Deck 20: Drugs Affecting the Gastrointestinal System

Question 1

Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:

A) Omeprazole (Prilosec) twice a day
B) Ranitidine (Zantac) twice a day
C) Famotidine (Pepcid) once a day
D) Metoclopramide (Reglan) four times a day

Answer 1

Ranitidine (Zantac) twice a day

Question 2

Methylnaltrexone is used to treat constipation in:

A) Patients with functional constipation
B) Patients with irritable bowel syndrome-associated constipation
C) Children with encopresis
D) Opioid-associated constipation

Answer 2

Opioid-associated constipation

Question 3

An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:

A) Electrolytes, including potassium and chloride
B) Bone mineral density for osteoporosis
C) Magnesium level
D) Liver function

Answer 3

Electrolytes, including potassium and chloride

Question 4

Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last recorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?

A) Prochlorperazine (Compazine)
B) Meclizine (Antivert)
C) Promethazine (Phenergan)
D) Ondansetron (Zofran)

Question 5

Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:

A) May lead to toxicity if taken with aspirin
B) Is contraindicated in children with flu-like illness
C) Has antimicrobial effects against bacterial and viral enteropathogens
D) All of the above

Question 6

Patients taking antacids should be educated regarding these drugs, including letting them know that:

A) They may cause constipation or diarrhea
B) Many are high in sodium
C) They should separate antacids from other medications by 1 hour
D) All of the above

Question 7

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?

A) Patients with kidney stones
B) Pregnant patients
C) Patients with heartburn
D) Postmenopausal women

Question 8

Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:

A) Megaloblastic anemia
B) Osteoporosis
C) Hypertension
D) Strokes

Question 9

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:

A) Iron deficiency anemia, vitamin B₁₂ and calcium deficiency
B) Folate and magnesium deficiency
C) Elevated uric acid levels leading to gout
D) Hypokalemia and hypocalcemia

Question 10

Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:

A) Loperamide four times a day throughout the trip
B) Bismuth subsalicylate with each meal and at bedtime
C) A prescription for diphenoxylate with atropine to use if she gets diarrhea
D) None of the above

Question 11

Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

A) PEG 3350 (Miralax)
B) Bisacodyl (Dulcolax) suppository
C) Docusate (Colace) suppository
D) Polyethylene glycol electrolyte solution

Question 12

Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:

A) Can be given to patients of all ages, including infants and children, for viral gastroenteritis
B) Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
C) Is the treatment of choice for the diarrhea associated with E. coli 0157
D) May be used in pregnancy and by lactating women