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NURS8024 PHARM EXAM 1 COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS | VERIFIED EXAM QUESTIONS

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NURS8024 PHARM EXAM 1 COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS | VERIFIED EXAM QUESTIONS .Gastric acid secretion by parietal cells of the gastric mucosa are stimulated by - ANSWERS-*acetycholine, histamine, gastrin .Receptor-mediated binding of acetylcholine, histamine, or gastrin results in - ANSWERS-*the activation of protein kinases, which in turn stimulates the H+/K+-adenosine triphosphatase (ATPase) proton pump .Gastrin and acetylcholine stimulate release of - ANSWERS-histamine .receptor binding of prostaglandin E2 and somatostatin diminish - ANSWERS-gastric acid production .Antacids - ANSWERS-weak bases that react with gastric acid to form water and a salt → diminishing gastric acidity Reduce pepsin activity - pepsin inactive at a pH 4 Wide variety* in chemical composition, acid-neutralizing capacity, sodium content, palatability, and price Acid neutralizing ability* of an antacid depends on its capacity to neutralize gastric HCl and on whether the stomach is full or empty • food delays stomach emptying, allowing more time for the antacid to react .Therapeutic uses of antacids - ANSWERS-• Symptomatic relief of peptic ulcer disease (PUD) and gastroesophageal reflux (GERD) • May promote healing of duodenal ulcers, but not robust evidence for efficacy in Tx of acute gastric ulcers • Calcium carbonate preparations • also used as calcium supplements for the treatment of osteoporosis .Commonly used antacid drugs - ANSWERS-Classes • Calcium salts: calcium carbonate: Tums/Rolaids • Sodium bicarbonate: Alka-Seltzer • Aluminum salts - Aluminum hydroxide: Amphojel; Aluminum carbonate: Basaljel • Magnesium salts/ magnesium oxide: Milk of Magnesia • Combination products • Aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta) • Alginic acid, magnesium trisilicate, calcium stearate (Gaviscon) .Adverse effects of antacids - ANSWERS-• Aluminum hydroxide tends to be constipating • Magnesium hydroxide tends to cause diarrhea • Binding of phosphate by aluminum-containing antacids → hypophosphatemia • Sodium bicarbonate → belching and flatulence, potential for systemic alkalosis • Sodium content of antacids → can be important in pts w/ HTN or CHF • Excessive intake of calcium carbonate along w/ calcium foods → hypercalcemia .Mucosal Protective Agents - ANSWERS-Cytoprotective compounds Sucralfate Bismuth Compounds .Cytoprotective Compounds - ANSWERS-enhance mucosal protection mechanisms → preventing mucosal injury, ↓ inflammation, promotes healing of existing ulcers .Sucralfate - ANSWERS-complex of aluminum hydroxide and sulfated sucrose • Small, poorly soluble molecule • Polymerizes in stomach acid → binds to injured tissue, forms physical barrier coating over ulcer bed- impairs diffusion of HCl and prevents degradation of mucus by pepsin and acid • Accelerates healing of peptic ulcers and ↓ recurrence rate • Stimulates prostaglandin release, mucus and bicarbonate output • *BIG drawback.... Must be taken qid• used in long-term maintenance therapy to prevent recurrence • Requires an acidic pH for activation -should not be administered with H2 antagonists or antacids • Little of the drug is absorbed systemically, very well tolerated • Can interfere w/ absorption of other drugs by binding to them • Does not prevent NSAID-induced ulcers .Bismuth Compounds - ANSWERS-• Coats ulcers → protective layer against acid and pepsin • May stimulate prostaglandin, mucus, and bicarbonate secretion • Antimicrobial effect- binds enterotoxins • reduces stool frequency & liquidity in acute infectious diarrhea • Causes black stools- harmless • Avoid in renal insufficiency .In geriatric patients avoid use of - ANSWERS-- antacids that contain magnesium in patients with renal failure - sodium-containing antacids because of fluid retention .Antacids in Pediatrics - ANSWERS-Safety not established in children .Antacids during pregnancy and lactation - ANSWERS-No FDA category established, although antacids generally are considered safe for use in pregnancy .Antisecretory agents - ANSWERS-Histamine-2 receptor antagonists Proton pump inhibitors

