NURS8024 Pharm Exam 1 questions with answers

NURS8024 Pharm Exam 1 questions with |\ |\ |\ |\ |\ |\




answers


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


Receptor-mediated binding of acetylcholine, histamine, or gastrin |\ |\ |\ |\ |\ |\


results in - CORRECT ANSWERS ✔✔*the activation of protein
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kinases, which in |\ |\




turn stimulates the H+/K+-adenosine triphosphatase (ATPase)
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proton pump |\




Gastrin and acetylcholine stimulate release of - CORRECT
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ANSWERS ✔✔histamine |\




receptor binding of prostaglandin E2 and
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somatostatin diminish - CORRECT ANSWERS ✔✔gastric acid|\ |\ |\ |\ |\ |\ |\


production


Antacids - CORRECT ANSWERS ✔✔weak bases that react with
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gastric acid to |\ |\




form water and a salt → diminishing gastric acidity
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Reduce pepsin activity - pepsin inactive at a pH >4
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,Wide variety* in chemical composition, acid-neutralizing capacity,
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sodium content, palatability, and price
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Acid neutralizing ability* of an antacid depends on its capacity to
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neutralize gastric HCl and on whether the stomach is full or
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empty
• food delays stomach emptying, allowing more time for the
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antacid to react |\ |\




Therapeutic uses of antacids - CORRECT ANSWERS ✔✔• |\ |\ |\ |\ |\ |\ |\ |\


Symptomatic relief of peptic ulcer disease (PUD) and |\ |\ |\ |\ |\ |\ |\ |\


gastroesophageal reflux (GERD) |\ |\




• May promote healing of duodenal ulcers, but not
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robust evidence for efficacy in Tx of acute gastric
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ulcers
• Calcium carbonate preparations
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• also used as calcium supplements for the treatment of
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osteoporosis


Commonly used antacid drugs - CORRECT ANSWERS ✔✔Classes
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• Calcium salts: calcium carbonate: Tums/Rolaids
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• Sodium bicarbonate: Alka-Seltzer
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• Aluminum salts - Aluminum hydroxide: Amphojel; Aluminum
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carbonate: Basaljel |\




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


Adverse effects of antacids - CORRECT ANSWERS ✔✔• Aluminum
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hydroxide tends to be constipating
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• Magnesium hydroxide tends to cause diarrhea
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• Binding of phosphate by aluminum-containing antacids →
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hypophosphatemia
• Sodium bicarbonate → belching and flatulence, potential for
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systemic alkalosis |\




• Sodium content of antacids → can be important in pts w/ HTN
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or CHF |\




• Excessive intake of calcium carbonate along w/ calcium foods →
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hypercalcemia
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Mucosal Protective Agents - CORRECT ANSWERS
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✔✔Cytoprotective compounds |\




Sucralfate
Bismuth Compounds
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Cytoprotective Compounds - CORRECT ANSWERS ✔✔enhance |\ |\ |\ |\ |\ |\


mucosal protection
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mechanisms → preventing mucosal injury, ↓ inflammation,
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promotes healing of existing ulcers
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, Sucralfate - CORRECT ANSWERS ✔✔complex of aluminum
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hydroxide and sulfated sucrose |\ |\ |\




• Small, poorly soluble molecule
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• Polymerizes in stomach acid → binds to injured tissue, forms
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physical barrier coating over ulcer bed- impairs diffusion of HCl
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and prevents degradation of mucus by pepsin and acid
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• Accelerates healing of peptic ulcers and ↓ recurrence rate
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• Stimulates prostaglandin release, mucus and bicarbonate
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output
• *BIG drawback.... Must be taken qid• used in long-term
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maintenance therapy to prevent recurrence |\ |\ |\ |\




• Requires an acidic pH for activation -should not be
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administered with H2 antagonists or antacids |\ |\ |\ |\ |\




• Little of the drug is absorbed systemically, very well tolerated
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• Can interfere w/ absorption of other drugs by binding to them
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• Does not prevent NSAID-induced ulcers
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Bismuth Compounds - CORRECT ANSWERS ✔✔• Coats ulcers →
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protective layer against acid and pepsin |\ |\ |\ |\ |\




• May stimulate prostaglandin, mucus, and bicarbonate secretion
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• Antimicrobial effect- binds enterotoxins
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• reduces stool frequency & liquidity in acute infectious diarrhea
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• Causes black stools- harmless
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• Avoid in renal insufficiency
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In geriatric patients avoid use of - CORRECT ANSWERS ✔✔-
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antacids that contain magnesium in patients with renal failure
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