DRUGS USED IN PEPTIC ULCER & BILIARY DISEASES.
ASSESSMENT.
May do one of the following, NOT later than 5 January 007.:
A. Email answers to pharmacology.ums@gmail.com in the format:
Ans: 1: a; 2: b; 3: e; etc.
Name &/or matrix no.
B. Send answers, on a plain sheet of paper to the lecturer's mailbox at Pejabat
Pengurusan. in the format:
Ans: 1: a; 2: b; 3: e; etc.
Signature, name &/or matrix no.
C. Answer on this page and submit as per B.
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1. Which of the following antacids is the worst choice for a patient with hypertension or
congestive heart failure?
a.
b.
c.
d.
e.
Aluminum hydroxide
Magnesium citrate
Magnesium oxide
Magnesium trisilicate
Sodium bicarbonate
2. Dry mouth, visual disturbance, constipation, and difficulty in urination are side effects
commonly associated with use of:
a. Muscarinic receptor antagonists.
b. H2 receptor antagonists.
c. D2 receptor antagonists.
d. 5-HT3 receptor antagonists.
e. Gastrin receptor antagonists.
3 . Cimetidine and related antisecretory drugs act as antagonists at parietal cell:
a. M3 receptors.
b. Prostaglandin receptors.
c. H2 receptors.
d. H1 receptors.
e. Gastrin receptors.
4 A patient is receiving chenodeoxycholic acid (chenodiol). The most likely reason for
administering this drug is to:
a. Dissolve cholesterol stones in the bile ducts
b. Enhance intestinal digestion and absorption of dietary fats
c. Help treat dietary deficiencies of fat-soluble vitamins
d. Lower gastric pH in patients with achlorhydria
e. Suppress steatorrhea and its consequences
5. In the context of gastrointestinal disorders, misoprostol is specifically indicated for
which of the following?
a. Routine management of gastro-oesophageal reflux disease (GORD)
b. Prophylaxis of ulcers during long-term therapy with some nonsteroidal antiinflammatory drugs
c. Eradicating Helicobacter pylori in patients with acute duodenal ulcers
d. Prevention of acute stress ulcers (e.g.., in the postoperative setting)
e. Managing ulcers that tend to develop during pregnancy
6. Which agent would be the best alternative to switch to if the patient experienced loose
stools?
a
b.
c.
d.
e.
Magnesium citrate
Castor oil
Aluminum hydroxide
Sodium bicarbonate
Magnesium oxide
7. Which of the choice(s) below were previously recommended for PUD patients,
but are now known to be of no value?
I.
Smoking cessation
II.
Smaller, more frequent meals
III.
Bland or milk-based diets to avoid stomach irritation
A. I only
B. III only
C. I and II only
D. II and III only
E. I, II, and III
.,
8. A patient with multiple medical problems is taking several drugs, including
theophylline, warfarin, quinidine, and phenytoin. Despite the likelihood of interactions,
dosages of each are adjusted carefully so their serum concentrations and effects are
acceptable. However, the patient suffers some GI (gastrointestinal) distress, late one
night, and manage to get a "heartburn" remedy from a “24 hour clinic”, without
revealing to the 'young locum doctor', that he was on any other medication. Subsequently
he presents with excessive or toxic effects from all his other medications. He almost
certainly took which of the following drug?
a. Cimetidine
b. Famotidine
c. Nizatidine
d. Omeprazole
e. Ranitidine
9. Identify the correct ranitidine dosage regimen for an active ulcer and for maintenance
therapy.
A. Ranitidine 400 mg hs for active and 200 mg hs for maintenance
B. Ranitidine 300 mg bid for active and 150 mg bid for maintenance
C. Ranitidine 300 mg hs for active and 150 mg hs for maintenance
D. Ranitidine 150 mg bid for active and 300 mg hs for maintenance
E. Ranitidine 200 mg bid for active and 200 mg hs for maintenance
10. Mr. Jung has multiple gastric ulcers but has done nothing about them. Shortly after
consuming a large meal and large amounts of alcohol, he experiences significant GI
(gastrointestinal) distress. He takes a heartburn remedy (which he had previously bought
form Jiyant Supermarket.) Within a minute or two he develops what he will later
describe as a "bad bloated feeling." Several of the ulcers have begun to bleed and he
experiences searing pain.
Mr. Jung becomes profoundly hypotensive from upper GI blood loss and is transported
to the hospital. Endoscopy confirms multiple bleeds; the endoscopist remarks that it
appears as if the lesions had been literally stretched apart, causing additional tissue
damage that led to the hemorrhage. The drug or product Mr. Jung most likely took was:
a. An aluminum salt
b. An aluminum-magnesium combination antacid product
c. Magnesium hydroxide
d. Ranitidine
e. Sodium bicarbonate