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Questions and Answers
What stimulates histamine release from ECL cells?
What stimulates histamine release from ECL cells?
- Hyperacidity
- Hypochlorhydria
- Hypoglycemia
- Hypergastrinemia (correct)
Which drug inhibits acid secretion by 75-95% and stimulates mucin and bicarbonate secretion?
Which drug inhibits acid secretion by 75-95% and stimulates mucin and bicarbonate secretion?
- Sucralfate
- Ranitidine
- Omeprazole
- Misoprostol (correct)
What is a common adverse effect of Misoprostol?
What is a common adverse effect of Misoprostol?
- Constipation
- Headache
- Nausea
- Diarrhea (correct)
Which condition is contraindicated for Misoprostol use due to its effect on uterine contractions?
Which condition is contraindicated for Misoprostol use due to its effect on uterine contractions?
Which drug is a sulfated polysaccharide plus aluminium hydroxide used for gastric defense?
Which drug is a sulfated polysaccharide plus aluminium hydroxide used for gastric defense?
What is the primary function of somatostatin in the regulation of gastric acid secretion?
What is the primary function of somatostatin in the regulation of gastric acid secretion?
What is the primary mechanism of action of Proton Pump Inhibitors (PPIs) in reducing acid secretion?
What is the primary mechanism of action of Proton Pump Inhibitors (PPIs) in reducing acid secretion?
Which of the following mediators is responsible for stimulating histamine release from ECL cells in the gastric mucosa?
Which of the following mediators is responsible for stimulating histamine release from ECL cells in the gastric mucosa?
How do Asians with a slow metabolizing genotype of CYP2C19 react to Proton Pump Inhibitors (PPIs)?
How do Asians with a slow metabolizing genotype of CYP2C19 react to Proton Pump Inhibitors (PPIs)?
How does the lower esophageal sphincter (LES) help prevent gastroesophageal reflux disease (GERD)?
How does the lower esophageal sphincter (LES) help prevent gastroesophageal reflux disease (GERD)?
Which of the following drugs is known to interact with clopidogrel by preventing its conversion to the active form?
Which of the following drugs is known to interact with clopidogrel by preventing its conversion to the active form?
Which class of drugs is known for their ability to inhibit the secretion of gastric acid by parietal cells?
Which class of drugs is known for their ability to inhibit the secretion of gastric acid by parietal cells?
What is a potential adverse effect of stopping Proton Pump Inhibitors (PPIs) therapy?
What is a potential adverse effect of stopping Proton Pump Inhibitors (PPIs) therapy?
What is the main mechanism of action of proton pump inhibitors (PPIs) in the treatment of acid-related disorders?
What is the main mechanism of action of proton pump inhibitors (PPIs) in the treatment of acid-related disorders?
Histamine H2 receptor antagonists inhibit acid secretion by blocking which type of receptors on gastric parietal cells?
Histamine H2 receptor antagonists inhibit acid secretion by blocking which type of receptors on gastric parietal cells?
Which of the following is a mechanism used by the stomach to protect its mucosa against acid and pepsin damage?
Which of the following is a mechanism used by the stomach to protect its mucosa against acid and pepsin damage?
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Study Notes
Regulation of Gastric Acid Secretion
- Gastric acid secretion may be stimulated by hypergastrinemia, which releases histamine from ECL cells.
Drugs to Increase Mucosal Defense
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Misoprostol: a prostaglandin E1 analogue that stimulates EP3 receptors on parietal cells, decreasing cAMP and inhibiting acid secretion by 75-95%.
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Misoprostol also stimulates mucin and bicarbonate secretion, which are protective for the stomach mucosa.
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Adverse effects of misoprostol: diarrhea in up to 30% of patients, abdominal cramps, and may aggravate inflammatory bowel disease.
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Misoprostol is contraindicated during pregnancy due to uterine contractions.
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Sucralfate: a sulfated polysaccharide plus aluminum hydroxide that stimulates mucus secretion at an acidic pH.
Drugs to Reduce Acid Secretion
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Proton Pump Inhibitors (PPIs): most potent in reducing acid secretion (80-95% inhibition).
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PPIs are prodrugs activated by acid in parietal cells and irreversibly inhibit the proton pump.
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Adverse effects of PPIs: can interact with other drugs, inhibit their metabolism, and cause hypergastrinemia upon stopping treatment.
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Therapeutic uses of PPIs: gastric and duodenal ulcers, GERD, and Zollinger-Ellison syndrome.
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Histamine H2 Receptor Antagonists: less potent than PPIs, inhibit acid secretion by ~70%.
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Mechanism: block histamine H2 receptors on gastric parietal cells.
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Adverse effects: mostly minor, but cimetidine interacts with many drugs and tolerance to their acid-suppressing effect occurs within 2-3 days of use.
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