pharmacology GRM week #7 (brief)

Week 7-Chapter 51

1. What are the functions of HCl, bicarbonate, pepsinogen, intrinsic factor, mucus and prostaglandins in the stomach?
a. HCl: aids in digestion and barrier to infection,
b. bicarbonate: natural mechanism to prevent hyperactivity
c. pepsinogen: precursor to pepsin which digests protein
d. intrinsic factor: facilitates absorption of B12,
e. mucus: protection from HCl and digestive enzymes
f. prostaglandins: antiinflammatory and protective functions

2. Which cells produce HCl?
a. parietal cells

3. What usually causes hyperacidity in the stomach?
a. food, caffeine, chocolate, alcohol or emotional stress

4. What is the typical pH of the stomach?
a. 1-4

5. What is the primary target of the drugs that treat acid-related disorders?
a. parietal cells

6. What are the three types of receptors on the parietal cells?
a. acetylcholine (Ach), histamine, and gastrin

7. What is the name of the mechanism which transports HCl from the parietal cells to the stomach?
a. proton pump

8. How do anticholinergics reduce HCl production?
a. block Ach receptors which also decrease hydrogen ion secretion from parietal cells

9. Why do aluminum and calcium based antacids also contain magnesium?
a. contributes to acid-neutralizing capacity and conteracts constipating effects of calcium and aluminum

10. To what degree do antacid dosages raise the gastric pH?
a. 0.3 points, reducing it by 50%
b. 1 point, reducing it by 90%

11. How do H2 receptor blockers raise the gastric pH?
a. competitively block H2 receptor of acid-producing parietal cells and reduces responsiveness to histamin and stimulation of Ach and gastrin

12. How do PPI’s raise the gastric pH?
a. bind to proton pump preventing movement of hydrogen ions and blocks gastric acid secretion

13. When both antacids and H2 blockers are given, what is the proper practice?
a. Do not administer simultaneously.

14. Why are antacids to be given with water?
a. enhance absorption in stomach

15. In relation to other medications, how should antacids be given?
a. 1-2 hours before other medications are taken

16. What may happen if ranitidine is given rapidly IV?
a. hypotension


Week 7-Chapter 52

17. What is the definition of diarrhea?
a. abnormal passage of stools with increased frequency, fluidity, weight, or with increased stool water excretion

18. How do adsorbents work in treating diarrhea?
a. coat the wall of the GI tract, binding to causative bacteria or toxin to their surface to be eliminated from the body through stool

19. How do anticholinergic drugs reduce diarrhea?
a. slow peristalsis by reducing the rhythmic contractions and smooth muscle tone of the GI tract

20. How do opioids treat diarrhea?
a. reduce bowel motility

21. How do opiods affect absorption?
a. increases the absorption of water, electrolytes, and nutrients

22. Why might someone who takes oral anticoagulants with absorbants be at higher risk for bleeding?
a. may bind to vitamin K which is needed for clotting

23. Why does Lomotil contain atropine?
a. discourages recreational opiate use

24. What is the definition of constipation?
a. abnormally infrequent and difficult passage of feces through the lower GI tract

25. What problems can chronic laxative use cause?
a. laxative dependence, damage to bowel or intestinal problems

26. What are the three ways in which laxatives work?
a. affecting fecal consistency, increasing fecal movement through colon and facilitate defecation through the rectum

27. Describe the way in which the 5 categories of laxatives work. Know drug examples from each laxative category. Table 52-4
Laxatives: Drug Effects
*Bulk: Psyllium
Increase peristalsis, causes increased secretion of water and electrolytes in small bowel, inhibits absorption of water in small bowel, increases water in fecal mass, softens fecal mass

*Emollient: Mineral oil
Increase peristalsis, causes increased secretion of water and electrolytes in small bowel, inhibits absorption of water in small bowel, increases wall permeability in small bowel, increases water in fecal mass, softens fecal mass

*Hyperosmatic: Glycerin
Increase peristalsis, acts only in large bowel, increases water in fecal mass, softens fecal mass

*Saline: Magnesium hydroxide
Increase peristalsis, causes increased secretion of water and electrolytes in small bowel, inhibits absorption of water in small bowel, increases water in fecal mass, softens fecal mass

*Stimulant: Senna
Increase peristalsis, causes increased secretion of water and electrolytes in small bowel, inhibits absorption of water in small bowel, increases wall permeability in small bowel, increases water in fecal mass, softens fecal mass

28. How does lactulose reduce serum ammonia levels in patients with hepatic encephalopathy?
a. converts ammonia to ammonium which cannot be reabsorbed in the small intestine

29. How long does it take polyethylene glycol 3350 to cleanse the bowel if it is taken properly?
a. 4 hours

30. What color does bismuth subsalicylate turn the stool?
a. black or grey