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NURS8024 PHARM EXAM 1 COMPLETE
QUESTIONS WITH 100% VERIFIED
ANSWERS



\.Gastric acid secretion by parietal cells of the gastric mucosa are
stimulated by - ANSWERS✔-*acetycholine, histamine, gastrin


\.Receptor-mediated binding of acetylcholine, histamine, or gastrin
results in - ANSWERS✔-*the activation of protein kinases, which in
turn stimulates the H+/K+-adenosine triphosphatase (ATPase) proton
pump


\.Gastrin and acetylcholine stimulate release of - ANSWERS✔-histamine


\.receptor binding of prostaglandin E2 and

somatostatin diminish - ANSWERS✔-gastric acid production


\.Antacids - ANSWERS✔-weak bases that react with gastric acid to
form water and a salt → diminishing gastric acidity

,Reduce pepsin activity - pepsin inactive at a pH >4


Wide variety* in chemical composition, acid-neutralizing capacity,
sodium content, palatability, and price


Acid neutralizing ability* of an antacid depends on its capacity to
neutralize gastric HCl and on whether the stomach is full or empty
• food delays stomach emptying, allowing more time for the antacid to
react


\.Therapeutic uses of antacids - ANSWERS✔-• Symptomatic relief of
peptic ulcer disease (PUD) and gastroesophageal reflux (GERD)
• May promote healing of duodenal ulcers, but not
robust evidence for efficacy in Tx of acute gastric
ulcers
• Calcium carbonate preparations
• also used as calcium supplements for the treatment of osteoporosis


\.Commonly used antacid drugs - ANSWERS✔-Classes
• Calcium salts: calcium carbonate: Tums/Rolaids
• Sodium bicarbonate: Alka-Seltzer

,• Aluminum salts - Aluminum hydroxide: Amphojel; Aluminum
carbonate: Basaljel
• Magnesium salts/ magnesium oxide: Milk of Magnesia
• Combination products
• Aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta)
• Alginic acid, magnesium trisilicate, calcium stearate
(Gaviscon)


\.Adverse effects of antacids - ANSWERS✔-• Aluminum hydroxide tends
to be constipating
• Magnesium hydroxide tends to cause diarrhea
• Binding of phosphate by aluminum-containing antacids →
hypophosphatemia
• Sodium bicarbonate → belching and flatulence, potential for systemic
alkalosis
• Sodium content of antacids → can be important in pts w/ HTN or CHF
• Excessive intake of calcium carbonate along w/ calcium foods →
hypercalcemia


\.Mucosal Protective Agents - ANSWERS✔-Cytoprotective compounds
Sucralfate
Bismuth Compounds

, \.Cytoprotective Compounds - ANSWERS✔-enhance mucosal protection
mechanisms → preventing mucosal injury, ↓ inflammation, promotes
healing of existing ulcers


\.Sucralfate - ANSWERS✔-complex of aluminum hydroxide and sulfated
sucrose
• Small, poorly soluble molecule
• Polymerizes in stomach acid → binds to injured tissue, forms physical
barrier coating over ulcer bed- impairs diffusion of HCl and prevents
degradation of mucus by pepsin and acid
• Accelerates healing of peptic ulcers and ↓ recurrence rate
• Stimulates prostaglandin release, mucus and bicarbonate output
• *BIG drawback.... Must be taken qid• used in long-term maintenance
therapy to prevent recurrence
• Requires an acidic pH for activation -should not be administered with
H2 antagonists or antacids
• Little of the drug is absorbed systemically, very well tolerated
• Can interfere w/ absorption of other drugs by binding to them
• Does not prevent NSAID-induced ulcers


\.Bismuth Compounds - ANSWERS✔-• Coats ulcers → protective layer
against acid and pepsin

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