Gastrointestinal Diseases and Proton Pump Inhibitors
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Questions and Answers

What is the main mechanism of action of proton pump inhibitors like Omeprazole?

  • Inhibit the hydrogen-potassium ATPase in gastric cells (correct)
  • Inhibit the production of histamine receptors
  • Increase the production of stomach acid
  • Enhance the function of ATP in the gastrointestinal system

Which condition is Proton Pump Inhibitors commonly used to treat?

  • GERD (Gastroesophageal Reflux Disease) (correct)
  • High blood pressure
  • Influenza
  • Arthritis

Why should Proton Pump Inhibitors be taken on an empty stomach?

  • To reduce the risk of liver toxicity
  • To prevent interactions with food molecules
  • To avoid neutralizing stomach acid too early (correct)
  • To ensure better absorption in the intestines

What is a potential adverse effect associated with long-term use of Proton Pump Inhibitors?

<p>Osteoporosis (B)</p> Signup and view all the answers

How do Histamine H2 Receptor Antagonists like Cimetidine work to reduce stomach acid production?

<p>Block histamine receptors on stomach cells (C)</p> Signup and view all the answers

Which of the following drugs inhibits the production of acids and stimulates the production of prostaglandins by binding to prostaglandin receptors?

<p>Misoprostol (B)</p> Signup and view all the answers

Which drug is used in the treatment of gastroparesis diabetica and belongs to the class of drugs called macrolides?

<p>Clarithromycin (B)</p> Signup and view all the answers

Which of the following drugs reduces peristalsis and increases intestinal transit time by inhibiting the secretion of acetylcholine and prostaglandins?

<p>Loperamida (A)</p> Signup and view all the answers

Which drug is used for the prevention of nausea and vomiting by antagonizing the dopamine D2 receptor?

<p>Domperidone (C)</p> Signup and view all the answers

Which of the following drugs stimulates the 5HT4 receptor, but is no longer used due to its association with cardiac arrhythmias?

<p>Cisaprida (B)</p> Signup and view all the answers

Which drug is used for the treatment of infections caused by Helicobacter pylori and belongs to the class of drugs called antagonists of the histamine H2 receptor?

<p>Ranitidine (A)</p> Signup and view all the answers

Flashcards

Proton Pump Inhibitors (PPIs)

Drugs that block the proton pump, inhibiting hydrogen, potassium, and ATPase in the gastric parietal cells, leading to reduced acid secretion.

H2 Receptor Antagonists

A group of drugs that reduce stomach acid production by blocking histamine receptors in parietal cells.

Mucosal Protective Agents

These drugs protect the stomach lining from damage, often used for ulcers or NSAID-induced damage.

Antacids

They neutralize stomach acid directly, providing fast relief from heartburn.

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Treatment of H. pylori Infection

A combination of drugs used to eradicate H. pylori infection, often including a PPI, an antibiotic, and a bismuth subsalicylate.

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Motility Modulators

These drugs influence gastrointestinal motility, either by speeding it up or slowing it down.

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Laxatives

Drugs that promote bowel movement by increasing water retention in the intestines, softening stools, or stimulating the defecation reflex.

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Examples of PPIs

Omeprazole, esomeprazole, lansoprazole, rabeprazole, and pantoprazole are examples.

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Examples of H2 Receptor Antagonists

Cimetidine, ranitidine, famotidine, and nizatidine are examples.

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Examples of Mucosal Protective Agents

Sucralfate and misoprostol are examples.

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Examples of Antacids

Sodium bicarbonate, calcium carbonate, and aluminum magnesium are examples.

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Study Notes

Gastrointestinal

  • Inhibitors of proton pump:
  • Omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole
  • Inhibit hydrogen, potassium, and ATPase in the gastric parietal cells
  • Prodrugs, taken on an empty stomach, and inactivated in the form of a sulfenamide
  • Used for ulcer healing, GERD, esophagitis, Zollinger-Ellison syndrome, and with antibiotics for H. pylori
  • Increase warfarin potency (anticoagulant), do not mix with methotrexate due to liver metabolism
  • Adverse reaction: osteoporosis, may cause vitamin B12 deficiency

H2 Receptor Antagonists

  • Cimetidine, ranitidine, famotidine, nizatidine
  • Inhibit acid production by antagonizing H2 receptors of histamine in gastric parietal cells
  • Used for ulcer healing, GERD, and prevention of ulcers
  • Adverse effects: diarrhea, abdominal pain, constipation

Mucosal Protective Agents

  • Sucralfate, misoprostol
  • Misoprostol prevents mucosal lesions caused by NSAIDs
  • Inhibit acid production, stimulate prostaglandin production (binding to prostaglandin receptors)
  • Used for stress ulcer prophylaxis

Antacids

  • Sodium bicarbonate, calcium carbonate, aluminum magnesium
  • Neutralize hydrochloric acid in the stomach
  • Used for heartburn relief

Treatment of H. pylori Infection

  • Inhibitor of proton pump + clarithromycin + metronidazole
  • Inhibitor of proton pump - metronidazole + bismuth subsalicylate + tetracycline
  • H2 receptor antagonist + bismuth subsalicylate (525 mg) + metronidazole + tetracycline

Motility Modulators

  • Antagonists of dopamine receptor:

    • Metoclopramide and domperidone
    • M-antagonize D2 receptor in the upper GI tract, agonize 5HT4 receptor, antagonize vagal and central 5HT3, and sensitize muscarinic receptors in smooth muscle
    • Adverse effect: Parkinson's syndrome symptoms, galactorrhea
    • D-antagonize D2 receptor
  • Used for nausea and vomiting prevention

  • Agonists of serotonin receptor:

    • Cisapride, prucalopride
    • Stimulate 5HT4 receptors
    • Used for GERD, gastroparesis, pseudo-obstruction, and constipation
    • Adverse effects: cardiac arrhythmias, tachycardia, ventricular fibrillation, torsades de pointes
  • Macrolides and Erythromycin:

    • Oleandomycin, azithromycin, clarithromycin
    • Used for diabetic gastroparesis
  • Motility Suppressors:

    • Botulinum toxin in the lower esophageal sphincter

Laxatives

  • Picosulfate sodium, senna, glycerol
  • P: changes permeability in the large intestine
  • S: reduces liquid absorption
  • G: stimulates defecation reflex in rectal nerve endings and increases osmotic pressure
  • Used for constipation relief
  • Adverse effects vary by medication

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Description

This quiz covers topics related to gastrointestinal diseases such as gastric ulcers, GERD, and the use of proton pump inhibitors like omeprazole, esomeprazole, lansoprazole, rabeprazole, and pantoprazole. Proton pump inhibitors inhibit the hydrogen-potassium ATPase pump and are used for treating various stomach conditions.

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