NR 565 PHARMACOLOGY WEEK 7 | ADVANCED PHARMACOLOGY PRACTICE QUESTIONS &
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
Definition: Acid reflux/heartburn - correct answer ✔✔A burning sensation in the chest +
recurrent regurgitation of acidic stomach contents into the mouth or throat; can affect teeth
and esophagus
Acid reflux/heartburn symptoms - correct answer ✔✔Burning sensation in chest, sour taste,
stomach/chest pain, sore throat/hoarseness, wheezing/coughing, eroded teeth enamel
When is GERD defined - correct answer ✔✔If heartburn/acid reflux symptoms interfere with
daily life or occur more than 2x/week
Defensive factors to protect against ulcers: Mucus - correct answer ✔✔Secreted by GI mucosa
cells, forms protective barrier against acid and pepsin
Defensive factors to protect against ulcers: Bicarbonate - correct answer ✔✔Secreted by
epithelial cells of stomach/duodenum; most is trapped by mucus layer to neutralize H ions;
produced + secreted by pancreas into duodenum
Defensive factors to protect against ulcers: Blood flow - correct answer ✔✔Essential for
maintaining mucosal integrity
Defensive factors to protect against ulcers: Prostaglandins - correct answer ✔✔Stimulate
secretion of bicarb and mucus; promotes vasodilation, helps to maintain blood flow, surpasses
secretion of gastric acid
Factors that increase the risk of ulcer development - correct answer ✔✔H. pylori: can colonize
the stomach + duodenum
NSAIDs: underlying cause of many ulcers
, HCL: Absolute requirement for ulcer development
Pepsin: enzyme in HCL that can injure unprotected mucosal cells
Smoking: delays healing, increases risk of recurrence
Therapeutic effect: Proton Pump Inhibitors - correct answer ✔✔Most effective for inhibiting
acid secretion; bind to gastric PPs, blocking acid production; decreased acid = decreased reflux
and GERD symptoms
Role of gastric parietal cells - correct answer ✔✔Produce + release acid/hydrogen when
activated by histamine, gastrin, + acetylcholine; gastric PP moves acid into stomach and k+ into
parietal cells; HCL is formed when H+ binds to cl-
Other info: PPIs - correct answer ✔✔Takes 2-3 days to reach max effect; acid activated;
irreversibly block H+ and amount of HCL produced
Side effects: PPIs - correct answer ✔✔Headache, nausea, diarrhea
Long-term use: renal complications, bone fractures, dementia, decreased absorption of ca+,
mg+, + B12
Contraindications: PPIs - correct answer ✔✔Hypocalcemia; increased risk of CAP with short-
term use
*Pts. taking NSAIDs can take PPIs for ulcer prophylaxis
Medications: PPIs - correct answer ✔✔OTC: esomeprazole (Nexium), lansoprazole (Prevacid),
omeprazole (Prilosec)
RX: dexlansoprazole (dexilant), pantoprazole (protonix), rabeprazole (aciphex)
Therapeutic action: Histamine-2 Receptor Antagonists (H2RA) - correct answer ✔✔Decreases
acid secretion by blocking histamine 2-receptors in gastric parietal cells; provides relief from
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
Definition: Acid reflux/heartburn - correct answer ✔✔A burning sensation in the chest +
recurrent regurgitation of acidic stomach contents into the mouth or throat; can affect teeth
and esophagus
Acid reflux/heartburn symptoms - correct answer ✔✔Burning sensation in chest, sour taste,
stomach/chest pain, sore throat/hoarseness, wheezing/coughing, eroded teeth enamel
When is GERD defined - correct answer ✔✔If heartburn/acid reflux symptoms interfere with
daily life or occur more than 2x/week
Defensive factors to protect against ulcers: Mucus - correct answer ✔✔Secreted by GI mucosa
cells, forms protective barrier against acid and pepsin
Defensive factors to protect against ulcers: Bicarbonate - correct answer ✔✔Secreted by
epithelial cells of stomach/duodenum; most is trapped by mucus layer to neutralize H ions;
produced + secreted by pancreas into duodenum
Defensive factors to protect against ulcers: Blood flow - correct answer ✔✔Essential for
maintaining mucosal integrity
Defensive factors to protect against ulcers: Prostaglandins - correct answer ✔✔Stimulate
secretion of bicarb and mucus; promotes vasodilation, helps to maintain blood flow, surpasses
secretion of gastric acid
Factors that increase the risk of ulcer development - correct answer ✔✔H. pylori: can colonize
the stomach + duodenum
NSAIDs: underlying cause of many ulcers
, HCL: Absolute requirement for ulcer development
Pepsin: enzyme in HCL that can injure unprotected mucosal cells
Smoking: delays healing, increases risk of recurrence
Therapeutic effect: Proton Pump Inhibitors - correct answer ✔✔Most effective for inhibiting
acid secretion; bind to gastric PPs, blocking acid production; decreased acid = decreased reflux
and GERD symptoms
Role of gastric parietal cells - correct answer ✔✔Produce + release acid/hydrogen when
activated by histamine, gastrin, + acetylcholine; gastric PP moves acid into stomach and k+ into
parietal cells; HCL is formed when H+ binds to cl-
Other info: PPIs - correct answer ✔✔Takes 2-3 days to reach max effect; acid activated;
irreversibly block H+ and amount of HCL produced
Side effects: PPIs - correct answer ✔✔Headache, nausea, diarrhea
Long-term use: renal complications, bone fractures, dementia, decreased absorption of ca+,
mg+, + B12
Contraindications: PPIs - correct answer ✔✔Hypocalcemia; increased risk of CAP with short-
term use
*Pts. taking NSAIDs can take PPIs for ulcer prophylaxis
Medications: PPIs - correct answer ✔✔OTC: esomeprazole (Nexium), lansoprazole (Prevacid),
omeprazole (Prilosec)
RX: dexlansoprazole (dexilant), pantoprazole (protonix), rabeprazole (aciphex)
Therapeutic action: Histamine-2 Receptor Antagonists (H2RA) - correct answer ✔✔Decreases
acid secretion by blocking histamine 2-receptors in gastric parietal cells; provides relief from
