Deck 11: Drugs Used in the Treatment of Common Disorders of the Gastrointestinal System

Question 1

When prochlorperazine (Compazine)is administered rectally to relieve nausea and vomiting,what is the likely effect if it is used in too high of a dose or for the first time?

A)Dizziness and fainting
B)Skin rash
C)Blood dyscrasia
D)Increased heart rate

Answer 1

Dizziness and fainting

Question 2

What is the half-life of PPIs?

A)Less than an hour
B)Less than 2 hours
C)Less than 3 hours
D)Less than 4 hours

Answer 2

Less than 2 hours

Question 3

Which of the following chemical classes do antacids fall under?

A)Strong acids
B)Weak acids
C)Strong bases
D)Weak bases

Answer 3

Weak bases

Question 4

In patients with gastroesophogeal reflux disease (GERD),how long after eating does relaxation of the lower esophageal sphincter occur?

A)15 to 30 minutes
B)30 to 45 minutes
C)1 to 2 hours
D)2 to 3 hours

Question 5

When should PPIs be taken?

A)Before breakfast
B)After lunch
C)During dinner
D)Before sleeping

Question 6

How much more potent is ranitidine (Zantac)compared to cimetidine (Tagamet)?

A)1 to 7 times
B)5 to 12 times
C)7 to 14 times
D)8 to 16 times

Question 7

Which of the following does not help reduce diarrhea?

A)Milk
B)Rice
C)Toast
D)Applesauce

Question 8

At least how many milliequivalents must antacids neutralize per dose?

A)1 mEq
B)3 mEq
C)5 mEq
D)10 mEq

Question 9

Loperamide (Imodium)inhibits peristalsis by a direct effect on the circular and longitudinal muscles of the intestinal wall.It also reduces fecal volume,increases viscosity and bulk,and diminishes the loss of fluid and electrolytes.However,its great advantage as an antidiarrheal over the old use of opiates is that it:

A)Is cheap to produce.
B)Has no side effects attributed to taking opiates,such as euphoria and addiction.
C)Makes people forget the discomfort of diarrhea.
D)Is effective in very small,one-time doses.

Question 10

The popular OTC preparations sold as Tums and Rolaids contain which of the following ingredients?

A)Cimetadine
B)Calcium carbonate
C)Magnesium sulfate
D)Magaldrate

Question 11

How much more potent is famotidine (Pepcid)compared to cimetidine (Tagamet)in controlling gastric acid secretion?

A)10 to 30 times
B)20 to 40 times
C)30 to 60 times
D)40 to 70 times

Question 12

For how long do antacids reduce acidity if they are ingested 1 hour after meals?

A)1 hour
B)2 hours
C)3 hours
D)4 hours

Question 13

Which of the following is not a main class of drugs used in the treatment of diarrhea?

A)Absorbent preparations
B)Opiates
C)Antiemetics
D)Anticholinergics

Question 14

Agents having anticholinergic properties are those that can be expected to:

A)Increase gastric acid production.
B)Decrease gastric acid production.
C)Increase emesis.
D)Decrease inflammation.

Question 15

How many treatment steps are there in the step-up approach to managing GERD?

A)Four
B)Three
C)Two
D)One

Question 16

By how much do PPIs reduce gastric acid?

A)70%
B)80%
C)90%
D)More than 90%

Question 17

Which of the following substances decreases the absorption of histamine-2 blockers,such as cimetidine,and causes increased gastric secretions because of the decreased absorption?

A)Grapefruit juice
B)Smoking
C)Bananas
D)White bread

Question 18

Which of the following is NOT a class of drugs used in the treatment of GERD?

A)Opiates
B)H2 blockers
C)Cytoprotective agents
D)Antacids

Question 19

How quickly can phenothiazines be absorbed?

A)10 to 20 minutes
B)22 to 30 minutes
C)34 to 40 minutes
D)45 to 50 minutes

Question 20

What is the half-life of histamine-2 receptor antagonists?

A)1 to 2 hours
B)2 to 3 hours
C)3 to 4 hours
D)4 to 5 hours

Question 21

If a patient asks how does the 5-HT receptor antagonist ondansetron (Zofran)act on the body to stop the nausea of cancer chemotherapy,you can simply state that it is an agent that is able to:

A)Return the acidity in your stomach back to normal limits.
B)Block central nervous system trigger zones so that nausea cannot be induced.
C)Act somewhat as an antihistamine might act.
D)Slow the natural wave motion of the stomach and intestine to make it less sensitive.

Question 22

Histamine-2 antagonists,such as ranitidine (Zantac)and famotidine (Pepcid),are still used to treat duodenal and gastric ulcers and lately have been used to treat heartburn as OTC products.When used OTC,the clinician should recommend that adults,elderly,and children older than 12 years:

A)Take doses 15 minutes to an hour before eating but no more than two doses per day.
B)Take a dose when heartburn is a problem and do so every 4 hours.
C)Only take the medicine at night when they are lying down.
D)Take the medicine first thing in the morning because it will last all day.

Question 23

A patient complains to you that she has a rash that started just after she took a PPI medication.Is this possible?

