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Question 1
What are the two main types of inhibitors of gastric acid production?
Proton pump inhibitors and H2 histamine receptor antagonists
Question 2
Primary function: - Proton pump inhibitors - H2 histamine receptor antagonist
decrease gastric acid secretion promote mucosal healing
Question 3
What is heartburn?
a burning sensation, usually from the lower chest area, moves upward towards the neck, within 2 hours after eating or when lying down or bending over
Question 4
What is the most common symptom of GERD
Frequent and persistent heartburn
Question 5
Antacids function
neutralize stomach acid, reducing its acidity
Question 6
Antisecretory medication function
reduce acid secretion in the stomach
Question 7
Treatment strategy for GERD and PUD
decrease acidity of stomach repair epithelial lining
Question 8
Direct vagal stimulation on gastric secretion
stimulates H+ secretion via ACh
Question 9
Indirect vagal stimulation on gastric secretion
stimulates gastrin secretion → stims H+ secretion
Question 10
Gastrin effect on gastric secretion
↑ H+ secretion via CCK ↑ enterochromaffin-like cells and histamine → H+ secretion
Question 11
Histamine effect on gastric secretion
stimulates H+ via activation of H2 receptors
Question 12
What factors can inhibit H+ secretion in the stomach?
Low pH (<3.0) in stomach Somatostatin Prostaglandins
Question 13
Effects of inhibiting H+ secretion?
Maintain mucosal barrier + stimulate bicarbonate secretion = protecting gastric mucosa
Question 14
Role of Cimetidine in regulation of H+ secretion?
prevents Histamine signaling by blocking the H2 receptor
Question 15
Which drug blocks stimulatory signal from Vagus nerve mediated by Acetylcholine?
Atropine
blocks signal from Vagus nerve
Question 16
Role of Omeprazole in the regulation of H+ secretion?
Inhibits the hydrogen/potassium pump
Question 17
What are H2 receptor antagonists/blockers?
Competitive, reversible antagonists of H2 receptors
Question 18
List the H2 receptor antagonists
• Cimetidine • Ranitidine • Famotidine • Nizatidine
Question 19
List the oral proton pump inhibitors
Omeprazole Lansoprazole Dexlansoprazole
Question 20
List the IV proton pump inhibitors?
Pantoprazole Esomeprazole
Question 21
What are the key members of the PPI class?
Omeprazole Lansoprazole Dexlansoprazole Pantoprazole Esomeprazole Rabeprazole
Question 22
What is the mechanism of action of PPIs and what do they inhibit?
irreversibly binds to and inhibits H⁺/K⁺-ATPase in parietal cells → blocks H+ ion secretion
Question 23
What med is used for pre/post op sedative for GI ulcer patients
diazepam
Question 24
What med is used for sedation of patient treated with cimetidine or omeprazole
lorazepam or oxazepam
Question 25
What are antacids and how do they work?
bind to H⁺ → neutralizes existing acid → higher pH → less pepsin activity → less mucosal damage → symptom relief
Question 26
What are the main uses of antacids?
Symptomatic relief
Question 27
List the antacids
Aluminum Hydroxide Magnesium hydroxide Calcium carbonate Sodium bicarbonate
Question 28
What is a possible adverse effect of all antacids
hypokalemia
Question 29
What is the effect of antacids on drug interactions?
Affect drug interactions by changing gastric and urinary pH
Question 30
How do antacids impact oral absorption of drugs?
alter the pH of the stomach and urine affecting the absorption of acidic and basic drugs
Question 31
What are sialagogues?
Enhance salivary secretion through promoting the parasympathetic nervous system
Question 32
List the Sialagogues
Pilocarpine Cevimeline
Question 33
What is the definition of an anti-sialagogue?
A drug that decreases salivary flow.
Question 34
List the anti-sialagogues
Atropine Scopolamine
Question 35
Anti-sialagogue MOA
Acetylcholine blockade at muscarinic receptor sites
Question 36
What is the brainstem vomiting center and what does it do?
located in the lateral medullary reticular formation coordinates motor activities associated with nausea and vomiting
Question 37
Types of antiemtics
antipsychotics metoclopramide H1 antihistamines anticholinergics serotonin 5-HT3 antagonists neurokinin antagonists cannabinoids corticosteroids
Question 38
Classes of Laxatives/Cathartics
• Bulk forming agents • Stimulant laxatives • Osmotic laxatives • Wetting Agents • Osmotic Cathartics • Chloride Channel Activators
Question 39
What is the difference between laxatives and cathartics?
Laxatives: ease passage of fully formed fecal matter from rectum Cathartics: cause evacuation of the entire colon
Question 40
List the bulk forming agents
Psyllium Methylcellulose Polycarbophil
Question 41
Bulk forming agents MOA
fibrous compounds: absorb water + expanding, ↑ the bulk of intestinal contents ↑ luminal pressure stimulates reflex peristalsis ↑ increased water content softens stool
Question 42
What are the adverse side effects of opioid analgesics on the GI tract?
Constipation, nausea, and vomiting
Question 43
What are the common adverse effects of antibiotics on the GI system, especially broad-spectrum antibiotics?
Diarrhea caused by Clostridium difficile overgrowth
Question 44
What is the primary use of Bismuth subsalicylate?
Antidiarrhea
Question 45
What condition can Bismuth subsalicylate cause?
Tongue pigmentation