GI Pharmacology and Therapeutics Quiz

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the definition of GERD?

GERD is caused by the retrograde movement of stomach contents into the esophagus due to lower esophageal sphincter (LES) dysfunction.

Which of the following are symptoms of GERD? (Select all that apply)

  • Chest Pain (correct)
  • Regurgitation (correct)
  • Heartburn (correct)
  • Chronic Cough (correct)
  • Laryngitis (correct)

What are some risk factors for GERD? (Select all that apply)

  • Smoking (correct)
  • Pregnancy (correct)
  • Citrus
  • Caffeine
  • Obesity (correct)
  • Chocolate
  • Alcohol Use (correct)
  • Spicy Foods

Which of the following medications are used to manage GERD?

<p>Calcium Channel Blockers (A), NSAIDS (B), Bisphosphonates (C)</p> Signup and view all the answers

What are some lifestyle modifications that can help manage GERD?

<p>Weight Loss (B), Avoiding Late Meals (C), Reducing Triggers (D), Elevating Head of Bed (E)</p> Signup and view all the answers

What is the first-line medication for moderate to severe GERD symptoms?

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

Long-term PPI use is recommended for all cases of GERD?

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

What is the mechanism of action of antacids?

<p>Antacids neutralize stomach acid.</p> Signup and view all the answers

Which of the following are examples of antacids? (Select all that apply)

<p>Tums (B), Mylanta (E), Maalox (F)</p> Signup and view all the answers

What is the mechanism of action of H2 Receptor Antagonists (H2 Blockers)?

<p>H2 Blockers block histamine on parietal cells, reducing acid production.</p> Signup and view all the answers

Which of the following are examples of H2 Receptor Antagonists (H2 Blockers)? (Select all that apply)

<p>Famotidine (B), Ranitidine (C), Tagamet (E), Pepcid (G)</p> Signup and view all the answers

What is the mechanism of action of Proton Pump Inhibitors (PPIs)?

<p>PPIs irreversibly inhibit the H+/K+ ATPase (proton pump) in parietal cells, reducing acid production.</p> Signup and view all the answers

Which of the following are examples of PPIs? (Select all that apply)

<p>Prilosec (A), Protonix (B), Esomeprazole (C), Omeprazole (D), Lansoprazole (E), Nexium (F), Pantoprazole (G), Prevacid (H)</p> Signup and view all the answers

What is the mechanism of action of prokinetic agents?

<p>Prokinetic agents improve motility and LES tone, promoting gastric emptying.</p> Signup and view all the answers

Which of the following are examples of prokinetic agents? (Select all that apply)

<p>Domperidone (A), Metoclopramide (B), Erythromycin (C), Reglan (D)</p> Signup and view all the answers

What is the definition of peptic ulcer disease (PUD)?

<p>Peptic ulcers are mucosal erosions in the stomach or duodenum due to acid-pepsin activity.</p> Signup and view all the answers

What are the main causes of peptic ulcer disease (PUD)? (Select all that apply)

<p>Zollinger-Ellison Syndrome (A), H. pylori infection (B), NSAID use (C), Stress (D)</p> Signup and view all the answers

What are some complications of peptic ulcer disease (PUD)? (Select all that apply)

<p>Bleeding (A), Gastric outlet obstruction (B), Perforation - a hole in the lining of the stomach or duodenum (C)</p> Signup and view all the answers

H. pylori testing is recommended for all patients diagnosed with PUD.

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

Which of the following are management guidelines for PUD? (Select all that apply)

<p>Use PPI prophylaxis in patients on long-term NSAIDs (A), Avoid smoking and alcohol (B), Discontinue NSAIDs if possible (C), Switch to COX-2 inhibitors if necessary (D), Maintain a healthy weight (E)</p> Signup and view all the answers

What is the function of the gastric acid pump?

<p>The gastric acid pump actively secretes hydrogen ions (H+) into the stomach, combining with chloride ions (Cl-) to form HCl.</p> Signup and view all the answers

What are the main stimulants that activate the gastric acid pump? (Select all that apply)

<p>Gastrin (A), Acetylcholine (D), Histamine (E)</p> Signup and view all the answers

What is the mechanism of action of PPIs?

