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Questions and Answers
What is the function of prostaglandin E produced by the gastric mucosa?
What is thought to be involved in the pathogenesis of peptic ulcers?
What is the use of misoprostol in patients taking NSAIDs?
Why is misoprostol contraindicated in pregnancy?
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What is the most common adverse effect of misoprostol?
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Why are PPis preferred agents for the prevention of NSAID-induced ulcers?
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What is the primary mechanism of action of diphenoxylate in the treatment of severe diarrhea?
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Which of the following is NOT a type of gastrointestinal disorder mentioned in the chapter?
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What is the effect of antacids on pepsin activity?
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Which class of drugs is used to heal peptic ulcers?
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What is the purpose of using antacids?
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What is the brand name of the H2 receptor antagonist nizatidine?
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Which antibiotic is used to treat gastrointestinal infections?
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What is the primary indication for the use of bismuth compounds?
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What is the primary factor that determines the efficacy of an antacid?
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Why do antacids work more effectively when taken after meals?
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What is the primary site of absorption of proton pump inhibitors?
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What is a common combination of salts used in antacids?
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Which of the following drugs is most likely to have its efficacy reduced by H2 receptor antagonists?
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What is the reaction product of calcium carbonate with HCl?
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What is a potential adverse effect of sodium bicarbonate antacids?
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What is the final step in the secretion of gastric acid?
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Which of the following is a common adverse effect of proton pump inhibitors, particularly in elderly patients?
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What is a therapeutic use of antacids?
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What is a common use of calcium carbonate preparations aside from antacids?
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Which of the following drugs is inhibited by cimetidine?
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What is the mechanism of action of proton pump inhibitors?
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What is a potential adverse effect of aluminum hydroxide antacids?
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Which of the following is a type of proton pump inhibitor?
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What is the purpose of the enteric coating of proton pump inhibitors?
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What is the reason for not administering sucralfate with PPis, H2 antagonists, or antacids?
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What is the primary use of bismuth subsalicylate in the treatment of peptic ulcers?
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What percentage of patients who undergo chemotherapy experience nausea and/or vomiting?
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What is the term used to describe nausea and vomiting produced by chemotherapeutic agents?
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What is the primary reason for the effective management of chemotherapy-induced nausea and vomiting?
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What is a factor that influences the incidence and severity of chemotherapy-induced nausea and vomiting?
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What is an effect of bismuth subsalicylate on the ulcer?
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What is the purpose of Figure 40.8?
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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.
