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Questions and Answers
Which laboratory test is recommended for monitoring patients on Famotidine?
Which laboratory test is recommended for monitoring patients on Famotidine?
Which of the following is NOT a Proton Pump Inhibitor (PPI)?
Which of the following is NOT a Proton Pump Inhibitor (PPI)?
For which condition is Eradication of Helicobacter pylori a potential indication for Proton Pump Inhibitors?
For which condition is Eradication of Helicobacter pylori a potential indication for Proton Pump Inhibitors?
Which statement regarding Omeprazole dosing is correct?
Which statement regarding Omeprazole dosing is correct?
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What is the recommended initial therapy for pregnant patients with acid-related disorders?
What is the recommended initial therapy for pregnant patients with acid-related disorders?
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What is the primary mechanism of action of Famotidine?
What is the primary mechanism of action of Famotidine?
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In patients with renal impairment, what adjustment in dosing of Famotidine may be necessary?
In patients with renal impairment, what adjustment in dosing of Famotidine may be necessary?
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Which of the following is NOT an indication for using Famotidine?
Which of the following is NOT an indication for using Famotidine?
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What is the typical onset of antisecretory effect of Famotidine?
What is the typical onset of antisecretory effect of Famotidine?
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Which of the following is recommended as initial therapy for acid-related dyspepsia?
Which of the following is recommended as initial therapy for acid-related dyspepsia?
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Which of the following is a common agent belonging to the class of Proton Pump Inhibitors (PPIs)?
Which of the following is a common agent belonging to the class of Proton Pump Inhibitors (PPIs)?
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What is a common indication for the use of Proton Pump Inhibitors (PPIs)?
What is a common indication for the use of Proton Pump Inhibitors (PPIs)?
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For which condition is Omeprazole commonly dosed?
For which condition is Omeprazole commonly dosed?
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Which medication is typically considered as an initial therapy for acid-related disorders?
Which medication is typically considered as an initial therapy for acid-related disorders?
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What is a common monitoring parameter for the drug Famotidine?
What is a common monitoring parameter for the drug Famotidine?
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Study Notes
Acid-Peptic Diseases
- Acid-peptic diseases include gastroesophageal reflux, peptic ulcer, and stress-related mucosal injury.
- Drug treatment of acid-peptic disorders includes antacids, H2-receptor antagonists, and proton pump inhibitors.
Antacids
- Antacids neutralize acid in the stomach and inhibit pepsin, a proteolytic enzyme.
- They reduce acid reaching the duodenum and differ in how they neutralize acid.
- Examples of antacids include:
- Calcium Carbonate (Tums)
- Magnesium Hydroxide
- Aluminum Hydroxide (Amphojel)
- Sodium Bicarbonate (Alka Seltzer)
Calcium Carbonate
- Indication: antacid for various GI symptoms, including acid indigestion and GERD; calcium supplement for osteoporosis.
- Dosing: use as needed for periodic episodes (1 or less times per week); if needed for more than 1 time per week or symptoms persist longer than 2 weeks, see a provider for alternative treatment.
- Pharmacokinetics/Pharmacodynamics: carbonate requires acid to be absorbed, food helps absorption; absorbed in small intestine; only approximately 500 mg should be taken at one time; calcium absorption occurs in small intestine, dependent on vitamin D.
- Drug interactions: may decrease absorption of cefpodoxime and cefuroxime; may decrease absorption of itraconazole and ketoconazole.
H2-Receptor Antagonists
- Examples of H2-receptor antagonists include:
- Famotidine (Pepcid)
- Cimetidine (Tagamet)
- Nizatidine (Axid)
Famotidine
- Indications: GERD, promote healing of gastric and duodenal ulcers, prevent occurrence of stress ulcers, heartburn.
- Dosing: adult - mild intermittent symptoms (less than 2 episodes weekly) without evidence of erosive esophagitis, can be used as needed or added to bedtime proton pump inhibitor dose.
- Mechanism of Action: blocks H2 receptors in gastric parietal cells, suppresses basal and meal-stimulated acid secretion in a dose-dependent manner.
- Pharmacokinetics/Pharmacodynamics: onset of antisecretory effect within 60 minutes, peak effect 1-3 hours (oral), excreted in urine, prolonged T1/2 with renal impairment, available in oral and parenteral preparations.
- Adverse Effects: diarrhea, headache, drowsiness, muscular pain, constipation, elevated liver enzymes, vitamin B12 deficiency, thrombocytopenia, confusion in elderly.
Proton Pump Inhibitors (PPIs)
- Examples of PPIs include:
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (Aciphex)
- Pantoprazole (Protonix)
- Indications: peptic ulcer disease, GERD, Zollinger-Ellison syndrome, NSAID-associated ulcers, eradication of Helicobacter pylori.
- Dosing: adult - lowest dose possible for shortest duration; administer dose 30-60 minutes before breakfast.
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Description
Test your knowledge on drugs used in acid-peptic diseases with this quiz based on Debra Forzese, Pharm.D.'s lecture. Learn about antacids, H2-receptor antagonists, proton pump inhibitors, and the drug treatment of acid-peptic disorders.
