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Questions and Answers
Which type of laxative chemically irritates the lining of the GI tract?
Which type of laxative chemically irritates the lining of the GI tract?
What is the primary function of bulk stimulants?
What is the primary function of bulk stimulants?
Which laxative is known for causing a thorough evacuation of the intestine?
Which laxative is known for causing a thorough evacuation of the intestine?
Which laxative is contraindicated during pregnancy due to its potential to induce labor?
Which laxative is contraindicated during pregnancy due to its potential to induce labor?
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What is a common adverse effect associated with the use of laxatives?
What is a common adverse effect associated with the use of laxatives?
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Which statement accurately reflects the pharmacokinetics of most laxatives?
Which statement accurately reflects the pharmacokinetics of most laxatives?
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Which condition is a contraindication for laxative use?
Which condition is a contraindication for laxative use?
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What effect may occur in a neonate if magnesium laxatives are used during lactation?
What effect may occur in a neonate if magnesium laxatives are used during lactation?
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What is the primary action of proton pump inhibitors?
What is the primary action of proton pump inhibitors?
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Which condition are proton pump inhibitors commonly used to treat in the short term?
Which condition are proton pump inhibitors commonly used to treat in the short term?
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Which proton pump inhibitor is considered safe for children?
Which proton pump inhibitor is considered safe for children?
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What potential adverse effect of proton pump inhibitors is related to long-term use?
What potential adverse effect of proton pump inhibitors is related to long-term use?
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What common CNS effect can be experienced by patients taking proton pump inhibitors?
What common CNS effect can be experienced by patients taking proton pump inhibitors?
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What is a common adverse effect associated with the frequent use of laxatives?
What is a common adverse effect associated with the frequent use of laxatives?
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What is a major consideration for using proton pump inhibitors in pregnant women?
What is a major consideration for using proton pump inhibitors in pregnant women?
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What is a common gastrointestinal side effect of proton pump inhibitors?
What is a common gastrointestinal side effect of proton pump inhibitors?
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Which laxative type increases GI tract motility by enlarging bulk?
Which laxative type increases GI tract motility by enlarging bulk?
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What is a primary indication for laxative use?
What is a primary indication for laxative use?
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Which laxative pulls fluid out of the venous system into the small intestine?
Which laxative pulls fluid out of the venous system into the small intestine?
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Which is a contraindication for bulk laxative use?
Which is a contraindication for bulk laxative use?
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What can excessive laxative use lead to in the GI tract?
What can excessive laxative use lead to in the GI tract?
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Which laxative type works by a saline pull effect?
Which laxative type works by a saline pull effect?
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Which group of patients should use polyethylene glycol-electrolyte solution with caution?
Which group of patients should use polyethylene glycol-electrolyte solution with caution?
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What effects may accompany laxative use related to sympathetic stress reaction?
What effects may accompany laxative use related to sympathetic stress reaction?
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What are the most common adverse effects associated with bulk laxatives?
What are the most common adverse effects associated with bulk laxatives?
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Which laxative is known for having a detergent action on the intestinal bolus?
Which laxative is known for having a detergent action on the intestinal bolus?
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What is a characteristic of glycerin when used as a laxative?
What is a characteristic of glycerin when used as a laxative?
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Which group of patients should use lubricants with caution?
Which group of patients should use lubricants with caution?
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Which adverse effect is less likely to occur with lubricant laxatives than with stimulant laxatives?
Which adverse effect is less likely to occur with lubricant laxatives than with stimulant laxatives?
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What happens when mineral oil coats the intestinal bolus?
What happens when mineral oil coats the intestinal bolus?
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Which of the following is a common CNS effect associated with laxative use?
Which of the following is a common CNS effect associated with laxative use?
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What is a major concern about the use of mineral oil as a laxative?
What is a major concern about the use of mineral oil as a laxative?
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What is the primary action of H2 antagonists in ulcer disease treatment?
What is the primary action of H2 antagonists in ulcer disease treatment?
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Which of the following drugs is the prototype H2 antagonist?
Which of the following drugs is the prototype H2 antagonist?
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What potential side effect is associated with long-term use of cimetidine?
What potential side effect is associated with long-term use of cimetidine?
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Which H2 antagonist is specifically highlighted as being eliminated by the kidneys?
Which H2 antagonist is specifically highlighted as being eliminated by the kidneys?
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Which condition should warrant caution during the use of H2 antagonists?
Which condition should warrant caution during the use of H2 antagonists?
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What is a common CNS effect of H2 antagonists?
What is a common CNS effect of H2 antagonists?
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Which of the following H2 antagonists is approved for use in children aged 1 to 16?
Which of the following H2 antagonists is approved for use in children aged 1 to 16?
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What is the action of the gastric acid pump inhibitors?
What is the action of the gastric acid pump inhibitors?
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Study Notes
Gastrointestinal System - Drugs
- Drugs used to treat ulcer disease: Various drugs are used to treat ulcer disease.
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Histamine-2 Antagonists: H2 antagonists selectively block H2 receptors on parietal cells, preventing gastrin release, histamine release, and ultimately decreasing hydrochloric acid production. This also reduces pepsin production. High doses can cause cardiac arrhythmias.
