MARYVILLE PHARM EXAM 4 WITH
100% CORRECT ANSWERS 2026
Adverse effects of chronic long-term use of PPI? correct
answers >> osteoporosis
What is the most common cause of PUD? correct answers >>
H. pylori followed by NSAIDS and ASA
How to initially treat PUD and H. pylori? correct answers >>
Triple Therapy; PPI BID, Amoxil 1 gm BID (metronidazole if
allergic), Clarithromycin 500 mg QD 7-14 days
If initial treatment fails what is the next line of therapy for H.
pylori? correct answers >> Quadruple therapy; PPI BID 8-12
weeks, metronidazole, tetracycline, bismuth subsalicylate x 14
days
How is H. pylori transmitted? correct answers >> fecal-oral
How is Carafate given and what does it do? correct answers
>> 30 before meals with no other meds; binds to lesion to
protect from stomach acid
1. What is the Step Down Approach with GERD? correct
answers >> (GOAL to step down to lower PPI dose or trans to
H2Ra) PPI QD x 8 wks, if not working then BID x 4-8 weeks; after 4
wks lower PPI; if no better in 8 weeks at BID then GI referral
, What is the Step Up Approach with GERD correct answers >>
(Use in pts with mild disease and sx) lifestyle modifications and
OTC antacids followed by H2RA blockers and PPI's
Once treatment for H. pylori is complete how is pt managed?
correct answers >> continue a long-term PPI
what is recommended for traveler's' diarrhea? correct answers
>> Bismuth salicylate (Pepto) with each meal and at bedtime as
it binds the exotoxins made by e. coli
What are the monitoring parameters for long-term PPI therapy?
correct answers >> Iron panel, B12, Calcium
If a patient has GERD and takes TUMS with no symptom relief,
how do you STEP-UP their therapy? correct answers >> (step
up) by starting H2Ra (blocker)
If a patient takes a PPI once daily, how do you STEP-UP their
therapy if they have no symptom relief? correct answers >>
PPI BID x 4-12 weeks
How does metoclopramide (Reglan) (prokinetic agent) improve
GERD symptoms? correct answers >> Increases the tone of
the lower esophageal sphincter (works on both serotonin &
dopamine receptors)
What are important counseling points when administering
antacids? correct answers >> MUST BE SEPARATED FROM
100% CORRECT ANSWERS 2026
Adverse effects of chronic long-term use of PPI? correct
answers >> osteoporosis
What is the most common cause of PUD? correct answers >>
H. pylori followed by NSAIDS and ASA
How to initially treat PUD and H. pylori? correct answers >>
Triple Therapy; PPI BID, Amoxil 1 gm BID (metronidazole if
allergic), Clarithromycin 500 mg QD 7-14 days
If initial treatment fails what is the next line of therapy for H.
pylori? correct answers >> Quadruple therapy; PPI BID 8-12
weeks, metronidazole, tetracycline, bismuth subsalicylate x 14
days
How is H. pylori transmitted? correct answers >> fecal-oral
How is Carafate given and what does it do? correct answers
>> 30 before meals with no other meds; binds to lesion to
protect from stomach acid
1. What is the Step Down Approach with GERD? correct
answers >> (GOAL to step down to lower PPI dose or trans to
H2Ra) PPI QD x 8 wks, if not working then BID x 4-8 weeks; after 4
wks lower PPI; if no better in 8 weeks at BID then GI referral
, What is the Step Up Approach with GERD correct answers >>
(Use in pts with mild disease and sx) lifestyle modifications and
OTC antacids followed by H2RA blockers and PPI's
Once treatment for H. pylori is complete how is pt managed?
correct answers >> continue a long-term PPI
what is recommended for traveler's' diarrhea? correct answers
>> Bismuth salicylate (Pepto) with each meal and at bedtime as
it binds the exotoxins made by e. coli
What are the monitoring parameters for long-term PPI therapy?
correct answers >> Iron panel, B12, Calcium
If a patient has GERD and takes TUMS with no symptom relief,
how do you STEP-UP their therapy? correct answers >> (step
up) by starting H2Ra (blocker)
If a patient takes a PPI once daily, how do you STEP-UP their
therapy if they have no symptom relief? correct answers >>
PPI BID x 4-12 weeks
How does metoclopramide (Reglan) (prokinetic agent) improve
GERD symptoms? correct answers >> Increases the tone of
the lower esophageal sphincter (works on both serotonin &
dopamine receptors)
What are important counseling points when administering
antacids? correct answers >> MUST BE SEPARATED FROM
