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