Pharmacology: H2 Antagonists and PPIs
40 Questions
0 Views

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 primary action of H2 antagonists in treating ulcer disease?

  • Blocking H2 receptors on parietal cells (correct)
  • Stimulating the release of gastrin
  • Inhibiting the release of prostaglandins
  • Increasing hydrochloric acid production
  • Which of the following drugs is specifically eliminated by the kidneys?

  • Nizatidine (correct)
  • Ranitidine
  • Famotidine
  • Cimetidine
  • What adverse effect is specifically associated with long-term use of cimetidine?

  • Gynecomastia (correct)
  • Hypotension
  • Dizziness
  • Diarrhea
  • Which H2 antagonist is considered the prototype?

    <p>Cimetidine</p> Signup and view all the answers

    What is a common gastrointestinal side effect of H2 antagonists?

    <p>Diarrhea</p> Signup and view all the answers

    Which of the following H2 antagonists is approved for use in children ages 1 to 16?

    <p>Famotidine</p> Signup and view all the answers

    Which side effects can occur with high levels of H2 antagonists?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    What caution should be considered when prescribing H2 antagonists?

    <p>Risk of liver dysfunction</p> Signup and view all the answers

    What is the main action of the drugs that block acid production in the stomach?

    <p>Block the H+, K+-ATPase pump</p> Signup and view all the answers

    Which condition is NOT treated with proton pump inhibitors?

    <p>Chronic constipation</p> Signup and view all the answers

    How quickly do proton pump inhibitors reach peak levels in the body?

    <p>3 to 5 hours</p> Signup and view all the answers

    What is a common central nervous system side effect of proton pump inhibitors?

    <p>Dizziness</p> Signup and view all the answers

    What adverse effect is associated with long-term use of proton pump inhibitors?

    <p>Increased incidence of Clostridium difficile diarrhea</p> Signup and view all the answers

    Which proton pump inhibitor is preferred for children under 18 years?

    <p>Lansoprazole</p> Signup and view all the answers

    What common adverse effect may occur in the gastrointestinal system due to proton pump inhibitors?

    <p>Vomiting</p> Signup and view all the answers

    Why are laxative drugs commonly abused?

    <p>To stimulate gastrointestinal movement</p> Signup and view all the answers

    Which of the following is a common adverse effect of frequent laxative use?

    <p>Cathartic dependence</p> Signup and view all the answers

    What can excessive laxative use potentially lead to?

    <p>Constipation and stool drying</p> Signup and view all the answers

    Which laxative works by pulling fluid into the lumen of the small intestine?

    <p>Lactulose</p> Signup and view all the answers

    What is NOT a central nervous system effect commonly associated with laxative use?

    <p>Increased reflexes</p> Signup and view all the answers

    Which laxative type increases motility by enhancing bulk and stimulating local receptors?

    <p>Bulk stimulants</p> Signup and view all the answers

    In which condition are bulk laxatives contraindicated?

    <p>Ulcerative colitis</p> Signup and view all the answers

    What is the effect of polyethylene glycol-electrolyte solution on patients with a history of seizures?

    <p>Causes electrolyte absorption issues</p> Signup and view all the answers

    What type of agent is magnesium citrate considered?

    <p>Osmotic laxative</p> Signup and view all the answers

    What are the most common gastrointestinal adverse effects associated with bulk laxatives?

    <p>Diarrhea, abdominal cramping, and nausea</p> Signup and view all the answers

    What is the primary function of docusate as a laxative?

    <p>Coat the intestinal bolus to retain moisture</p> Signup and view all the answers

    Which adverse effect is less likely to occur with lubricant laxatives compared to stimulants?

    <p>CNS effects like dizziness</p> Signup and view all the answers

    What form is glycerin used in for its laxative effects?

    <p>Rectal suppository</p> Signup and view all the answers

    What contraindications are associated with the use of lubricant laxatives?

    <p>Heart block, CAD, and acute abdominal conditions</p> Signup and view all the answers

    What common CNS effects may accompany laxative use?

    <p>Dizziness and headache</p> Signup and view all the answers

    What type of laxative stimulates the nerve plexus in the intestinal wall?

    <p>Chemical stimulants</p> Signup and view all the answers

    How does mineral oil function as a laxative?

    <p>By forming a barrier that prevents water absorption</p> Signup and view all the answers

    Which laxative is commonly used when a thorough evacuation of the intestine is desirable?

    <p>Castor oil</p> Signup and view all the answers

    What is a potential issue associated with the use of mineral oil?

    <p>Leakage and staining due to stool consistency</p> Signup and view all the answers

    Which laxative is considered milder than castor oil and is typically used for overnight effects?

    <p>Cascara</p> Signup and view all the answers

    Why are laxatives contraindicated in patients with acute abdominal disorders?

