HSC 343 FINAL EXAM QUESTIONS WITH
100% CORRECT ANSWERS
How do you treat ulcers?
Ulcers are usually colonized by H pylori which delay the healing process. Strategies for PUD
combine an H2 antagonist or PPI+ an antacid + an antibiotic
Most H2 blockers have best efficacy if given 30-60 min before meal
Watch coadministration of other drugs with antacids!
You are also treating them for acid in the belly
Treatment of ulcers are combination it always involve an antibiotics, antacids, and something to
decrease acid secretions
How do you treat GERD?
Main treatment goal: neutralization of stomach acid
Oxyntic glands in stomach secrete acid (parietal cells)
To get maximum acid secretion, these cells need to be stimulated by gastrin + ACh + histamine
If any one of these 3 is ↓, acid secretion will be markedly ↓
Cimetidine
HISTAMINE RECEPTOR PUD/GERD
Inhibits P450 enzymes. Well tolerated, but watch for rental/hepatic tox in older patients.
Ranitidine
HISTAMINE RECEPTOR PUD/GERD
Less P450 inhibition
,Omeprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Esomeprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Lansoprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Calcium
ANTACIDS
Constipation, hypercalcemia
Magnesium
ANTACIDS
Diarrhea
Misoprostol
PG derivative. Protects stomach by ↑ HCO3 + mucus secretion. Do NOT use in pregnancy!
Sucralfate
Forms protective coat over ulcer, causes constipation
What is the combination pack for Ulcer Treatment?
1. Helidac
2. Pylera
3.Prevpac
Which antacids cause constipation?
, Aluminum Salts
Ca Carbonate
Which antacids cause diarrhea?
Mg Salts
What antacids cause a happy medium?
Na citrate
Why is it important to diagnosis diarrhea?
Cause of diarrhea should be identified if protracted (lasting for a long time)
Fluids and electrolytes may be sufficient
If infection is present, an antidiarrheal may NOT be indicated
Watch for dehydration in extremes of age (old people and babies)
Employees must wash their hands
Loperamide
OPIOID FOR DIARRHEA
Do NOT use w/MAOIs
Bismuth Subsalicylate
ABSORBENT FOR DIARRHEA
Adsorbs toxins, irritants, Good for travelers' diarrhea
Should NOT be used in children w/ diarrhea secondary to unknown cause (Reyes) or in aspirin
sensitivity
Kaolin/Pectin
ABSORBENT FOR DIARRHEA
Do NOT use in children < 3
Cholestyramine
100% CORRECT ANSWERS
How do you treat ulcers?
Ulcers are usually colonized by H pylori which delay the healing process. Strategies for PUD
combine an H2 antagonist or PPI+ an antacid + an antibiotic
Most H2 blockers have best efficacy if given 30-60 min before meal
Watch coadministration of other drugs with antacids!
You are also treating them for acid in the belly
Treatment of ulcers are combination it always involve an antibiotics, antacids, and something to
decrease acid secretions
How do you treat GERD?
Main treatment goal: neutralization of stomach acid
Oxyntic glands in stomach secrete acid (parietal cells)
To get maximum acid secretion, these cells need to be stimulated by gastrin + ACh + histamine
If any one of these 3 is ↓, acid secretion will be markedly ↓
Cimetidine
HISTAMINE RECEPTOR PUD/GERD
Inhibits P450 enzymes. Well tolerated, but watch for rental/hepatic tox in older patients.
Ranitidine
HISTAMINE RECEPTOR PUD/GERD
Less P450 inhibition
,Omeprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Esomeprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Lansoprazole
PPI
Inhibits H+ secretion by blocking H+/K+ ATPase. Also inhibits P450.
Calcium
ANTACIDS
Constipation, hypercalcemia
Magnesium
ANTACIDS
Diarrhea
Misoprostol
PG derivative. Protects stomach by ↑ HCO3 + mucus secretion. Do NOT use in pregnancy!
Sucralfate
Forms protective coat over ulcer, causes constipation
What is the combination pack for Ulcer Treatment?
1. Helidac
2. Pylera
3.Prevpac
Which antacids cause constipation?
, Aluminum Salts
Ca Carbonate
Which antacids cause diarrhea?
Mg Salts
What antacids cause a happy medium?
Na citrate
Why is it important to diagnosis diarrhea?
Cause of diarrhea should be identified if protracted (lasting for a long time)
Fluids and electrolytes may be sufficient
If infection is present, an antidiarrheal may NOT be indicated
Watch for dehydration in extremes of age (old people and babies)
Employees must wash their hands
Loperamide
OPIOID FOR DIARRHEA
Do NOT use w/MAOIs
Bismuth Subsalicylate
ABSORBENT FOR DIARRHEA
Adsorbs toxins, irritants, Good for travelers' diarrhea
Should NOT be used in children w/ diarrhea secondary to unknown cause (Reyes) or in aspirin
sensitivity
Kaolin/Pectin
ABSORBENT FOR DIARRHEA
Do NOT use in children < 3
Cholestyramine
