NURS 8102N Advanced Pharmacology
2025/2026 Midterm Exam with Correctly
Answered Questions Actual Exam (Score A)
Columbia University
what is the underlying cause of gastric ulcers and some duodenal ulcers?
NSAIDs
Zollinger-Ellison Syndrome (ZES)
disorder of excess acid secretion in the stomach resulting in peptic ulcer disease
what patients with gastric or duodenal ulcers should receive antibiotics?
those with documented H. pylori infection
risk factors for ulcer development?
Older than 60 years, history of ulcers, high-dose NSAID therapy
when should prophylaxis for ulcers be given?
,patients have risk factors. treatment with PPI (omeprazole) is preferred. alternative
Misoprostol but causes diarrhea.
antibiotics for patients with gastric or duodenal ulcers
clarithromycin, amoxicillin, bismuth, metronidazole
Clarithromycin (Biaxin)
- Suppresses growth of H. pylori by inhibiting protein synthesis
- In the absence of resistance, treatment is highly effective
- Unfortunately, rate of resistance is rising, exceeding 20% in some areas
Most common side effects:
- Nausea
- Diarrhea
- Distortion of taste
Amoxicillin
h. pylori is highly sensitive to amoxicillin. rate of resistance is low. kill bacteria by
disrupting the cell wall.
most common side effect: diarrhea
,Bismuth
topically to disrupt cell wall of H. pylori.
adverse effect: black coloration to the tongue or stool. long-term therapy may carry
risk for neurologic injury.
tetracycline
inhibits bacterial protein synthesis.
can stain teeth. not for pregnant women or children
Metronidazole (Flagyl)
effective against sensitive strains of H. pylori.
more the 40% of strains are resistant.
adverse effects: nausea, headache, disulfiram like reaction with used with alcohol.
avoid alcohol, not used in pregnancy.
how do you prevent antibiotic resistance
American College of Gastroenterology recommends using two or preferably three
antibiotics.
antisecretory agent (PPI or histamine-2 receptor antagonist) should also be used.
, antibiotics for H. pylori if patient has a penicillin allergy
metronidazole instead of amoxicillin
combination packs for h. pylori ulcers
omeclamox-pak, Pylera, prevpac.
hsitamine-2 receptor antagonists
treat gastric and duodenal ulcers. promote ulcer healing by suppressing secretion of
gastric acid.
monitor for gastric PH should increase to 5 or above.
use with caution in patients with renal or hepatic dysfunction.
inform patient to report lethargy, somnolence, restlessness, confusion, or
hallucinations.
cimetidine, ranitidine, famotidine, and nizatidine.
Cimetidine (Tagamet)
histamine H2 receptor antagonist.
mechanism of action: Blocks H2 receptors = reduces volume of gastric juice & its
hydrogen ion concentration. Suppresses basal acid secretion & secretion stimulated by
gastrin and acetylcholine. high doses in patients with Zollinger-ellison syndrome is
used to heal ulcers
2025/2026 Midterm Exam with Correctly
Answered Questions Actual Exam (Score A)
Columbia University
what is the underlying cause of gastric ulcers and some duodenal ulcers?
NSAIDs
Zollinger-Ellison Syndrome (ZES)
disorder of excess acid secretion in the stomach resulting in peptic ulcer disease
what patients with gastric or duodenal ulcers should receive antibiotics?
those with documented H. pylori infection
risk factors for ulcer development?
Older than 60 years, history of ulcers, high-dose NSAID therapy
when should prophylaxis for ulcers be given?
,patients have risk factors. treatment with PPI (omeprazole) is preferred. alternative
Misoprostol but causes diarrhea.
antibiotics for patients with gastric or duodenal ulcers
clarithromycin, amoxicillin, bismuth, metronidazole
Clarithromycin (Biaxin)
- Suppresses growth of H. pylori by inhibiting protein synthesis
- In the absence of resistance, treatment is highly effective
- Unfortunately, rate of resistance is rising, exceeding 20% in some areas
Most common side effects:
- Nausea
- Diarrhea
- Distortion of taste
Amoxicillin
h. pylori is highly sensitive to amoxicillin. rate of resistance is low. kill bacteria by
disrupting the cell wall.
most common side effect: diarrhea
,Bismuth
topically to disrupt cell wall of H. pylori.
adverse effect: black coloration to the tongue or stool. long-term therapy may carry
risk for neurologic injury.
tetracycline
inhibits bacterial protein synthesis.
can stain teeth. not for pregnant women or children
Metronidazole (Flagyl)
effective against sensitive strains of H. pylori.
more the 40% of strains are resistant.
adverse effects: nausea, headache, disulfiram like reaction with used with alcohol.
avoid alcohol, not used in pregnancy.
how do you prevent antibiotic resistance
American College of Gastroenterology recommends using two or preferably three
antibiotics.
antisecretory agent (PPI or histamine-2 receptor antagonist) should also be used.
, antibiotics for H. pylori if patient has a penicillin allergy
metronidazole instead of amoxicillin
combination packs for h. pylori ulcers
omeclamox-pak, Pylera, prevpac.
hsitamine-2 receptor antagonists
treat gastric and duodenal ulcers. promote ulcer healing by suppressing secretion of
gastric acid.
monitor for gastric PH should increase to 5 or above.
use with caution in patients with renal or hepatic dysfunction.
inform patient to report lethargy, somnolence, restlessness, confusion, or
hallucinations.
cimetidine, ranitidine, famotidine, and nizatidine.
Cimetidine (Tagamet)
histamine H2 receptor antagonist.
mechanism of action: Blocks H2 receptors = reduces volume of gastric juice & its
hydrogen ion concentration. Suppresses basal acid secretion & secretion stimulated by
gastrin and acetylcholine. high doses in patients with Zollinger-ellison syndrome is
used to heal ulcers