<p>PPIs inhibit the H+/K+ ATPase enzyme in gastric parietal cells, reducing stomach acid production.</p> Signup and view all the answers

What are some common medications for GERD, Peptic Ulcer Disease, Zollinger-Ellison Syndrome, and NSAID-induced ulcers? (Select all that apply)

<p>Nexium (A), Lansoprazole (B), Esomeprazole (E), Omeprazole (G), Prevacid (H), Prilosec (I), Protonix (K), Pantoprazole (L)</p> Signup and view all the answers

What are some adverse effects of PPIs? (Select all that apply)

<p>Potential kidney injury (A), B12 deficiency (B), Hypomagnesemia (C), C. difficile infection (D), Increased risk of fractures (E)</p> Signup and view all the answers

When should the lowest effective dose of a PPI be used?

<p>All of the above (D)</p> Signup and view all the answers

Long-term PPI use in patients without a clear indication is recommended.

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

What is the mechanism of action for histamine H2 blockers?

<p>Histamine H2 blockers block histamine H2 receptors on gastric parietal cells, decreasing acid secretion.</p> Signup and view all the answers

Which of the following are common medications for histamine H2 blockers? (Select all that apply)

<p>Nizatidine (A), Ranitidine (B), Cimetidine (C), Famotidine (D), Zantac (E)</p> Signup and view all the answers

What are the indications for histamine H2 blockers? (Select all that apply)

<p>Nocturnal Acid Suppression (A), Mild Heartburn (B), Peptic Ulcer Disease (C), GERD (D)</p> Signup and view all the answers

Which of the following adverse effects are associated with cimetidine? (Select all that apply)

<p>Drug interactions via CYP450 inhibition (A), Gynecomastia (B), CNS effects in elderly patients with renal impairment (C), Rare dizziness (D), Headaches (E)</p> Signup and view all the answers

What are the prescribing pearls for H2 blockers? (Select all that apply)

<p>Combine with PPIs for breakthrough nighttime symptoms (A), Preferred for on-demand relief of symptoms (B), Use cautiously in elderly patients (C), Adjust dose in renal impairment (D)</p> Signup and view all the answers

Match the features of PPIs and H2 blockers.

<p>PPIs = Fractures, C. diff risk H2 Blockers = CNS effects in elderly</p> Signup and view all the answers

What is the mechanism of action for histamine H2 blockers (e.g., ranitidine, famotidine)?

<p>Histamine H2 blockers inhibit histamine receptors on parietal cells, decreasing acid secretion.</p> Signup and view all the answers

For which conditions are H2 blockers effective? (Select all that apply)

<p>Occasional heartburn (A), Mild GERD (B), Nocturnal acid suppression (C), Duodenal ulcers (short-term use) (D)</p> Signup and view all the answers

What are the advantages of H2 blockers?

<p>H2 blockers have a faster onset of action (30-60 minutes), and are generally less potent than PPIs.</p> Signup and view all the answers

What is the dosage example of famotidine for GERD?

<p>Famotidine 20 mg BID or 40 mg QHS for GERD.</p> Signup and view all the answers

What is the mechanism of action for proton pump inhibitors (e.g., omeprazole, pantoprazole)?

<p>Proton pump inhibitors irreversibly inhibit H+/K+ ATPase, suppressing gastric acid production.</p> Signup and view all the answers

For which conditions are PPIs first-line treatment? (Select all that apply)

<p>Erosive esophagitis (A), Zollinger-Ellison syndrome (B), Peptic ulcer disease (PUD) (C), Severe GERD (D)</p> Signup and view all the answers

PPIs are effective in treating H. pylori-associated ulcers?

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

What are the advantages of PPIs?

<p>PPIs provide longer-lasting acid suppression (up to 24 hours).</p> Signup and view all the answers

What is the dosing example for omeprazole?

<p>Omeprazole 20 mg QD, 30 minutes before breakfast.</p> Signup and view all the answers

What are some key prescribing points for H2 Blockers? (Select all that apply)

<p>Tailor therapy duration (B), Short-term or as-needed use for mild/moderate cases (C)</p> Signup and view all the answers

What are some key prescribing points for PPIs? (Select all that apply)

<p>Long-term or severe cases (A), Prescribe before meals for maximum effectiveness (B), Consider tapering to avoid rebound acid hypersecretion (C), Tailor therapy duration (e.g., 8 weeks for GERD, lifelong for Zollinger-Ellison syndrome) (D)</p> Signup and view all the answers

A 45-year-old man presents with occasional heartburn, especially after large meals. He has no history of esophageal injury or ulcer. Which medication would you prescribe?

<p>Famotidine 20 mg once or twice daily as needed.</p> Signup and view all the answers

A 60-year-old woman has been diagnosed with erosive esophagitis confirmed by endoscopy. What is the best treatment?

