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NURS8024 Pharm Exam 1: Questions & Answers (100% Complete)
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NURS8024 Pharm Exam 1: Questions & Answers (100% Complete)
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NURS8024 Pharm Exam 1: Questions & Answers (100%Complete)
Which areas of the skin is drug penetration higher on? Right Ans - the face,
scalp, intertriginous areas, and perineum
- more susceptible to irritatation & allergic contact reactions
- Skin sites occluded by apposing surfaces (axillae, groin, and inframammary
areas) also vulnerable to drug-related toxicity--> May require less drug for
equivalent effect
what are the pediatric drug considerations for antidepressants? Right Ans -
Questionable increased suicidality in adolescents, FDA added a black box
warning; fluoxetine, sertraline and fluvoxamine are approved in the U.S.
What three things stimulate Gastric acid secretion by parietal cells in the
gastric mucosa? Right Ans - 1. acetycholine
2. histamine
3. gastrin
What does receptor-mediated binding of acetylcholine, histamine, or gastrin
results in Right Ans - *the activation of protein kinases, which in
turn stimulates the H+/K+-adenosine triphosphatase (ATPase) proton pump
What do gastrin and Ach stimulate the release of? Right Ans - Histamine
what does receptor binding of prostaglandin E2 and
somatostatin diminish? Right Ans - gastric acid production
weak bases that react with gastric acid to
form water and a salt → diminishing gastric acidity
Reduce pepsin activity - pepsin inactive at a pH >4
Wide variety* in chemical composition, acid-neutralizing capacity, sodium
content, palatability, and price Right Ans - Antacids
,what does the acid neutralizing ability of an antacid depend on? Right Ans -
its capacity to neutralize gastric HCl and on whether the stomach is full or
empty
• food delays stomach emptying, allowing more time for the antacid to react
• Symptomatic relief of peptic ulcer disease (PUD) and gastroesophageal
reflux (GERD)
• May promote healing of duodenal ulcers, but not
robust evidence for efficacy in Tx of acute gastric
ulcers
• Calcium carbonate preparations
• also used as calcium supplements for the treatment of osteoporosis Right
Ans - Therapeutic uses of antacids
Classes
• Calcium salts: calcium carbonate: Tums/Rolaids
• Sodium bicarbonate: Alka-Seltzer
• Aluminum salts - Aluminum hydroxide: Amphojel; Aluminum carbonate:
Basaljel
• Magnesium salts/ magnesium oxide: Milk of Magnesia
• Combination products
• Aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta)
• Alginic acid, magnesium trisilicate, calcium stearate
(Gaviscon)
-these all have short duration Right Ans - Commonly used antacid drugs
• Aluminum hydroxide tends to be constipating
• Magnesium hydroxide tends to cause diarrhea
• Binding of phosphate by aluminum-containing antacids →
hypophosphatemia
• Sodium bicarbonate → belching and flatulence, potential for systemic
alkalosis
• Sodium content of antacids → can be important in pts w/ HTN or CHF
• Excessive intake of calcium carbonate along w/ calcium foods →
hypercalcemia Right Ans - Adverse effects of antacids
Cytoprotective compounds
Sucralfate
Bismuth Compounds Right Ans - Mucosal Protective Agents
,enhance mucosal protection
mechanisms → preventing mucosal injury, ↓ inflammation, promotes healing
of existing ulcers Right Ans - Cytoprotective Compounds
complex of aluminum hydroxide and sulfated sucrose
• Small, poorly soluble molecule
• Polymerizes in stomach acid → binds to injured tissue, forms physical
barrier coating over ulcer bed- impairs diffusion of HCl and prevents
degradation of mucus by pepsin and acid
• Accelerates healing of peptic ulcers and ↓ recurrence rate
• Stimulates prostaglandin release, mucus and bicarbonate output Right
Ans - Sucralfate
What are the drawback to using sucralfate to treat a GI ulcer? Right Ans - -
must be taken TID
-should not be administered with H2 antagonists or antacids cuz it requires an
acidic pH for activation
-does not prevent NSAID induced ulcers (use PPI)
-Can interfere with absorption of other drugs by binding to them so should
take at least 1 hour before meals and separate from other medications
• Coats ulcers → protective layer against acid and pepsin
• May stimulate prostaglandin, mucus, and bicarbonate secretion
• Antimicrobial effect- binds enterotoxins
• reduces stool frequency & liquidity in acute infectious diarrhea
• Causes black stools- harmless
• Avoid in renal insufficiency Right Ans - Bismuth compounds (Pepto-
Bismol)
Safety not established in children Right Ans - Antacids in Pediatrics : Safety
not established in Children
When should you avoid using antacids in geriatric patients? Right Ans - -
antacids that contain magnesium in patients with renal failure
- sodium-containing antacids because of fluid
retention
No FDA category established, although ____________
, generally are considered safe for use in pregnancy Right Ans - Antacids
during pregnancy and lactation
Histamine-2 receptor antagonists
Proton pump inhibitors Right Ans - Antisecretory agents
ranitidine, *cimetidine, famotidine, nizatidine Right Ans - Examples of
Histamine-2 receptor antagonists
• omeprazole, esomeprazole
• Lansoprazole, pantoprazole
• rabeprazole Right Ans - Examples of Proton pump inhibitors
• MOA
• Acts selectively on H2 receptors in the stomach, blood vessels, and other
sites (no effect on H1 receptors)
• Competitively blocks binding of histamine to H2 receptors
• less effective than PPIs against stimulated secretion
• Four drugs: cimetidine*. ranitidine, famotidine, and nizatidine
• Can inhibit > 90% basal, food-stimulated and nocturnal secretion of gastric
acid after a single dose
• Main clinical use is to inhibit gastric acid secretion
• particularly effective against nocturnal acid secretion Right Ans - H2
Receptor antagonists
• H2 antagonists very safe
• ADE < 3% of patients - diarrhea, h/a, fatigue, myalgias, constipation
• Drugs such as ketoconazole, which depend on an acidic medium for gastric
absorption, may not be efficiently absorbed if taken w/ H2 blocker
• Not used for NSAID-induced ulcers
• Better healing and prevention with PPIs Right Ans - H2 Receptor
antagonist adverse drug effects (ADEs)
• Inhibits cytochrome P450 and can slow metabolism -potentiating the action
of other drugs
• warfarin, diazepam, phenytoin, quinidine,
carbamazepine, theophylline, and imipramine
• Cimetidine can have endocrine effects, acts as a
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