NSG 533 Adv Pharm: Module 1: GI: Chp 17 | QUESTIONS AND ANSWERS
Which drug class is most effective in treating erosive PPIs
lesions:?
Name 4 H2RAs: Cimetidine (Tagamet)
Famotidine (Pepcid)
Ranitidine (Zantac)
Nizatidine (Axid)
What is the action of H2RAs? Decrease acid secretion by blocking histamine 2-receptors in gastric parietal cells
Name 4 benefits of H2RAs 1. Relieve GERD symptoms
2. Can be administered prophylactically
3.More effective at controlling chronic GERD symptoms than ANTACIDS
4. Intermittent & routine dosing possible based on degree of symptom
control needed.
Name 2 drawbacks of H2RAs 1. Less effective in controlling chronic GERD symptoms than PPIs
2. Renal elimination may require dose adjustment in kidney dysfunction patients
What are the side effects associated with H2RAs? H/A, nausea (Cimetidine), weak inhibitor, common drug interactions, gynecomastia,
& Vit B-12 deficiency which affects patients' tolerance
Name the benefits of Antacids 1. Useful for intermittent treatment of GERD symptoms
2. Immediate symptom relief
3.Usually well-tolerated
, What are the drawbacks of Antacids? 1. Requires frequent dosing
2. Aluminum or Magnesium containing antacids may result in
electrolyte imbalances esp. in pts. w/renal impairment
3.May interfere w/absorption of fluoroquinolones, tetracyclines, iron products,
& thyroid hormones
(doses should be several hours apart)
What are the side effects of Antacids? May cause
Constipation or Diarrhea depending on the formulation used
What is the Pharmacological Therapy Effectiveness of Antacids briefly neutralize gastric acid but lacks acid-suppressive properties & are
Antacids? inferior to H2RAs
What is the Pharmacological Therapy Effectiveness of Histamine-2 Receptor Antagonists decrease acid secretion to a lesser extent than
H2RAs? PPIs (& are therefore inferior to PPIs)
What is the Pharmacological Therapy Effectiveness of Proton Pump Inhibitors block the rate-limiting step in acid secretion from gastric
PPIs? parietal cells & block all pathways for gastric acid secretion & therefore are better
than H2RAs
What is the treatment goal of pharmacological therapy in Increase the pH of gastric content by; 1) Direct gastric acid neutralization 2)
GERD? Reduce acid production through inhibiting the stimulation of pathways to
decrease GERD symptoms and prevent tissue damage
Which Bariatric Surgery is effective in reducing GERD Roux-en-Y gastric bypass
symptoms in obese patients?
Which Bariatric Surgery is ineffective in reducing Vertical banded gastroplasty
GERD symptoms in obese patients?
Which is more beneficial in esophagitis symptom In a 7-year follow-up study, Antireflux surgery provided more symptom control in
control; Omeprazole or Antireflux surgery? esophagitis patients
Name 4 Factors indicating when Antireflux Surgery is an 1) S/Es are intolerable/undesired
appropriate option for patients w/well documented 2) Adherence is a challenge
GERD: 3)Large Hiatal Hernia is present
4) Refractory GERD symptoms
What is Antireflux Surgical Fundoplication? A surgical procedure which increases LES (lower esophageal sphincter) pressures
by wrapping the fundus (upper part) of the stomach around the distal end of the
esophagus
What are LES stimulators? (5/5) Antireflux tx. option & alternative to fundoplication surgery: LES stimulators are
surgically inserted to modulate LES pressures and reduce refluxate from the
stomach
What is LINX? (4/5) Antireflux tx. option & alternative to fundoplication surgery where bands of
interlinked titanium beads with magnetic cords are placed around the LES to
assist in maintaining LES pressure
Which drug class is most effective in treating erosive PPIs
lesions:?
Name 4 H2RAs: Cimetidine (Tagamet)
Famotidine (Pepcid)
Ranitidine (Zantac)
Nizatidine (Axid)
What is the action of H2RAs? Decrease acid secretion by blocking histamine 2-receptors in gastric parietal cells
Name 4 benefits of H2RAs 1. Relieve GERD symptoms
2. Can be administered prophylactically
3.More effective at controlling chronic GERD symptoms than ANTACIDS
4. Intermittent & routine dosing possible based on degree of symptom
control needed.
Name 2 drawbacks of H2RAs 1. Less effective in controlling chronic GERD symptoms than PPIs
2. Renal elimination may require dose adjustment in kidney dysfunction patients
What are the side effects associated with H2RAs? H/A, nausea (Cimetidine), weak inhibitor, common drug interactions, gynecomastia,
& Vit B-12 deficiency which affects patients' tolerance
Name the benefits of Antacids 1. Useful for intermittent treatment of GERD symptoms
2. Immediate symptom relief
3.Usually well-tolerated
, What are the drawbacks of Antacids? 1. Requires frequent dosing
2. Aluminum or Magnesium containing antacids may result in
electrolyte imbalances esp. in pts. w/renal impairment
3.May interfere w/absorption of fluoroquinolones, tetracyclines, iron products,
& thyroid hormones
(doses should be several hours apart)
What are the side effects of Antacids? May cause
Constipation or Diarrhea depending on the formulation used
What is the Pharmacological Therapy Effectiveness of Antacids briefly neutralize gastric acid but lacks acid-suppressive properties & are
Antacids? inferior to H2RAs
What is the Pharmacological Therapy Effectiveness of Histamine-2 Receptor Antagonists decrease acid secretion to a lesser extent than
H2RAs? PPIs (& are therefore inferior to PPIs)
What is the Pharmacological Therapy Effectiveness of Proton Pump Inhibitors block the rate-limiting step in acid secretion from gastric
PPIs? parietal cells & block all pathways for gastric acid secretion & therefore are better
than H2RAs
What is the treatment goal of pharmacological therapy in Increase the pH of gastric content by; 1) Direct gastric acid neutralization 2)
GERD? Reduce acid production through inhibiting the stimulation of pathways to
decrease GERD symptoms and prevent tissue damage
Which Bariatric Surgery is effective in reducing GERD Roux-en-Y gastric bypass
symptoms in obese patients?
Which Bariatric Surgery is ineffective in reducing Vertical banded gastroplasty
GERD symptoms in obese patients?
Which is more beneficial in esophagitis symptom In a 7-year follow-up study, Antireflux surgery provided more symptom control in
control; Omeprazole or Antireflux surgery? esophagitis patients
Name 4 Factors indicating when Antireflux Surgery is an 1) S/Es are intolerable/undesired
appropriate option for patients w/well documented 2) Adherence is a challenge
GERD: 3)Large Hiatal Hernia is present
4) Refractory GERD symptoms
What is Antireflux Surgical Fundoplication? A surgical procedure which increases LES (lower esophageal sphincter) pressures
by wrapping the fundus (upper part) of the stomach around the distal end of the
esophagus
What are LES stimulators? (5/5) Antireflux tx. option & alternative to fundoplication surgery: LES stimulators are
surgically inserted to modulate LES pressures and reduce refluxate from the
stomach
What is LINX? (4/5) Antireflux tx. option & alternative to fundoplication surgery where bands of
interlinked titanium beads with magnetic cords are placed around the LES to
assist in maintaining LES pressure
