PC707 Module 3-GI Exam 2024 ( Unit A: Peptic Ulcer and GE Reflux Unit B: Laxatives and Anti-Diarrheal Drugs Unit C: Chronic Constipation, Irritable Bowel Syndrome, and Inflammatory Bowel Disease Unit D: Antiemetic Drugs and Oral Ulcer Treatments)

PC707 Module 3-GI Exam 2024 ( Unit A: Peptic Ulcer and GE Reflux Unit B: Laxatives and Anti-Diarrheal Drugs Unit C: Chronic Constipation, Irritable Bowel Syndrome, and Inflammatory Bowel Disease Unit D: Antiemetic Drugs and Oral Ulcer Treatments) Antacids Examples - Answer ️️ -Calcium carbonate (Tums, Rolaids), Sodium bicarbonate (Alka Seltzer), Magnesium (Milk of Magnesia), Aluminum (Amphogel), Bismuth subsalicylate (Pepto-Bismol) Antacid Indications - Answer ️️ -Dyspepsia Acts immediately but weaker and short-lived Antacid MOA - Answer ️️ -Neutralize hydrochloric acid in the stomach, thereby increasing gastric pH above 4.0 Patient Teaching for Antacids - Answer ️️ -Be sure to separate antacids from other medications by 2 hours Avoid sodium bicarbonate in pregnancy for risk of fetal alkalosis and/or fluid overload Antacid Safety Concerns - Answer ️️ -Sodium bicarbonate may contribute to HTN Sodium-based antacids should be avoided in patients with cardiovascular disease Magnesium-containing antacids may cause diarrhea, contraindicated in renal insufficiency, may decrease absorption of warfarin (Coumadin) Bismuth subsalicylate contraindicated during pregnancy, lactation, in children <12 y/o H2RA Examples - Answer ️️ -Cimetidine (Tagamet), famotidine (Pepcid, Zantac 360), nizatidine (Axid) H2RA Indications - Answer ️️ -Gastric and duodenal ulcers H2RA MOA - Answer ️️ -Blocks H2 receptors to reduce the volume of gastric acid (onset of action slower than antacids but faster than PPIs - moderate acid reduction) H2RA Safety Concerns - Answer ️️ -Cimetidine is a potent CYP inhibitor, many D2D interactions (warfarin, theophylline, phenytoin, opioids) Potential pneumonia Ranitidine (original Zantac) pulled off market d/t carcinogens, new formulation is famotidine PPI Examples - Answer ️️ -Omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix) PPI Indications - Answer ️️ -Gastric and duodenal ulcers Most effective at suppressing acid but the slowest onset of action compared to antacids and H2RAs PPI MOA - Answer ️️ -Prodrug inhibition of the proton pumps that secrete gastric acid PPI Safety Concerns - Answer ️️ -Fractures Pneumonia Acid rebound C. diff Can reduce the absorption of drugs that rely on acid Prostaglandin Analog Example - Answer ️️ -Misoprostol (Cytotec) Prostaglandin Analog Indication - Answer ️️ -Prevention of GI ulcers related to long-term NSAID use Prostaglandin Analog MOA - Answer ️️ -Protects gastric mucosa by binding to prostaglandin receptors. This inhibits gastric acid secretion and increases mucus production Prostaglandin Analog Safety Concerns - Answer ️️ -Causes uterine contractions, therefore Category X (contraindicated) in pregnancy **Off-label use for induction of labor** Mucosal Protectant Example - Answer ️️ -Sucralfate (Carafate) Mucosal Protectant Indication - Answer ️️ -Antiulcer Mucosal Protectant MOA - Answer ️️ -Creates a protective barrier against pepsin and gastric acid Prokinetic Example - Answer ️️ -Metoclopramide (Reglan) Prokinetic Indication - Answer ️️ -Sometimes us