UTA 5334 ADVANCED PHARMACOLOGY
EXAM 1 | LATEST 2025 QUESTIONS AND
VERIFIED ANSWERS
◉ Most cases of PUD are caused by Answer: Helicobacter pylori and
eradication of this bacterium not only promotes healing but also
greatly reduces the chance of recurrence.
develop when there is an imbalance between mucosal defensive
factors and aggressive factors.
The major defensive factors are mucus and bicarbonate. The major
aggressive factors are H. pylori, nonsteroidal antiinflammatory
drugs.
◉ Mucus Defense factor Answer: is secreted continuously by cells of
the GI mucosa, forming a barrier that protects underlying cells from
attack by acid and pepsin
,◉ Bicarbonate defense factor Answer: is secreted by epithelial cells
of the stomach and duodenum. It serves to neutralize any hydrogen
ions that penetrate the mucus.
produced by the pancreas is secreted into the lumen of the
duodenum, where it neutralizes acid delivered from the stomach
◉ Adequate blood flow (GI) Answer: to cells of the GI mucosa is
essential for maintaining mucosal integrity.
◉ Prostaglandins Defense mechanism Answer: stimulate secretion
of mucus and bicarbonate, and they promote vasodilation, which
helps maintain submucosal blood flow.
They provide additional protection by suppressing secretion of
gastric acid.
◉ H. pylori Answer: is a gram-negative bacillus that can colonize the
stomach and duodenum. By residing in the space between epithelial
cells and the mucus barrier that protects these cells, the bacterium
manages to escape destruction by acid and pepsin.
can remain in the GI tract for decades.
◉ NSAIDs affect on GI Answer: are the underlying cause of many
gastric ulcers and some duodenal ulcers.
,inhibit the biosynthesis of prostaglandins. By doing so they can
decrease submucosal blood flow, suppress secretion of mucus and
bicarbonate, and promote secretion of gastric acid.
also irritate the gastric mucosa directly.
◉ Gastric acid affect on GI Answer: is an absolute requirement for
peptic ulcer generation: in the absence of acid, no ulcer will form.
causes ulcers directly by injuring cells of the GI mucosa and
indirectly by activating pepsin, a proteolytic enzyme.
hypersecretion by itself is insufficient to cause ulcers
◉ Zollinger-Ellison syndrome Answer: is the primary disorder in
which hypersecretion of acid alone causes ulcers. The syndrome is
caused by a tumor that secretes gastrin, a hormone that stimulates
gastric acid production. The amount of acid produced is so large that
it overwhelms mucosal defenses. Pepsin is a proteolytic enzyme
present in gastric juice. Like gastric acid, pepsin can injure
unprotected cells of the gastric and duodenal mucosa
◉ PUD goals of drug therapy Answer: (1) alleviate symptoms, (2)
promote healing, (3) prevent complications (hemorrhage,
perforation, and obstruction), and (4) prevent recurrence. Except for
antibiotics, the drugs employed do not alter the disease process.
they simply create conditions conducive to healing. Because
nonantibiotic therapies do not cure ulcers, the relapse rate after
, their discontinuation is high. the relapse rate after antibiotic therapy
is low.
◉ Drug classes used to treat PUD Answer: antibiotics, antisecretory
agents (PPIs and H2 receptor antagonists); mucosal protectants,
antisecretory agents that enhance mucosal defenses and antacids
◉ Drugs act in three basic ways to promote ulcer healing. Answer:
they can (1) eradicate H. pylori (antibiotics), (2) reduce gastric
acidity (antisecretory agents, misoprostol, and antacids), and (3)
enhance mucosal defenses (sucralfate and misoprostol).
◉ risk factors for ulcer development Answer: older than 60 years,
history of ulcers, high-dose NSAID therapy
◉ prophylactic PUD drug therapy Answer: PPIs (e.g., omeprazole)
are preferred. Misoprostol is also effective but can cause diarrhea.
Antacids, sucralfate, and H2 receptor blockers are not
recommended.
◉ NSAID-induced ulcers Answer: can be treated with any ulcer
medication. However, H2 receptor blockers and PPIs are preferred. If
possible, the offending NSAID should be discontinued to accelerate
healing. If the NSAID cannot be discontinued, a PPI is the best choice
to promote healing.
