Pharm Chapter 15

Which of the following adverse reactions is common to all of the currently marketed H2-blocking agents?

Abnormal liver function tests

All of these medications are used for treatment of GERD except which of the following? A. Antacids B. Antibiotics C. Gastrointestinal stimulants D. Proton pump inhibitors (PPIs) E. Histamine2 (H2)-receptor blockers

Antibiotics

Phenothiazines, such as prochlorperazine (Compazine), have all except which of the following actions? A. Sedation B. Antiemetic C. Antihistaminic D. Antisialagogue E. Antidiarrheal

Antidiarrheal

All of the following drugs are used as laxatives except one. Which one is the exception? Bulk laxatives Lubricants Stimulants Stool softeners (emollients) Antiemetics Osmotic (saline) laxatives

Antiemetics

The first line of therapy for inflammatory bowel disease is the use of immunosuppressant drugs. Patients who smoke should be encouraged to quit as soon as possible. Both statements are true. Both statements are false. The first statement is true; the second statement is false. The first statement is false; the second statement is true.

B. Both statements are false

What is the mechanism of action of histamine2 (H2)-receptor blockers in the treatment of gastrointestinal diseases? A. hydrochloric acid in the stomach B. Increase gastric mucus and inhibit gastric acid secretion C. Combine with proteins on the surface of the ulcer site, forming a protective complex D. Block and inhibit basal and nocturnal gastric acid secretion by competitive inhibition at the site of the receptors of the parietal cells E. Inhibit the hydrogen/potassium adenosine triphosphatase enzyme system at the surface of the gastric parietal cell

Block and inhibit basal and nocturnal gastric acid secretion by competitive inhibition at the site of the receptors of teh parietal cells.

Sucralfate can be thought of as a "bandage" for ulcers because it inhibits the action of pepsin and absorbs the bile salts.

Both parts of the statement and the reason are correct, but not related.

Combining H2-blockers with antacids has a definite therapeutic advantage. In fact, antacids increase their absorption and should be administered within 1 hour of H2-blockers. Both statements are true. Both statements are false. The first statement is true; the second statement is false. The first statement is false; the second statement is true.

Both statements are false

Many indications for the use of laxatives exist. Therefore overuse is common and does not have any harmful adverse effects. Both statements are true. Both statements are false. The first statement is true; the second statement is false. The first statement is false; the second statement is true.

Both statements are false

Magnesium sulfate should be used with caution in patients with renal impairment because hypermagnesemia has been reported in patients with renal disease.

Both the statement and the reason are correct and related.

What are the primary etiologies of gastric ulcers? Stress Spicy foods The organism Helicobacter pylori Chronic use of the nonsteroidal antiinflammatory drugs (NSAIDs), especially in elderly adults All of the above c and d

C and D

Adverse drug effects on long-term use of proton pump inhibitors include all except which of the following?? A. Headache B. Diarrhea C. Acute gastritis D. Increased risk of osteoporotic fractures E. Increased risk of clostridium difficile-associated diarrhea

C. Acute gastritis

Which medication is indicated for relief of symptoms associated with diabetic gastroparesis (gastric stasis)? A. (Carafate) B. Misoprostol (Cytotec) C. Calcium carbonate D. Metoclopramide (Reglan)

D. Metoclopramide (Reglan)

The following are actions of metoclopramide except for one. Which one is the exception? a. Decreases peristalsis by acting directly on smooth muscle of the gastrointestinal tract b. Blocks the action of dopamine c. Accelerates gastric emptying time d. Increases the tone of the lower esophageal sphincter

Decreases peristalsis by acting directly on smooth muscle of the gastrointestinal tract

Which medication would be safer than cimetidine (Tagamet) for Mr. Jamison based on his other medications of warfarin, lisinopril, metoprolol, and diltiazem? A. Ranitidine (Zantac) B. Famotidine (Pepcid/Pepcid AC) C. Nizatidine (Axid/Axid AR) D. All of the above B and C only

E. B & C only

Which histamine-2 (H2)-blocking agent has been associated with dry mouth and taste alterations?

Famotidine

Which gastrointestinal disease is the most prevalent among the U.S. population? A. Crohn's disease B. Ulcerative colitis C. Barrett's esophagus D. Peptic ulcer disease E. Gastroesophageal reflux disease

Gastroesophageal reflux disease

All of the following are adverse drug effects of cimetidine (Tagamet) except one. Which one is the exception? Slurred speech Delusions and confusion Increased sperm count and increased sexual potency Headache Gynecomastia

Increased sperm count and increased sexual potency

Cimetidine interacts with other medications, resulting in a delay in elimination and an increase in serum levels of some drugs, possibly producing toxicity by the following mechanism: Inhibition of the first-pass effect Inhibition of glomerular filtration Inhibition of liver microsomal enzymes Inhibition of biliary excretion

Inhibition of liver microsomal enzymes

All are types of laxatives except which of the following? A. Stimulants B. Lubricants C. Bulk laxatives D. Isotonic laxatives E. Stool softeners F. Osmotic laxatives

Isotonic laxatives

While obtaining a patient's medication history, the dental hygienist learns that the client takes cimetidine (Tagamet) as prescribed to treat a peptic ulcer. The dental hygienist continues gathering medication history data to assess for potential drug interactions. What is the most likely scenario if lidocaine local anesthetic (LA) is administered? LA is ineffective in therapeutic doses. LA may cause systemic toxicity in therapeutic doses. LA may cause systemic toxicity in large doses. No change in efficacy of LA. Allergic reaction may occur.

