, confusion, seizures)

Answer 15

Bismuth Salicylate (TOPNOTCH)

Question 16

Increases gastric emptying and intestinal motility

Answer 16

Prokinetic agents

Metoclopramide, Domperidone, Erythromycin

*Metoclopramide and domperidone block D2 receptors. Erythromycin stimulates motilin receptors. Increases gastric emptying and intestinal motility.

(TOPNOTCH)

Question 17

______ and ______ block D receptors ; _______ stimulates motilin receptors

Answer 17

Metoclopramide and domperidone, Erythromycin (TOPNOTCH)

Question 18

T or F: Domperidone does not cross the BBB (less toxic)

Answer 18

TRUE (TOPNOTCH)

Question 19

Indigestible, hydrophilic colloids that absorb water, forming a bulky emollient gel that distends the colon and promotes peristasis

Answer 19

Bulk-forming Laxatives: Psyllium, Methylcellulose, Polycarbophil

• Increases the bulk of your stool so that the colon will be distended. It will signal the enteric nervous system to activate peristalsis for defecation.

Question 20

Soften stool material, Permitting water and lipids to penetrate

Answer 20

Stool-softener: Docusate, Glycerine, Suppository, Mineral oil (TOPNOTCH)

Question 21

Soluble but nonabsorbable compound that result in increased stool liquidity due to an obligate increase in fecal fluid

Answer 21

Osmotic Laxatives: Lactulose, Magnesium oxide, Sorbitol, Magnesium citrate, Sodium phosphate, Polyethylene Glycol (TOPNOTCH)

Question 22

Directly stimulate enteric nervous system and colonic electrolyte and fluid secretion

Answer 22

Stimulant Laxatives: Bisacodyl, Aloe, Senna, Cascara, Castor oil (TOPNOTCH)

Question 23

Activates opioid receptors in enteric nervous system. Slows motility with negligible CNS effects

Answer 23

Antidiarrheal agent

Diphenoxylate, Loperamide, Kaolin+Pectin, Colloidal Bismuth

*Do not use in children less than 4 years of age (increased chance of causing paralytic ileus) Reverse ileus by administering Bethanechol

Question 24

Blocks chemoreceptor trigger zone and enteric nervous system 5-HT3 receptors ; For Vomiting (Post chemothereaphy, postoperative)

Answer 24

Ondansetron, Granisetron, Dolasetron, Palonosetron (TOPNOTCH)

Question 25

Probably inhibits production of eicosanoid inflammatory mediators ; for Inflammatory bowel disease (mild to moderate)

Answer 25

Immunomodulator Mesalamine, Balsalazide, Olsalazine, Sulfasalazine, Mesalazine (TOPNOTCH) Used only for mild CONTROLLED cases of IBD. Flareups should be given immunosuppressants such as corticosteroids, TNF antagonists, Cyclosporine etc.