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NURS8024 Pharm Exam 1- Questions and Answers
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NURS8024 Pharm Exam 1- Questions and AnswersCytoprotective Compounds Correct Ans-enhance mucosal protection
mechanisms → preventing mucosal injury, ↓ inflammation, promotes healing of existing
ulcers
Sucralfate Correct Ans-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
• *BIG drawback.... Must be taken qid• used in long-term maintenance therapy to prevent
recurrence
• Requires an acidic pH for activation -should not be administered with H2 antagonists or
antacids
• Little of the drug is absorbed systemically, very well tolerated
• Can interfere w/ absorption of other drugs by binding to them
• Does not prevent NSAID-induced ulcers
Bismuth Compounds Correct Ans-• Coats ulcers → protective layer against acid and pepsin
• May stimulate prostaglandin, mucus, and bicarbonate secretion
• Antimicrobial effect- binds enterotoxins
, NURS8024 Pharm Exam 1- Questions and Answers
• reduces stool frequency & liquidity in acute infectious diarrhea
• Causes black stools- harmless
• Avoid in renal insufficiency
In geriatric patients avoid use of Correct Ans-- antacids that contain magnesium in patients
with renal failure
- sodium-containing antacids because of fluid
retention
Antacids in Pediatrics Correct Ans-Safety not established in children
Antacids during pregnancy and lactation Correct Ans-No FDA category established,
although antacids
generally are considered safe for use in pregnancy
Antisecretory agents Correct Ans-Histamine-2 receptor antagonists
Proton pump inhibitors
Examples of Histamine-2 receptor antagonists Correct Ans-ranitidine, *cimetidine,
famotidine, nizatidine
Examples of Proton pump inhibitors Correct Ans-• omeprazole, esomeprazole
, NURS8024 Pharm Exam 1- Questions and Answers
• Lansoprazole, pantoprazole
• rabeprazole
H2 Receptor antagonists Correct Ans-• 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
H2 Receptor antagonist ADEs Correct Ans-• 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
, NURS8024 Pharm Exam 1- Questions and Answers
Cimetidine Correct Ans-• 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
nonsteroidal antiandrogen. (effects include gynecomastia, galactorrhea, and reduced sperm
count)
Gastric acid secretion by parietal cells of the gastric mucosa are stimulated by Correct Ans-
*acetycholine, histamine, gastrin
Receptor-mediated binding of acetylcholine, histamine, or gastrin results in Correct Ans-
*the activation of protein kinases, which in
turn stimulates the H+/K+-adenosine triphosphatase (ATPase) proton pump
Gastrin and acetylcholine stimulate release of Correct Ans-histamine
receptor binding of prostaglandin E2 and
somatostatin diminish Correct Ans-gastric acid production
Antacids Correct Ans-weak bases that react with gastric acid to
form water and a salt → diminishing gastric acidity
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