LA may cause systemic toxicity in large doses

Which agent inhibits the H+/K+ ATPase found at the surface of the gastric parietal cell?

Lansoprazole

Many drugs have a potential to be abused. Certain gastrointestinal drugs such as emetics __________ and have been abused by patients with __________.

Laxatives, bulimia

Stimulation of motility of the upper gastrointestinal tract and increasing the tone of the lower esophageal sphincter is the required for relief of symptoms of diabetic gastroparesis and the usual drug indicated for this action is: Sucralfate (Carafate) Misoprostol (Cytotec) Metoclopramide (Reglan) Cimetidine (Tagamet) Simethicone (Mylicon, Gas-X)

Metoclopramide (reglan)

All of the following can be used as antacids except: Sodium bicarbonate Calcium carbonate Aluminum salts Mineral oil

Mineral oil

Use of which laxative is able to interfere with the absorption of the fat-soluble vitamins (A, D, E, and K)?

Mineral oil

Which of the following agents is the drug of choice for NSAID-induced ulcers?

Misoprostol

_ is indicated in the management of NSAID-induced ulcers, with the mechanism of action of increasing gastric mucus and inhibiting gastric acid secretion. Sucralfate (Carafate) Misoprostol (Cytotec) Metoclopramide (Reglan) Cimetidine (Tagamet) Simethicone (Mylicon, Gas-X)

Misoprostol (Cytotec)

All of the following drugs are H2-receptor blockers except one. Which one is the exception? Cimetidine (Tagamet) Famotidine (Pepcid) Ranitidine (Zantac) Omeprazole (Prilosec) Nizatidine (Axid)

Omeprazole (Prilosec)

Which suggestions could the dental hygienist make for the patient with peptic ulcer disease or gastroesophageal reflux disease? A. aspirin or NSAIDs to alleviate the discomfort of the disease. B. Allow the patient to determine the most comfortable position for dental treatment. C. Encourage the patient to maintain good oral hygiene and drink plenty of water. D. Use tart sugarless gum or candy to alleviate the symptoms of dry mouth. E. Patients with taste changes or loss of tooth enamel should be referred to their primary care physicians for further evaluation. All of the above apply. Only b, c, d, and e apply.

Only b, c, d, and e apply

Which of the following gastrointestinal drugs is used to treat nausea?

Prochlorperazine

Which two classes of drugs are used to reduce acid in gastroesophageal reflux disease? Proton pump inhibitors and H2-blockers Proton pump inhibitors and H1-blockers Antibiotics and antacids

Proton pump inhibitors and h2 blockers

Which drug regimen is currently being used to treat peptic ulcers? Proton pump inhibitors or H2-blocker and antibiotics Calcium channel blockers and antibiotics Antacids and proton pump inhibitors

Proton pump inhibitors or H-2 blockers and antibiotics

Proton pump inhibitors (PPIs) heal ulcers more rapidly than H2-receptor blockers or any other medication. Unfortunately, their usefulness is limited due to the rapid development of tolerance to the PPIs. Both statements are true. Both statements are false. The first statement is true; the second statement is false. The first statement is false; the second statement is true.

The first statement is true; the second statement is false

Ulcers and gastroesophageal reflux diseases are common gastrointestinal tract diseases. With the discovery of the etiology of ulcers, the incidence of ulcers in the population has increased A. Both statements are true B. Both statements are false C. The first statement is true; the second statement is false D. The first statement is false; the second statement is true

The first statement is true; the second statement is false

Which classes of drugs are considered to be antidiarrheal drugs? A. Opioids B. Adsorbents C. Anticholinergics D. Antihistamines a and c a and b All of the above

a and b

Advantages of proton pump inhibitors over H2-receptor blockers in the treatment of gastric ulcers include: More rapid healing Tolerance does not occur Lower cost All of the above a and b only

a and b only

Which lifestyle changes should be recommended for the patient with gastroesophageal reflux disease (GERD)? A. Eat small, frequent meals B. Avoid caffeine and alcohol C. three meals with no snacks D. Avoid eating for 4 hours before bedtime E. Raise the head of the bed with pillows or bricks a, b, d, and f b, c, d, and e

a, b, d, and f

Mr. Jamison is a 65-year-old patient who had a myocardial infarction a year ago. He is currently on warfarin, cimetidine, lisinopril, metoprolol, and diltiazem. He is scheduled for extractions of his remaining lower teeth to be fitted for an immediate denture. What are the possible implications on his dental treatment based on his medication history? A. Decreased bleeding response B. Increased bleeding response C. Decreased toxicity response to local anesthesia D. Increased toxicity response to local anesthesia a and c b and d

b and d

What action does smoking have on gastric acid secretion? Smoking decreases gastric acid secretion. Smoking increases gastric acid secretion. Smoking does not affect gastric acid secretion.

smoking increases gastric acid secretion