<p>Omeprazole 20-40 mg QD for 8 weeks.</p> Signup and view all the answers

A 50-year-old man with a history of GERD takes famotidine but reports persistent symptoms that wake him up at night. What is the next step?

<p>Switch to a PPI, such as esomeprazole 20-40 mg QD before breakfast.</p> Signup and view all the answers

A patient with peptic ulcer disease caused by H. pylori is starting treatment. Which medication should be included?

<p>Pantoprazole 40 mg BID as part of triple therapy.</p> Signup and view all the answers

A 35-year-old man asks for advice on managing his nighttime GERD symptoms. He has already tried lifestyle modifications. Which option is best?

<p>Famotidine 20 mg QHS or as needed.</p> Signup and view all the answers

What is the definition of antacids?

<p>Antacids are over-the-counter medications that neutralize gastric acid, providing symptomatic relief from heartburn and dyspepsia.</p> Signup and view all the answers

What are the key factors of antacids? (Select all that apply)

<p>Side effects (A), Rapid onset of action (B), Neutralizing capacity (D)</p> Signup and view all the answers

What is the mechanism of action of sodium bicarbonate?

<p>Sodium bicarbonate reacts with gastric acid to produce carbon dioxide and sodium chloride, rapidly increasing gastric pH.</p> Signup and view all the answers

What is the mechanism of action of calcium carbonate?

<p>Calcium carbonate neutralizes gastric acid, producing calcium chloride and CO2.</p> Signup and view all the answers

What is the mechanism of action of magnesium hydroxide?

<p>Magnesium hydroxide neutralizes gastric acid without producing CO2.</p> Signup and view all the answers

What is the mechanism of action of aluminum hydroxide?

<p>Aluminum hydroxide neutralizes gastric acid and may bind bile salts, offering some protection to the gastric mucosa.</p> Signup and view all the answers

What is the purpose of combination products in antacids?

<p>Combination products combine magnesium (to offset constipation) and aluminum (to offset diarrhea) for balanced effects.</p> Signup and view all the answers

What are the main categories of medications used for treating gastrointestinal disorders?

<p>The main categories of medications used for treating gastrointestinal disorders are antacids, PPIs, H2 Blockers, prokinetic agents, and anti-diarrheals.</p> Signup and view all the answers

Match the features of different medication categories with their respective characteristics.

<p>Antacids = Tums, Maalox PPIs = Omeprazole, Pantoprazole H2 Blockers = Famotidine, Ranitidine</p> Signup and view all the answers

What is the definition of anti-diarrheal medications?

<p>Anti-diarrheal medications are used to reduce the frequency and urgency of bowel movements, manage dehydration, and improve patient comfort in various diarrheal conditions.</p> Signup and view all the answers

What are the common conditions treated with anti-diarrheal medications? (Select all that apply)

<p>Diarrhea from short bowel syndrome or malabsorption (A), Acute non-infectious diarrhea (B), Traveler's diarrhea (C), Radiation- or chemotherapy-induced diarrhea (D), Chronic diarrhea (E), Diarrhea from inflammatory bowel disease (IBD) (F)</p> Signup and view all the answers

What is the mechanism of action for opiate receptor agonists?

<p>Opiate receptor agonists activate mu-opioid receptors in the GI tract, slowing intestinal motility and allowing more time for water absorption.</p> Signup and view all the answers

Which of the following are examples of opiate receptor agonists? (Select all that apply)

<p>Lomotil (A), Loperamide (B), Imodium (C), Diphenoxylate/Atropine (D)</p> Signup and view all the answers

What is the mechanism of action for bile acid binders?

<p>Bile acid binders bind bile acids in the gut, reducing their diarrheal effect.</p> Signup and view all the answers

Which of the following are examples of bile acid binders? (Select all that apply)

<p>Colestipol (A), Cholestyramine (B)</p> Signup and view all the answers

What is the mechanism of action for antisecretory agents?

<p>Antisecretory agents reduce intestinal fluid secretion.</p> Signup and view all the answers

Which of the following are examples of antisecretory agents? (Select all that apply)

<p>Pepto-Bismol (A), Bismuth Subsalicylate (B), Octreotide (C)</p> Signup and view all the answers

What is the mechanism of action for mixed mechanism agents?

