Gastrointestinal and Antiemetic Drugs
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Questions and Answers

What is the function of prostaglandin E produced by the gastric mucosa?

  • Increases pepsin activity
  • Inhibits secretion of mucus and bicarbonate
  • Stimulates secretion of acid
  • Inhibits secretion of acid and stimulates secretion of mucus and bicarbonate (correct)
  • What is thought to be involved in the pathogenesis of peptic ulcers?

  • Excess of pepsin
  • Deficiency of prostaglandins (correct)
  • Deficiency of pepsin
  • Excess of prostaglandins
  • What is the use of misoprostol in patients taking NSAIDs?

  • To treat NSAID-induced gastric ulcers
  • To treat rheumatoid arthritis
  • To stimulate uterine contractions
  • To prevent NSAID-induced gastric ulcers (correct)
  • Why is misoprostol contraindicated in pregnancy?

    <p>It can stimulate uterine contractions and cause miscarriage</p> Signup and view all the answers

    What is the most common adverse effect of misoprostol?

    <p>Dose-related diarrhea</p> Signup and view all the answers

    Why are PPis preferred agents for the prevention of NSAID-induced ulcers?

    <p>They have fewer adverse effects than misoprostol</p> Signup and view all the answers

    What is the primary mechanism of action of diphenoxylate in the treatment of severe diarrhea?

    <p>Decreasing gut peristaltic activity</p> Signup and view all the answers

    Which of the following is NOT a type of gastrointestinal disorder mentioned in the chapter?

    <p>Diverticulitis</p> Signup and view all the answers

    What is the effect of antacids on pepsin activity?

    <p>Decrease pepsin activity</p> Signup and view all the answers

    Which class of drugs is used to heal peptic ulcers?

    <p>H2 receptor antagonists</p> Signup and view all the answers

    What is the purpose of using antacids?

    <p>To reduce gastric acidity</p> Signup and view all the answers

    What is the brand name of the H2 receptor antagonist nizatidine?

    <p>Axid</p> Signup and view all the answers

    Which antibiotic is used to treat gastrointestinal infections?

    <p>Metronidazole</p> Signup and view all the answers

    What is the primary indication for the use of bismuth compounds?

    <p>Treatment of peptic ulcers</p> Signup and view all the answers

    What is the primary factor that determines the efficacy of an antacid?

    <p>The capacity of the antacid to neutralize gastric HCl</p> Signup and view all the answers

    Why do antacids work more effectively when taken after meals?

    <p>Food delays stomach emptying, allowing more time for the antacid to react</p> Signup and view all the answers

    What is the primary site of absorption of proton pump inhibitors?

    <p>Duodenum</p> Signup and view all the answers

    What is a common combination of salts used in antacids?

    <p>Aluminum and magnesium</p> Signup and view all the answers

    Which of the following drugs is most likely to have its efficacy reduced by H2 receptor antagonists?

    <p>Ketoconazole</p> Signup and view all the answers

    What is the reaction product of calcium carbonate with HCl?

    <p>CaCl2 and CO2</p> Signup and view all the answers

    What is a potential adverse effect of sodium bicarbonate antacids?

    <p>Transient metabolic alkalosis</p> Signup and view all the answers

    What is the final step in the secretion of gastric acid?

    <p>H+/K+-ATPase enzyme system</p> Signup and view all the answers

    Which of the following is a common adverse effect of proton pump inhibitors, particularly in elderly patients?

    <p>Altered mentation</p> Signup and view all the answers

    What is a therapeutic use of antacids?

    <p>Symptomatic relief of heartburn</p> Signup and view all the answers

    What is a common use of calcium carbonate preparations aside from antacids?

    <p>Prevention of osteoporosis</p> Signup and view all the answers

    Which of the following drugs is inhibited by cimetidine?

    <p>All of the above</p> Signup and view all the answers

    What is the mechanism of action of proton pump inhibitors?

    <p>Inhibition of H+/K+-ATPase enzyme system</p> Signup and view all the answers

    What is a potential adverse effect of aluminum hydroxide antacids?

    <p>Constipation</p> Signup and view all the answers

    Which of the following is a type of proton pump inhibitor?