    <p>They may exacerbate inflammation or lead to rupture.</p> Signup and view all the answers

    What is one of the adverse effects associated with laxative use?

    <p>Abdominal cramping</p> Signup and view all the answers

    Which laxative should be avoided during pregnancy due to its potential to induce premature labor?

    <p>Castor oil</p> Signup and view all the answers

    Which of the following laxatives is least likely to be absorbed into the system?

    <p>Bulk stimulants</p> Signup and view all the answers

    In which condition should laxatives be used with caution due to the risk of electrolyte changes?

    <p>Heart block</p> Signup and view all the answers

    Study Notes

    Chapter 9: Gastrointestinal System

    • This chapter covers drugs used to treat ulcer disease, constipation, and related topics.

    Drugs Used to Treat Ulcer Disease

    • Histamine-2 Antagonists: These drugs selectively block H2 receptors on parietal cells.

      • This prevents gastrin release, which reduces histamine release.
      • It ultimately blocks hydrochloric acid production and decreases pepsin production.
      • H2 receptor sites are also in the heart, and high drug levels can cause cardiac arrhythmias.
      • Examples include cimetidine (Tagamet, Tagamet HB), famotidine (Pepcid, Pepcid AC), nizatidine (Axid), and ranitidine (Zantac).
      • Specific uses and special considerations for each drug are provided.
    • Pharmacokinetics:

      • Cimetidine, ranitidine, and famotidine are available in oral and parenteral forms.
      • Nizatidine is available only in oral form.
      • Cimetidine (prototype) is associated with antiandrogenic effects like gynecomastia and galactorrhea.
      • It is metabolized in the liver and can slow the metabolism of other drugs. It's excreted in urine.
      • Ranitidine and famotidine are more potent, longer-acting, and don't have the same antiandrogenic effects or marked slowing of metabolism as cimetidine. They are also metabolized in the liver and excreted in urine.
      • Famotidine is approved for use in children aged 1 to 16 years.
      • Nizatidine is similar to ranitidine in its effects but is eliminated by the kidneys, with no first-pass liver metabolism. It's the drug of choice for patients with liver dysfunction.
    • Contraindications and Cautions:

      • Use caution during pregnancy or lactation due to potential fetal/newborn effects.
      • Exercise caution with hepatic or renal dysfunction as it may affect drug metabolism and excretion.
      • Note adverse effects like diarrhea, constipation, CNS effects, cardiac arrhythmias, and hypotension. Also, long-term cimetidine use can cause gynecomastia and impotence.
    • Proton Pump Inhibitors (PPIs):

      • Specifically inhibit the H+, K+-ATPase enzyme system.
      • This lowers gastric acid levels in the stomach.
      • Recommended for short-term treatment of active duodenal ulcers, GERD, erosive esophagitis and benign, active gastric ulcers. Also for long-term treatment of certain pathological conditions.
      • Used as maintenance therapy for healing, and in combination with amoxicillin and clarithromycin for H. pylori infection treatment.
      • Several examples like dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole are listed, with their indications for use.
      • Pharmacokinetics and safety considerations for these drugs are also discussed.
      • Note adverse effects like GI effects, CNS effects, upper respiratory symptoms, and possible effects like bone loss, low calcium/magnesium levels, and C. difficile diarrhea/pneumonia in long-term use..

    Drugs Used in the Treatment of Constipation

    • Laxatives:

      • Used for short-term relief of constipation.
      • Available as OTC preparations.
      • Overuse can lead to chronic intestinal disorders.
      • Types include chemical stimulants (irritate GI lining), bulk stimulants (bulk up stool), and lubricants (facilitate movement).
    • Chemical Stimulants:

      • Directly stimulate nerve plexus in intestinal wall.
      • Examples include castor oil, bisacodyl, cascara, and senna. Important to note their specific effects and situations where they are recommended.
    • Bulk Stimulants:

      • Increase intestinal motility by increasing fluid and bulk in intestinal contents.
      • Examples include lactulose, magnesium citrate/hydroxide, polyethylene glycol-electrolyte solution, and psyllium. Note different types and how they work.
    • Lubricants:

      • Ease defecation without stimulating GI tract movement.
      • Examples include mineral oil, docusate, and glycerin. Note these are used for lubrication.
    • Pharmacokinetics and Contraindications:

      • The methods of absorption, and excretion are described for each drug class.
      • Notes are included about contraindications, such as cautions with acute abdominal disorders, pregnancy, and lactation.
      • Potential for adverse effects such as diarrhea and abdominal cramping are also discussed.

    Studying That Suits You

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

    Quiz Team

    Related Documents

    Description

    This quiz tests your knowledge on H2 antagonists and proton pump inhibitors (PPIs) in treating ulcer disease. Questions include drug actions, side effects, and specific usage in children. Assess your understanding of these critical medications in gastroenterology.

    More Like This

    Use Quizgecko on...
    Browser
    Browser