<p>Mixed mechanism agents act on opioid receptors (mu and kappa agonist, delta antagonist) to reduce bowel motility.</p> Signup and view all the answers

Which of the following is an example of a mixed mechanism agent? (Select all that apply)

<p>Eluxadoline (A), Viberzi (B)</p> Signup and view all the answers

Flashcards

GERD

Gastroesophageal reflux disease caused by the retrograde movement of stomach contents into the esophagus due to LES dysfunction.

Symptoms of GERD

Common symptoms include heartburn, regurgitation, chest pain, chronic cough, and laryngitis.

Risk Factors for GERD

Obesity, smoking, alcohol use, certain foods, pregnancy, and specific medications increase GERD risk.

Antacids

Over-the-counter medications that neutralize stomach acid for immediate short-term relief.

Signup and view all the flashcards

H2 Blockers

Medications that block histamine receptors, reducing acid production; used for mild to moderate GERD.

Signup and view all the flashcards

Proton Pump Inhibitors (PPIs)

Powerful medications that irreversibly inhibit gastric acid secretion, used for severe GERD.

Signup and view all the flashcards

Mechanism of PPIs

PPIs work by irreversibly blocking the H+/K+ ATPase enzyme in parietal cells, decreasing acid production.

Signup and view all the flashcards

Prokinetic Agents

Medications that enhance motility and lower esophageal sphincter tone, aiding gastric emptying.

Signup and view all the flashcards

Peptic Ulcer Disease (PUD)

Ulcers in the stomach or duodenum caused by acid-pepsin activity, often linked to H. pylori infection.

Signup and view all the flashcards

H. pylori

A common bacteria responsible for many peptic ulcers; treatment requires eradication.

Signup and view all the flashcards

Triple Therapy for PUD

Treatment regimen involving a PPI, Amoxicillin, and Clarithromycin for H. pylori eradication.

Signup and view all the flashcards

Antidiarrheals

Medications used to reduce diarrhea frequency and urgency, providing symptom relief.

Signup and view all the flashcards

Opiate Receptor Agonists

Medications like Loperamide that slow intestinal motility by activating opioid receptors.

Signup and view all the flashcards

Eluxadoline

A medication for IBS-D that targets opioid receptors to reduce diarrhea and abdominal pain.

Signup and view all the flashcards

Cholinergic vs. Anticholinergic

Cholinergic drugs enhance acetylcholine effects; anticholinergic drugs inhibit acetylcholine actions.

Signup and view all the flashcards

Promotility Agents

Medications like Metoclopramide that enhance GI motility for conditions like gastroparesis.

Signup and view all the flashcards

Gastric Acid Pump

The H+/K+ ATPase enzyme in parietal cells responsible for producing gastric acid.

Signup and view all the flashcards

Cytoprotective Agents

Medications like Sucralfate that protect the gastric mucosa and promote healing.

Signup and view all the flashcards

Bile Acid Diarrhea (BAD)

Diarrhea caused by excess bile acids reaching the colon, increasing water secretion.

Signup and view all the flashcards

Antisecretory Agents

Medications that reduce intestinal fluid secretion, used in certain diarrhea conditions.

Signup and view all the flashcards

Clinical Pearls for Anti-Diarrheals

Use cautiously in infectious diarrhea; focus on hydration and underlying conditions.

Signup and view all the flashcards

Common GI Pathogens

Pathogens like E. coli and C. difficile that cause various gastrointestinal diseases.

Signup and view all the flashcards

Indications for PPIs

Used primarily for GERD, peptic ulcer disease, and Zollinger-Ellison syndrome.

Signup and view all the flashcards

Side Effects of PPIs

Come with risks such as fractures, C. difficile infection, and vitamin deficiencies.

Signup and view all the flashcards

Calcium Channel Blockers (Off-label uses)

Medications that can be used off-label to relax smooth muscle, like in esophageal spasms.

Signup and view all the flashcards

Eluxadoline Contraindications

Not for use in patients without gallbladders, severe liver impairment, or pancreatitis history.

Signup and view all the flashcards

Antispasmodics

Drugs that relieve or prevent muscle spasms in the GI tract; used for IBS and urinary spasms.

Signup and view all the flashcards

Dosing for Eluxadoline

Typically 100 mg twice daily with food or 75 mg for certain patient conditions.

