Finall Exam:l NU641/l NUl 641l (Latestl
2025/l 2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
QUESTION
laxatives
Answer:
6l classes
stimulants:l senna,l bisacodyl,l castorl oil
osmtic:l magnesiuml hydroxide,l magl citreate,l polyethlynenel glycoll (PEG)
bulkl producingl laxatives:l psyllium,l methylcellulose,l andl polycarbophil
lubricants:l minerall oil
surfactants:l docusatel compountsl [makel thingsl slippery]
hyperosmolarl laxatives:l glycerin,l lactulose
QUESTION
laxativesl PD
Answer:
•Stimulants:l directl actionl onl intestinall mucosal byl stimulatingl thel myentericl plexus
•Osmotics:l drawl waterl intol thel intestinall lumen
•Bulk-Producingl Laxatives:l naturall andl semisyntheticl polysaccharidesl andl cellulosel thatl
mixesl withl waterl inl thel intestine
•Lubricants:l softenl stooll andl lubricatesl intestine
•Surfactants:l reducel thel surfacel tensionl ofl thel oil-waterl interfacel onl thel stooll andl
facilitatel admixturel ofl fatl andl waterl intol thel stool
•Hyperosmolarl Laxatives:l drawsl waterl intol intestine
QUESTION
,Laxativesl contraindicators/l ADR
Answer:
alll arel contraindicatedl inl thel presensel ofl nausea,l vomitingl orl undiagnosedl abdominall
painl orl ifl bowll obstructionl isl suspectedl orl diagnosed
-magl hydroxidel contral inl renall dysfunction
ADR:l cramping,l gas,l bloating
QUESTION
laxativesl clinicall use
Answer:
dependentl onl classl ofl drug
rapidl responsel andl shortl terml usel (usuallyl whenl personl hasl limitedl movement):
=stimulantsl arel thel drugl ofl choicel (senna)
-osmoticl laxl alsol workl welll (magl hydroxide,l PEGl 3350)
-surfactantsl (docusate)
slowerl responsel andl longl term:
-bulkl formingl laxativesl (pysyllium,l methcellulose,l carbophil)
preg:l bulkl formingl laxativesl arel safestl ******
QUESTION
laxativesl ptl education
Answer:
admin:l rapidl actingl laxativesl arel bestl takenl inl thel morning,l slowerl atl night
QUESTION
GERD
Answer:
10-28%l prevelance
Patho:l
-lowerl esophageall sphincterl (LES)l tonel =l primaryl reason
-gastricl contentl regurgiationl intol thel esophagus
-patientl complainsl ofl burningl substernall painl thatl radiatesl upward
,-persistentl acidl refluxl thatl occursl morel thanl twicel al weekl isl consideredl GERD
medsl andl foodl thatl increasel stomachl phl canl makel itl worse
QUESTION
medicationsl forl GERD
Answer:
antacidsl [ifl usedl morel thanl twicel weeklyl thenl movingl up]
H2l receptorl antagonists
protonl pumpl inhibitors
prokinetics
QUESTION
treatmentl ofl GERD
Answer:
dyspepsial orl mildl GERD
-antacidsl andl lifestylel modification
-H2l reeptorl antagonistsl forl 4l tol 8l weeks,l ifl betterl continuel forl 12l weeksl thenl weanl off
moderatel tol severel GERD
-PPIl forl 8l weeksl [butl inl reall lifel ptsl arel almostl alwaysl onl longer]
-PPIl canl bel increasedl tol twicel dailyl forl 4-8l weeks.l ifl symptoml freel forl 4l weeks,l canl
stepl downl tol oncel dailyl andl reassessl inl 6-12l monthsl
l
-ifl betterl canl weanl PPI->l canl leadl tol reboundl ifl halfl al weekl tol longerl b/cl drugsl hasl
longl halfl life
-ifl notl workingl afterl 8l weeks,l refer
QUESTION
GERDl inl infants
Answer:
veryl common,l almostl 100%l ofl newborns,l mostl outgrowl byl 12-18l months
lifestylel mods=l couldl tryl eliminatingl cowl milk,l usel hydrolyzedl proteinl formula,l propl
headl ofl crib
empiricl medicationl treatmentl withoutl studiesl isl notl appropraitel forl infant->l onlyl ifl poorl
weightl gain,l feedingl difficulties,l persistentl irritability,l pain,l apneal andl cyanosisl
, canl usel H2RAl orl PPIl (8-12l weeks)
QUESTION
Anl adultl patientl presentsl withl complaintsl ofl heartburnl thatl isl minimallyl relievedl withl
Tumsl (calciuml carbonate)l andl isl diagnosedl withl mildl gastroesophageall refluxl diseasel
(GERD).l Anl appropriatel therapyl wouldl be:
A.Antacids
B.Histamine-2l receptorl antagonist
C.Prokinetics
D.Protonl pumpl inhibitorsl (PPIs)
Answer:
b
QUESTION
Thel nextl stepl inl treatmentl whenl anl adultl patientl hasl beenl onl PPIsl twicel dailyl forl 12l
weeksl andl notl improvingl is:
A.Addl al prokineticl (metoclopramide).
B.Referl thel patientl forl endoscopyl [GI]
C.Switchl tol anotherl PPI.
D.Addl al cytoprotectivel drug.