    <p>Lansoprazole</p> Signup and view all the answers

    What is the purpose of the enteric coating of proton pump inhibitors?

    <p>To protect the drug from degradation by gastric acid</p> Signup and view all the answers

    What is the reason for not administering sucralfate with PPis, H2 antagonists, or antacids?

    <p>It requires an acidic pH for activation</p> Signup and view all the answers

    What is the primary use of bismuth subsalicylate in the treatment of peptic ulcers?

    <p>As a component of quadruple therapy to heal H.pylori-related peptic ulcers</p> Signup and view all the answers

    What percentage of patients who undergo chemotherapy experience nausea and/or vomiting?

    <p>70% to 80%</p> Signup and view all the answers

    What is the term used to describe nausea and vomiting produced by chemotherapeutic agents?

    <p>Chemotherapy-induced nausea and vomiting (CINV)</p> Signup and view all the answers

    What is the primary reason for the effective management of chemotherapy-induced nausea and vomiting?

    <p>It demands especially effective management</p> Signup and view all the answers

    What is a factor that influences the incidence and severity of chemotherapy-induced nausea and vomiting?

    <p>The specific chemotherapeutic drug</p> Signup and view all the answers

    What is an effect of bismuth subsalicylate on the ulcer?

    <p>It coats and protects the ulcer</p> Signup and view all the answers

    What is the purpose of Figure 40.8?

    <p>To compare the emetic potential of anticancer drugs</p> Signup and view all the answers

    Study Notes

    Gastrointestinal and Antiemetic Drugs

    • This chapter describes drugs used to treat six common medical conditions involving the gastrointestinal (GI) tract.

    Peptic Ulcer Disease and Gastroesophageal Reflux Disease (GERD)

    • H2 receptor antagonists and proton pump inhibitors (PPIs) are used to heal peptic ulcers.
    • PPIs bind to the H+/K+-ATPase enzyme system (proton pump) and suppress the secretion of hydrogen ions into the gastric lumen.
    • Available PPIs include dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole.
    • Prostaglandin E, produced by the gastric mucosa, inhibits secretion of acid and stimulates secretion of mucus and bicarbonate (cytoprotective effect).
    • Misoprostol, an analog of prostaglandin E1, is approved for the prevention of NSAID-induced gastric ulcers.
    • Antacids are weak bases that react with gastric acid to form water and a salt to diminish gastric acidity.
    • Antacids reduce pepsin activity by increasing pH above 4.
    • Commonly used antacids are combinations of salts of aluminum and magnesium, such as aluminum hydroxide and magnesium hydroxide.

    Antiemetic Drugs

    • Chemotherapy-induced nausea and vomiting (CINV) occurs in nearly 70% to 80% of patients who undergo chemotherapy.
    • Factors influencing the incidence and severity of CINV include the specific chemotherapeutic drug, dose, route, and schedule of administration, and patient variables.
    • Several drugs are used to control CINV, including metoclopramide, ondansetron, granisetron, and dolasetron.
    • These drugs work by blocking the action of serotonin on the vomiting center in the brain.

    Prostaglandins

    • Prostaglandin E1 is used to prevent NSAID-induced gastric ulcers.
    • Misoprostol, an analog of prostaglandin E1, is approved for the prevention of NSAID-induced gastric ulcers.

    Antacids

    • Antacids are used for symptomatic relief of peptic ulcer disease, heartburn, and GERD.
    • They should be administered after meals for maximum effectiveness.
    • Calcium carbonate preparations are also used as calcium supplements for the prevention of osteoporosis.

    Sucralfate

    • Sucralfate is used to treat peptic ulcers and GERD.
    • It forms a protective barrier over the ulcer crater, shielding it from acid and pepsin.
    • Sucralfate should not be administered with PPIs, H2 antagonists, or antacids.

    Bismuth Subsalicylate

    • Bismuth subsalicylate is used as a component of quadruple therapy to heal H. pylori-related peptic ulcers.
    • It inhibits the activity of pepsin, increases secretion of mucus, and interacts with glycoproteins in necrotic mucosal tissue to coat and protect the ulcer.

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    Description

    This quiz covers the treatment of six common medical conditions involving the gastrointestinal tract, including peptic ulcers, GERD, and chemotherapy-induced emesis.

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