Signup and view all the flashcards

Study Notes

GI Pharmacology and Therapeutics

  • GERD is caused by the retrograde movement of stomach contents into the esophagus due to lower esophageal sphincter (LES) dysfunction.
  • Symptoms include heartburn, regurgitation, chest pain, chronic cough, and laryngitis.
  • Risk factors include obesity, smoking, alcohol use, dietary triggers (spicy foods, caffeine, citrus, chocolate), and pregnancy.
  • Medications like NSAIDs, calcium channel blockers, and bisphosphonates can contribute to GERD.
  • Guidelines for management include lifestyle modifications (weight loss, elevating head of bed, avoiding late meals, reducing triggers), a step-up therapy approach starting with H2 blockers for mild cases and progressing to PPIs for moderate to severe symptoms, and maintenance therapy involving long-term PPI use only for severe erosive esophagitis or Barrett's esophagus.
  • Medication choice depends on symptom severity and frequency.

Antacids

  • Mechanism: Neutralize stomach acid.
  • Examples: Tums (calcium carbonate), Maalox, Mylanta.
  • Best use: Mild and occasional heartburn; short-term relief.
  • Limitations: Not suitable for chronic/severe GERD, may interfere with medication absorption.

H2 Receptor Antagonists (H2 Blockers)

  • Mechanism: Block histamine on parietal cells, reducing acid production.
  • Examples: Famotidine (Pepcid), Ranitidine (withdrawn), Cimetidine (Tagamet).
  • Best use: Mild to moderate GERD symptoms; effective for nocturnal acid suppression.
  • Limitations: Tolerance develops with long-term use, less effective than PPIs for healing esophagitis.

Proton Pump Inhibitors (PPIs)

  • Mechanism: Irreversibly inhibit H+/K+ ATPase in parietal cells, reducing acid production.
  • Examples: Omeprazole (Prilosec), Esomeprazole (Nexium), Pantoprazole (Protonix), Lansoprazole (Prevacid).
  • Best use: First-line for moderate to severe GERD and erosive esophagitis; long-term control in chronic GERD.
  • Limitations: Takes 1-4 days for full effect; long-term use risks include vitamin B12 deficiency, hypomagnesemia, osteoporosis, and increased risk of infections.

Prokinetic Agents

  • Mechanism: Improve motility and LES tone, promoting gastric emptying.
  • Examples: Metoclopramide (Reglan), Domperidone (not available in all countries).
  • Best Use: Adjunct in GERD with delayed gastric emptying.
  • Limitations: Metoclopramide has significant side effects (e.g., tardive dyskinesia).

Alginates

  • Mechanism: Form a viscous barrier that floats on stomach contents, reducing reflux.
  • Examples: Gaviscon.
  • Best Use: Adjunct for symptomatic relief in mild GERD.

Peptic Ulcer Disease (PUD)

  • Definition: Mucosal erosions in the stomach or duodenum due to acid-pepsin activity.
  • Causes: H. pylori infection, NSAID use, stress, Zollinger-Ellison Syndrome.
  • Complications: Bleeding, perforation, gastric outlet obstruction.
  • Management: H. pylori testing, PPI prophylaxis in patients on long-term NSAIDs, discontinue NSAIDs if possible, switch to COX-2 inhibitors if required.
  • Treatment Principles: Reduce gastric acid to allow ulcer healing.

Triple Therapy:

  • PPI + Amoxicillin + Clarithromycin
  • Duration: 10-14 days
  • Alternative for penicillin-allergic patients: Replace Amoxicillin with Metronidazole.

Quadruple Therapy:

  • PPI + Bismuth subsalicylate + Metronidazole + Tetracycline
  • Duration: 10-14 days
  • Often used where clarithromycin resistance is high, or after failure of triple therapy.

Gastric Acid Pump

  • Location: parietal cells of the stomach lining.
  • Function: actively secretes hydrogen ions (H+) into the stomach, combining with chloride ions (Cl-) to form hydrochloric acid (HCl).

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

GI Pharmacology and Therapeutics PDF

More Like This

Pharmacology of PUD/GERD
21 questions

Pharmacology of PUD/GERD

QuaintDenver5737 avatar
QuaintDenver5737
GI Pharmacology and GERD Overview
30 questions

GI Pharmacology and GERD Overview

WorthySugilite678 avatar
WorthySugilite678
Gastrointestinal Pharmacology and GERD
30 questions

Gastrointestinal Pharmacology and GERD

WorthySugilite678 avatar
WorthySugilite678
GI Pharmacology and Therapeutics
45 questions

GI Pharmacology and Therapeutics

ImmaculateEuphonium avatar
ImmaculateEuphonium
Use Quizgecko on...
Browser
Open
Browser
Browser