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Questions and Answers
What is the main mechanism of action of proton pump inhibitors like Omeprazole?
What is the main mechanism of action of proton pump inhibitors like Omeprazole?
Which condition is Proton Pump Inhibitors commonly used to treat?
Which condition is Proton Pump Inhibitors commonly used to treat?
Why should Proton Pump Inhibitors be taken on an empty stomach?
Why should Proton Pump Inhibitors be taken on an empty stomach?
What is a potential adverse effect associated with long-term use of Proton Pump Inhibitors?
What is a potential adverse effect associated with long-term use of Proton Pump Inhibitors?
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How do Histamine H2 Receptor Antagonists like Cimetidine work to reduce stomach acid production?
How do Histamine H2 Receptor Antagonists like Cimetidine work to reduce stomach acid production?
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Which of the following drugs inhibits the production of acids and stimulates the production of prostaglandins by binding to prostaglandin receptors?
Which of the following drugs inhibits the production of acids and stimulates the production of prostaglandins by binding to prostaglandin receptors?
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Which drug is used in the treatment of gastroparesis diabetica and belongs to the class of drugs called macrolides?
Which drug is used in the treatment of gastroparesis diabetica and belongs to the class of drugs called macrolides?
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Which of the following drugs reduces peristalsis and increases intestinal transit time by inhibiting the secretion of acetylcholine and prostaglandins?
Which of the following drugs reduces peristalsis and increases intestinal transit time by inhibiting the secretion of acetylcholine and prostaglandins?
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Which drug is used for the prevention of nausea and vomiting by antagonizing the dopamine D2 receptor?
Which drug is used for the prevention of nausea and vomiting by antagonizing the dopamine D2 receptor?
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Which of the following drugs stimulates the 5HT4 receptor, but is no longer used due to its association with cardiac arrhythmias?
Which of the following drugs stimulates the 5HT4 receptor, but is no longer used due to its association with cardiac arrhythmias?
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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?
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?
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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
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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.
