Med Chem 2

  1. What are some direct irritants to the GI tract?
    • Potassium supps
    • bisphosphonates
    • NSAIDs
  2. What are some drugs that lower esophageal sphincter tone and cause GERD?
    • calcium channel blockers
    • theophylline
    • anti-cholinergics
    • codeine
    • narcotics
    • beta agonists
    • estrogen 
    • progesterone
  3. What type of bacteria is H. pylori?
    gram (-) rod
  4. What is the hallmark test to see if you have an H. pylori infection?
    • Urea test
    • labeled carbon 13 or 14 
  5. Explain the urea test.
    • H. pylori produces a urease enzyme that cleaves urea into CO2 and ammonia
    • the ammonia allows the bacteria to penetrate the protective mucous layer
    • patients eats carbon 13/14 radioactive labeled urea
    • plasma or breath is indication of (+) infection
  6. What is the ultimate mediator of acid secretion?
    H+ K+ ATPase proton pump
  7. Which H2RA increases transaminases (liver enzymes)?
    Nizatidine (Axid)
  8. What is the S enantiomer of omeprazole?
    esomeprazole (Nexium)
  9. Both men and women should take what in addition to a PPI?
    calcium supplements
  10. What is bad about PPIs?
    • decrease bone resorption of calcium by inhibiting the osteoclastic vacuolar H+K+ATPase
    • they make osteoporosis worse because they decrease stomach acid and you need stomach acid to absorb calcium salts: HYPOCHLORHYDRIA
  11. What is the role of prostaglandins?
    increase mucous and bicarbonate
  12. What property of PPIs makes them have a longer duration of action (up to 3 days)?
    highly protein bound 95-98%
  13. What are the two most common side effects of a PPI?
    • headache 
    • diarrhea
  14. Protonix
  15. Aciphex
  16. Prevacid
  17. Dexilant
  18. Nexium
  19. What would you give to an asian friend who needed a PPI?
    Nexium or Prilosec?
  20. Which H2RA has the most drug interactions and should not be recommended?
    Tagamet (cimetidine)
  21. Pepcid
  22. Ranitidine
  23. Duexis
  24. H2RA MOA
    reversible competitive antagonists at H2 receptors in gastric parietal cells
  25. What is the only PPI that is not indicated for treating a duodenal ulcer?
  26. Which drugs are primarily used to decrease motility by decreasing smooth muscle tone in the GI, biliary and urinary tracts providing anti-secretory effects?
    anticholinergics and antispasmodics (antimuscarinic)
  27. antispasmodics/anticholinergics/antimuscarinic MOA?
    inhibits the action of acetylcholine at the postganglionic parasympathetic neuroeffector sites
  28. What will a normal dose of an anticholinergics and a large dose do?
    • normal: muscarinic receptor antagonists
    • high: blocks nicotinic sites
  29. Name the belladonna alkaloids.
    • L-Hyoscyamine
    • Atropine sulfate
    • scopolamine hydrobromide
  30. Name the quaternary anticholinergics.
    • methscopolamine bromide
    • clininium bromide 
    • mepenzolate
    • glycopyrrolate
    • methantheline
    • propantheline
    • tridihexyl Cl
  31. antispasmodic used to treat functional bowel/IBS?
    Dicyclomine HCl (Bentyl)
  32. MOA saline laxatives?
    • osmosis caused by the salt anions and cations draws water into the gut lumen resulting in increased intraluminal pressure 
    • leads to increased peristalsis
Card Set
Med Chem 2
Quiz 1