A)Yes
B)No
C)Possibly if she is a heavy coffee drinker
D)Possibly if she is a heavy smoker

Question 24

Besides recommending drugs for the treatment of GERD,what lifestyle modifications can you suggest as part of a treatment plan?

A)Drink more water
B)Drink a lot of coffee
C)Eat more chocolate
D)Stay away from bananas

Question 25

The class of drugs known as 5-ASA initiates activity in the GI tract by:

A)Being acted upon by a stomach acid creating an acidic pH environment.
B)Being acted upon by bacteria in the colon.
C)Being acted upon by gastric enzymes.
D)Being absorbed passively into the bloodstream.

Question 26

Which of the following should not be administered for more than 6 weeks because it is an agent of high risk for inducing serious extrapyramidal symptoms?

A)misoprostol (Cytotec)
B)sucralfate (Carafate)
C)metoclopramide (Reglan)
D)mesalamine (Asacol)

Question 27

Propylene glycol is the ingredient in a preparation called Miralax,which is used to clean the bowel prior to surgery or for a rectal examination.Patients using this drug are advised to:

A)Drink a cupful full strength and wait an hour and it will take effect.
B)Drink a cupful every 10 minutes,up to 4 liters,or until stool is dislodged and discharge is clear and free of solids.Do this the night before surgery.
C)Place a tablespoonful in a large glass of water,stir vigorously,then drink it all at once and wait an half an hour for effect.
D)Warm the liquid before drinking it.

Question 28

Patients commonly take PPIs for long periods and way beyond recommend use for treating a peptic ulcer.The U.S.Food and Drug Administration (FDA)has determined that people who take them continuously for as long as a year are subject to:

A)Cancer of liver and bladder.
B)Hair loss.
C)Increased fractures of wrist,hip,and spine.
D)Damage to liver and spleen.

Question 29

Which of the following agents is listed in category X by the FDA for its history of causing birth defects among pregnant women?

A)famotadine (Pepcid)
B)sucalfrate (Carafate)
C)orlistat (Zenical)
D)mesalamine (Asacol)

Question 30

Which of the following agents would you suggest to help someone with a mild case of constipation?

A)prochlorperazine (Compazine)
B)meclizine (Antiver,Bonine)
C)scopolamine (Scopace)
D)docusate (Colace)

Question 31

You have recommended a phenothiazine agent for a child with nausea.How long would you tell the mother it should be before her child can expect relief after she administers the first oral dose?

A)20 minutes
B)30 to 40 minutes
C)60 to 75 minutes
D)2 hours

Question 32

Which of the following would you recommend to treat the nausea and vomiting induced as a side effect of a prescription drug?

A)sulfasalazine (Azulfadine)
B)prochlorperazine (Compazine)
C)scopalamine (Scopace)
D)meclazine (Bonine)

Question 33

How much more likely are women to develop irritable bowel syndrome (IBS)than men?

A)Two to three times more
B)Four to six times more
C)Eight to ten times more
D)Fifteen to twenty times more

Question 34

Although they have been popular for centuries,patients taking plant-based laxatives,such as senna and cascara sagrada,should be advised that:

A)Color of the feces will turn bright red.
B)Color of the urine will turn red-brown if used extensively.
C)Theses agents can induce a rash on the face.
D)These agents can interfere with oral diabetes drugs.

Question 35

There are six oral aminosalicylate preparations available in the United States: sulfasalazine (Azulfidine),mesalamine (Asacol,Lialda,Pentasa),balsalazide (Colazal),and olslazine (Dipentum).What distinguishes these drugs from each other is:

A)Cost to the patient.
B)Mechanism of delivery.
C)Half-life.
D)Side effect profile.

Question 36

A patient comes to see you and you diagnose him with a peptic ulcer.You would like to prescribe short-term (one month)therapy with esomeprazole (Nexium)to give the ulcer the required time to heal.You also notice that this patient has a heart condition for which he is taking digoxin (Lanoxin).Is it okay to continue with this therapy?

A)No
B)Yes
C)Yes,but only if you lower the dose of digoxin
D)Yes,but only if you raise the dose of esomeprazole

Question 37

What distinguishes dyspepsia from GERD?

A)GERD can be diagnosed on the basis of symptoms alone.
B)Dyspepsia only occurs infrequently.
C)Dyspepsia does not involve epigastric pain.
D)Patients with GERD will likely regurgitate every other month or so.

Question 38

What is the half-life of cytoprotective agents such as misoprostol (Cytotec)?

A)5 to 15 minutes
B)20 to 40 minutes
C)60 to 120 minutes
D)4 to 6 hours

Question 39

The agent lubiprostone (Amitiza)effectively softens and loosen a stool and thus is able to relieve idiopathic constipation.However,clinicians should alert patients to the side effect of:

A)Rash.
B)Nausea.
C)Rebound constipation.
D)Gallstones.Chapter 11.Drugs Used in the Treatment of Common Disorders of the Gastrointestinal System

Question 40

A patient complains of an acid stomach one hour after eating a large pepperoni pizza.You give the patient an over-the-counter (OTC)agent containing calcium carbonate.The patient asks,"How long will the reduced acidity last with this OTC product?" Identify the most appropriate response.

A)About an hour
B)About 3 hours
C)All day
D)Until tomorrow