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PHARMACOLOGY EXAM 4 CH 32, 45, 46, 50 NUR138 ECPI QUESTIONS WITH CORRECT ANSWERS
PHARMACOLOGY EXAM 4 CH 32, 45, 46, 50 NUR138 ECPI QUESTIONS WITH CORRECT ANSWERS
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PHARMACOLOGY EXAM 4 CH 32, 45, 46,50 NUR138 ECPI QUESTIONS WITH
CORRECT ANSWERS
Gastric or duodenal ulcers that involve digestions of the GI mucosa by the enzyme
pepsin - Answer-peptic ulcer disease PUD
What are the types of acid-controlling drugs? - Answer-antacids
H2 antagonists
Proton pump inhibitors
Bacterium found in the GI tract of 90% of patients w/duodenal ulcers and 70% of
patients w/gastric ulcers: - Answer-helicobacter pylori (H.pylori)
What is the first line therapy for H.pylori? - Answer-treated with a proton pump inhibitor
PPI and antibiotics
GI lesions;
Decreased bloodflow;
Mucosal ischemia;
Hyperfusion;
Reperfusion injury
Can be caused by NG tube and/or ventilators - Answer-Stress-related mucosal damage
Many antacid medications also contain the antiflatuent drug ___. - Answer-simethicone
Many aluminum and calcium based antacid formulations also include ___ which
contributes to the acid neutralizing capacity and also counteracts the _____ effects of
aluminum and calcium. - Answer-magnesium; constipating
Basic compounds used to neutralize stomach acid;
Contain salts of aluminum, magnesium, calcium and/or sodium - Answer-antacids
Calcium antacids may lead to the development of _______ and increased gastric acid
secretions. - Answer-kidney stones
Patients with renal failure must avoid antacids containing what? - Answer-magnesium
Calcium
What is a highly soluble antacid form with a quick onset, but a short duration of action? -
Answer-sodium bicarbonate
What are the MOA for antacids? - Answer-neutralize acid secretions;
,Promote gastric mucosal defense mechanism;
Stimulate secretions of:
Mucus: protective barrier against HCI
Bicarbonate: buffer acidic properties of HCI
Prostaglandins: prevent activation of proton pump
What do antacids NOT do? - Answer-prevent the overproduction of acid
What are contraindications for antacid use? - Answer-known allergy;
Renal failure;
Electrolyte disturbances;
GI obstruction
Have a constipating effect;
Often recommended for patients w/renal failure (easily excreted) - Answer-aluminum
salts
Commonly causes diarrhea;
Contraindicated w/renal failure;
Milk of Magnesia - Answer-magnesium salts
H.pylori is believed to be the underlying cause behind most ulcers. (T or F) - Answer-
True
There is not any reason you cannot give a patient with heart failure sodium bicarbonate
antacids? (T or F) - Answer-False
What food/drink should be avoided if a patient is having trouble with stomach
acid/heartburn? - Answer-caffeine
Chocolate
Alcohol
Large fatty meals
What antacids are recommended if a patient has renal compromise because it is easily
excreted? - Answer-aluminum containing
Sodium containing
What might a patient experience if their ph <7.35? - Answer-excess hydrochloric acid
(HCI) secreted by parietal cells;
Heart burn
Ph has a normal range of? - Answer-7.35-7.45
What type of drug interaction takes place of the stomach acid ph is increased? -
Answer-increased absorption of basic drugs;
Decreased absorption of acidic drugs
, What type of drug interaction takes place if the stomach acid ph is decreased? -
Answer-decreased absorption of basic drugs;
Increased absorption of acidic drugs
What type of drug interaction occurs if the urinary ph is increased? - Answer-increased
excretion of acidic drugs;
Decreased excretion of basic drugs
What is the MOA for histamine2 receptor antagonists (H2 receptor blockers? - Answer-
block the H2 receptor of parietal cells;
Reduce hydrogen ion secretion from parietal cells;
Increase stomach ph
What has been shown to decrease the effectiveness of H2 receptor antagonists? -
Answer-smoking
What is Zollinger-Ellison syndrome? - Answer-rare condition characterized by gastrin-
producing tumors in the duodenum and/or pancreas that lead to over-secretion of
gastrin, which lead to gastric and duodenal ulcers
What is a common treatment for Zollinger-Ellison Syndrome, GERD, PUD, erosive
esophagitis, as an adjunct for GI bleeding ? - Answer-H2 receptor antagonists:
Cimetidine (Tagamet)
Nizatidine (Axid)
Famotidine (Pepcid)
Ranitidine (Zantac)
Cimetidine (Tagamet) can cause issues with drugs that have a narrow therapeutic
range such as: - Answer-theophylline;
Warfarin;
Lidocaine;
Phenytoin
What is the MOA for proton pump inhibitors (PPI)? - Answer-prevent movement of
hydrogen ions from parietal cells into stomach;
Temporarily blocking all acid secretion
***should be taken on an empty stomach***
What is used as a short term treatment of active duodenal and benign gastric ulcers;
Zollinger-Ellison syndrome, NSAID induced ulcers; prophylactic for stress ulcers? -
Answer-proton pump inhibitor PPI
Lansoprazole (prevacid)
Omeprazole (prilosec)
Rabeprazole (aciphex)
Pantaprazole (protonix)
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