Medicine Quiz: Peptic Ulcer and Gastroesophageal Reflux Disease

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Questions and Answers

What is the mechanism of action of sucralfate in treating peptic ulcers?

It has anti-androgenic effects.

It neutralizes acidity in the stomach.

It forms a protective layer over the ulcer bed. (correct)

It inhibits acid secretion in the stomach.

What is the effect of H2 blockers on naproxen absorption?

It increases the dissolution rate of naproxen. (correct)

It decreases the absorption of naproxen.

It reduces the efficacy of naproxen.

It has no effect on naproxen absorption.

What is the mechanism of action of prostaglandin analogues in treating peptic ulcers?

They reduce the efficacy of NSAIDs.

They inhibit acid secretion and promote mucous and bicarbonate secretion. (correct)

They have anti-androgenic effects.

They neutralize acidity in the stomach.

What type of peptic ulcer is the most common?

Duodenum ulcer Signup and view all the answers

What is the adverse effect of aluminium hydroxide?

Constipation Signup and view all the answers

What is the mechanism of action of colloidal bismuth subcitrate?

It increases gastric mucosal PGE2, mucous, and HCO3 production. Signup and view all the answers

What is the mechanism of action of proton pump inhibitors?

Inhibit H+/K+-ATPase pump Signup and view all the answers

What is the mechanism of action of carbenoxolone?

It increases mucous production, especially thick, viscous mucous. Signup and view all the answers

What is the effect of histamine on acid secretion?

Increases acid secretion Signup and view all the answers

Which of the following is NOT a type of anti-H. pylori drug?

Carbenoxalone Signup and view all the answers

What is the effect of PGE2 on acid secretion?

Decreases acid secretion Signup and view all the answers

Why are proton pump inhibitors administered in enteric coated form or capsules?

To protect the drug from acid degradation Signup and view all the answers

What is the effect of Vitamin C on Helicobacter pylori?

It has an anti-H. pylori effect Signup and view all the answers

What is the main cause of gastroesophageal reflux disease?

Decreased forward movement of GIT Signup and view all the answers

What is the function of the chemoreceptor trigger zone?

To stimulate the emetic centre Signup and view all the answers

Which of the following is used to treat gastroesophageal reflux disease?

All of the above Signup and view all the answers

What is the function of the nucleus tractus solitarius?

To relay afferent impulses from the GIT Signup and view all the answers

What is apomorphine used for?

To stimulate the emetic centre Signup and view all the answers

Study Notes

Gastrointestinal Disorders and Treatments

Peptic ulcers occur in the stomach and duodenum, often resulting from an imbalance between aggressive (acid) and defensive (mucosa) factors.
Two types of peptic ulcers: gastric ulcers and duodenal ulcers (most common).
Acid secretion in the stomach is initiated by activation of the H+/K+-ATPase pump, influenced by histamine (H2), gastrin (CCK2), and acetylcholine (M1 and M3).

Treatment Options for Peptic Ulcers

Proton Pump Inhibitors (PPIs):
- Inhibit H+/K+-ATPase and neutralize stomach acidity.
- Administered orally (30 minutes before meals) or intravenously for certain PPIs.
- Long duration of action despite short half-life (1.5 hours) due to "hit and run" mechanism.
- Lansoprazole is considered most potent and safest for pregnancy; rabeprazole is the longest acting.
H2 Receptor Blockers:
- Block H2 receptors to reduce acid secretion.
- Common drugs include cimetidine (prototype), ranitidine, famotidine, and roxatidine.
- Less potent than PPIs; may lead to drug interactions, especially with enteric coated naproxen.
Antacids:
- Provide rapid relief from acidity; include systemic (e.g., sodium bicarbonate) and non-systemic options (e.g., aluminum hydroxide, magnesium hydroxide).
- Can alter drug absorption, affecting medications like tetracyclines and ketoconazole.
Cytoprotective Agents:
- Prostaglandin analogues (e.g., misoprostol) protect the gastric lining and reduce acid secretion.
- Ulcer protective drugs like sucralfate form a barrier over ulcers, protecting against stomach acid.

Specific Agents and Their Properties

Cimetidine:
- Less potent and an enzyme inhibitor with antiandrogenic side effects.
- Category B drug for pregnancy, implying safety.
Carbenoxolone:
- Steroidal agent from liquorice root, increases mucus production and can cause water retention.
Colloidal Bismuth Subcitrate:
- Enhances gastric mucosal defenses and may coat ulcer bases but can lead to discoloration of stool and tongue.

Gastroesophageal Reflux Disease (GERD)

Commonly presents as heartburn; caused by stomach acid reflux into the esophagus.
Treatment involves decreasing acid secretion or enhancing gastrointestinal motility.
Drugs used include PPIs, H2 blockers, prokinetic agents, and antacids.

Emetics and Anti-Emetics

Nausea and vomiting serve as protective reflexes against toxins in the gastrointestinal tract.
The vomiting center in the medulla oblongata is stimulated by drugs such as apomorphine or external factors like mustard and salt.

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Description

This quiz covers different types of peptic ulcers, including GERD, NSAID-induced ulcers, and Zollinger-Ellison syndrome, as well as treatments such as PPIs, H2 blockers, and their mechanisms of action.