Answer:
b
QUESTION
PUD
Answer:
pepticl ulcerl disease,l slightlyl higherl incidencel inl men
patho:l increasedl acidl andl pepsinl secretion,l impairedl mucosall cytoprotection,l usel ofl
nsiaidl andl hl pylori
gastric:l antrall stomachl regionl erosion,l gastrin
duodenal:l hl pyloril releasesl toxins,l phosphlolipasel enzymesl promotel inflammationl andl
erosion
2025/l 2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
QUESTION
laxatives
Answer:
6l classes
stimulants:l senna,l bisacodyl,l castorl oil
osmtic:l magnesiuml hydroxide,l magl citreate,l polyethlynenel glycoll (PEG)
bulkl producingl laxatives:l psyllium,l methylcellulose,l andl polycarbophil
lubricants:l minerall oil
surfactants:l docusatel compountsl [makel thingsl slippery]
hyperosmolarl laxatives:l glycerin,l lactulose
QUESTION
laxativesl PD
Answer:
•Stimulants:l directl actionl onl intestinall mucosal byl stimulatingl thel myentericl plexus
•Osmotics:l drawl waterl intol thel intestinall lumen
•Bulk-Producingl Laxatives:l naturall andl semisyntheticl polysaccharidesl andl cellulosel thatl
mixesl withl waterl inl thel intestine
•Lubricants:l softenl stooll andl lubricatesl intestine
•Surfactants:l reducel thel surfacel tensionl ofl thel oil-waterl interfacel onl thel stooll andl
facilitatel admixturel ofl fatl andl waterl intol thel stool
•Hyperosmolarl Laxatives:l drawsl waterl intol intestine
QUESTION
,Laxativesl contraindicators/l ADR
Answer:
alll arel contraindicatedl inl thel presensel ofl nausea,l vomitingl orl undiagnosedl abdominall
painl orl ifl bowll obstructionl isl suspectedl orl diagnosed
-magl hydroxidel contral inl renall dysfunction
ADR:l cramping,l gas,l bloating
QUESTION
laxativesl clinicall use
Answer:
dependentl onl classl ofl drug
rapidl responsel andl shortl terml usel (usuallyl whenl personl hasl limitedl movement):
=stimulantsl arel thel drugl ofl choicel (senna)
-osmoticl laxl alsol workl welll (magl hydroxide,l PEGl 3350)
-surfactantsl (docusate)
slowerl responsel andl longl term:
-bulkl formingl laxativesl (pysyllium,l methcellulose,l carbophil)
preg:l bulkl formingl laxativesl arel safestl ******
QUESTION
laxativesl ptl education
Answer:
admin:l rapidl actingl laxativesl arel bestl takenl inl thel morning,l slowerl atl night
QUESTION
GERD
Answer:
10-28%l prevelance
Patho:l
-lowerl esophageall sphincterl (LES)l tonel =l primaryl reason
-gastricl contentl regurgiationl intol thel esophagus
-patientl complainsl ofl burningl substernall painl thatl radiatesl upward
,-persistentl acidl refluxl thatl occursl morel thanl twicel al weekl isl consideredl GERD
medsl andl foodl thatl increasel stomachl phl canl makel itl worse
QUESTION
medicationsl forl GERD
Answer:
antacidsl [ifl usedl morel thanl twicel weeklyl thenl movingl up]
H2l receptorl antagonists
protonl pumpl inhibitors
prokinetics
QUESTION
treatmentl ofl GERD
Answer:
dyspepsial orl mildl GERD
-antacidsl andl lifestylel modification
-H2l reeptorl antagonistsl forl 4l tol 8l weeks,l ifl betterl continuel forl 12l weeksl thenl weanl off
moderatel tol severel GERD
-PPIl forl 8l weeksl [butl inl reall lifel ptsl arel almostl alwaysl onl longer]
-PPIl canl bel increasedl tol twicel dailyl forl 4-8l weeks.l ifl symptoml freel forl 4l weeks,l canl
stepl downl tol oncel dailyl andl reassessl inl 6-12l monthsl
l
-ifl betterl canl weanl PPI->l canl leadl tol reboundl ifl halfl al weekl tol longerl b/cl drugsl hasl
longl halfl life
-ifl notl workingl afterl 8l weeks,l refer
QUESTION
GERDl inl infants
Answer:
veryl common,l almostl 100%l ofl newborns,l mostl outgrowl byl 12-18l months
lifestylel mods=l couldl tryl eliminatingl cowl milk,l usel hydrolyzedl proteinl formula,l propl
headl ofl crib
empiricl medicationl treatmentl withoutl studiesl isl notl appropraitel forl infant->l onlyl ifl poorl
weightl gain,l feedingl difficulties,l persistentl irritability,l pain,l apneal andl cyanosisl
, canl usel H2RAl orl PPIl (8-12l weeks)
QUESTION
Anl adultl patientl presentsl withl complaintsl ofl heartburnl thatl isl minimallyl relievedl withl
Tumsl (calciuml carbonate)l andl isl diagnosedl withl mildl gastroesophageall refluxl diseasel
(GERD).l Anl appropriatel therapyl wouldl be:
A.Antacids
B.Histamine-2l receptorl antagonist
C.Prokinetics
D.Protonl pumpl inhibitorsl (PPIs)
Answer:
b
QUESTION
Thel nextl stepl inl treatmentl whenl anl adultl patientl hasl beenl onl PPIsl twicel dailyl forl 12l
weeksl andl notl improvingl is:
A.Addl al prokineticl (metoclopramide).
B.Referl thel patientl forl endoscopyl [GI]
C.Switchl tol anotherl PPI.
D.Addl al cytoprotectivel drug.
Answer:
b
QUESTION
PUD
Answer:
pepticl ulcerl disease,l slightlyl higherl incidencel inl men
patho:l increasedl acidl andl pepsinl secretion,l impairedl mucosall cytoprotection,l usel ofl
nsiaidl andl hl pylori
gastric:l antrall stomachl regionl erosion,l gastrin
duodenal:l hl pyloril releasesl toxins,l phosphlolipasel enzymesl promotel inflammationl andl
erosion