- Cimetidine (Tagamet, Tagamet HB): Used for duodenal ulcers, benign gastric ulcers, pathological hypersecretory syndromes, GERD, prophylaxis of stress ulcers, relief of heartburn, acid indigestion, and sour stomach. Not typically used in children under 16.
- Famotidine (Pepcid, Pepcid AC): Used for duodenal ulcers, benign gastric ulcers, pathological hypersecretory syndromes, GERD, relief of heartburn, acid indigestion, and sour stomach. Not typically used in children under 16.
- Nizatidine (Axid): Used for duodenal ulcers, benign gastric ulcers, pathological hypersecretory syndromes, GERD, relief of heartburn, acid indigestion, and sour stomach in adults.
- Ranitidine (Zantac): Same usage as other histamine-2 antagonists listed above. Not typically used in children.
- Pharmacokinetics of Histamine-2 Antagonists: Available in oral and injectable forms. Cimetidine is the first developed and is associated with antiandrogenic effects, including gynecomastia and galactorrhea. It is metabolized in the liver, slowing down the metabolism of other drugs. It is excreted in the urine. Ranitidine and famotidine are longer-acting and more potent, less associated with these antiandrogenic effects, and metabolized and excreted in the urine. Nizatidine elimination differs, predominantly through the kidneys.
- Contraindications: Caution is advised during pregnancy, lactation, or with hepatic or renal dysfunction due to potential impacts on drug metabolism and excretion.
- **Adverse effects:**Common side effects include GI distress (diarrhea, constipation) CNS effects (dizziness, headache, confusion), cardiac arrhythmias, and hypotension. Gynecomastia and impotence are possible with long-term use of cimetidine.
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Proton Pump Inhibitors (PPIs): PPIs suppress gastric acid secretion by inhibiting the H+, K+-ATPase enzyme, lowering stomach acid levels.
- Dexlansoprazole (Kapidex): Treatment of erosive esophagitis maintenance and treatment of heartburn associated with GERD.
- Esomeprazole (Nexium): Treatment of GERD, severe erosive esophagitis, duodenal ulcers, and pathological hypersecretory conditions.
- Lansoprazole (Prevacid): Treatment of gastric ulcer, GERD, pathological hypersecretory syndromes, maintenance to heal ulcers/esophagitis, and combined H pylori eradication therapy. Approved for use in children.
- Omeprazole (Prilosec): Treatment of gastric ulcers, GERD, pathological hypersecretory syndromes, maintenance therapy to heal ulcers/esophagitis, combined H pylori eradication therapy. OTC available for heartburn relief.
- Pantoprazole (Protonix): Treatment of GERD in adults, healing of erosive esophagitis, treatment for hypersecretory syndrome.
- Rabeprazole (Aciphex): Treatment of GERD and duodenal ulcers, maintenance therapy for healing duodenal ulcers, and to treat pathological hypersecretory conditions; combined therapy for eradicating H. pylori infection.
- Pharmacokinetics of PPIs: These drugs are acid labile, rapidly absorbed in the GI tract, reach peak levels within 3 to 5 hours, and undergo substantial liver metabolism. Omeprazole is a faster-acting and more quickly excreted drug.
- Contraindications & Cautions of PPI use for pregnant/lactating women and for patients under 18 (except lansoprazole)
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Adverse Effects: Possible CNS effects (dizziness, headache, weakness). Includes GI effects (diarrhea, abdominal pain, nausea, vomiting), upper respiratory tract symptoms (cough, congestion), and other effects like rash, alopecia, pruritus, dry skin and fever.
- Increased risk of bone loss, decreased calcium and magnesium, and an increased possibility of C. difficile and pneumonia with long-term use.
Gastrointestinal System - Constipation Treatment
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Laxatives: Laxatives (cathartic drugs) are indicated for short-term constipation relief. Several types exist:
- Chemical stimulants: irritate the GI tract lining, increasing motility. Examples include castor oil, bisacodyl, and cascara.
- Bulk stimulants: increase fecal bulk, inducing distension of the GI tract. Examples include lactulose, magnesium citrate and hydroxide, polyethylene glycol-electrolyte solution, and psyllium.
- Lubricants: lubricate the stool, facilitating easier passage. Examples include mineral oil and docusate.
- Pharmacokinetics of laxatives: Most laxatives are minimally absorbed and exert their effects directly within the GI tract, but changes can occur for patients with underlying issues.
- Contraindications & Cautions: Caution is advised for pregnant and lactating women.
- Adverse effects: Common adverse effects among laxatives include diarrhea, abdominal cramping, nausea, dizziness, headache, weakness, sweating, palpitations, flushing, and fainting.
Gastrointestinal System - Lubricants
- Lubricants: These medications make defecation easier, without stimulating the GI tract, useful for people with rectal surgery or hemorrhoids; Docusate, mineral oil, and glycerin serve these functions.
- Pharmacokinetics of lubricators: These do not generally absorb and are excreted in feces.
- Contraindications & Cautions: Caution is advised for acute abdominal disorders, heart block, CAD, debilitation, pregnancy, and lactation.
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Description
This quiz covers essential medications used to treat ulcer disease, focusing on Histamine-2 Antagonists. Learn about Cimetidine, Famotidine, Nizatidine, and their roles in managing gastric conditions. Test your knowledge on the mechanisms, uses, and precautions associated with these drugs.