EXAM 1 | LATEST 2025 QUESTIONS AND
VERIFIED ANSWERS
◉ Most cases of PUD are caused by Answer: Helicobacter pylori and
eradication of this bacterium not only promotes healing but also
greatly reduces the chance of recurrence.
develop when there is an imbalance between mucosal defensive
factors and aggressive factors.
The major defensive factors are mucus and bicarbonate. The major
aggressive factors are H. pylori, nonsteroidal antiinflammatory
drugs.
◉ Mucus Defense factor Answer: is secreted continuously by cells of
the GI mucosa, forming a barrier that protects underlying cells from
attack by acid and pepsin
,◉ Bicarbonate defense factor Answer: is secreted by epithelial cells
of the stomach and duodenum. It serves to neutralize any hydrogen
ions that penetrate the mucus.
produced by the pancreas is secreted into the lumen of the
duodenum, where it neutralizes acid delivered from the stomach
◉ Adequate blood flow (GI) Answer: to cells of the GI mucosa is
essential for maintaining mucosal integrity.
◉ Prostaglandins Defense mechanism Answer: stimulate secretion
of mucus and bicarbonate, and they promote vasodilation, which
helps maintain submucosal blood flow.
They provide additional protection by suppressing secretion of
gastric acid.
◉ H. pylori Answer: is a gram-negative bacillus that can colonize the
stomach and duodenum. By residing in the space between epithelial
cells and the mucus barrier that protects these cells, the bacterium
manages to escape destruction by acid and pepsin.
can remain in the GI tract for decades.
◉ NSAIDs affect on GI Answer: are the underlying cause of many
gastric ulcers and some duodenal ulcers.
,inhibit the biosynthesis of prostaglandins. By doing so they can
decrease submucosal blood flow, suppress secretion of mucus and
bicarbonate, and promote secretion of gastric acid.
also irritate the gastric mucosa directly.
◉ Gastric acid affect on GI Answer: is an absolute requirement for
peptic ulcer generation: in the absence of acid, no ulcer will form.
causes ulcers directly by injuring cells of the GI mucosa and
indirectly by activating pepsin, a proteolytic enzyme.
hypersecretion by itself is insufficient to cause ulcers
◉ Zollinger-Ellison syndrome Answer: is the primary disorder in
which hypersecretion of acid alone causes ulcers. The syndrome is
caused by a tumor that secretes gastrin, a hormone that stimulates
gastric acid production. The amount of acid produced is so large that
it overwhelms mucosal defenses. Pepsin is a proteolytic enzyme
present in gastric juice. Like gastric acid, pepsin can injure
unprotected cells of the gastric and duodenal mucosa
◉ PUD goals of drug therapy Answer: (1) alleviate symptoms, (2)
promote healing, (3) prevent complications (hemorrhage,
perforation, and obstruction), and (4) prevent recurrence. Except for
antibiotics, the drugs employed do not alter the disease process.
they simply create conditions conducive to healing. Because
nonantibiotic therapies do not cure ulcers, the relapse rate after
, their discontinuation is high. the relapse rate after antibiotic therapy
is low.
◉ Drug classes used to treat PUD Answer: antibiotics, antisecretory
agents (PPIs and H2 receptor antagonists); mucosal protectants,
antisecretory agents that enhance mucosal defenses and antacids
◉ Drugs act in three basic ways to promote ulcer healing. Answer:
they can (1) eradicate H. pylori (antibiotics), (2) reduce gastric
acidity (antisecretory agents, misoprostol, and antacids), and (3)
enhance mucosal defenses (sucralfate and misoprostol).
◉ risk factors for ulcer development Answer: older than 60 years,
history of ulcers, high-dose NSAID therapy
◉ prophylactic PUD drug therapy Answer: PPIs (e.g., omeprazole)
are preferred. Misoprostol is also effective but can cause diarrhea.
Antacids, sucralfate, and H2 receptor blockers are not
recommended.
◉ NSAID-induced ulcers Answer: can be treated with any ulcer
medication. However, H2 receptor blockers and PPIs are preferred. If
possible, the offending NSAID should be discontinued to accelerate
healing. If the NSAID cannot be discontinued, a PPI is the best choice
to promote healing.
