Git Pharmacology MCQs Quiz Questions And Answers

The correct answer includes sodium bicarbonate, magnesium salts (oxide, trisilicate, hydroxide), and aluminum salts (hydroxide, phosphate, glycinate). These substances are commonly used in antacids to help neutralize excess stomach acid and provide relief from heartburn and indigestion. Sodium bicarbonate acts as a quick-acting antacid, while magnesium salts and aluminum salts have a longer-lasting effect. They work by reacting with the acid in the stomach to form water and salt, reducing the acidity and relieving symptoms.

Acid secretion in the stomach is primarily stimulated by the hormone gastrin. Gastrin is produced by endocrine cells in the gastric antrum and acts on the parietal cells of the stomach to increase the production and release of gastric acid. Acetylcholine and histamine, on the other hand, inhibit acid secretion. Prostaglandin E, a hormone-like substance, also stimulates acid secretion in the stomach. Therefore, the correct answer is that acid secretion is stimulated by gastrin.

The principles of ulcer management include providing symptomatic relief, promoting ulcer healing, preventing recurrence once healing has occurred, and preventing complications. These principles focus on addressing the symptoms of the ulcer, facilitating the healing process, ensuring that the ulcer does not reoccur, and minimizing any potential complications that may arise. By following these principles, healthcare professionals can effectively manage ulcers and improve the patient's overall well-being.

The general management of peptic ulcer disease includes various measures to alleviate symptoms and promote healing. Stopping smoking is important because smoking can worsen symptoms and delay healing. Avoiding strong coffee or tea is recommended as they can stimulate acid production and irritate the stomach lining. Alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided as they can increase the risk of developing ulcers and hinder the healing process. Drug therapy is also an essential part of treating peptic ulcers, as medications like proton pump inhibitors or H2 blockers can help reduce stomach acid production and promote healing.

Sucralfate is a medication that forms a protective barrier in the stomach to prevent and treat ulcers. However, in severe renal failure, the drug can accumulate in the body and potentially cause harm. This is because sucralfate is excreted by the kidneys, and when the kidneys are not functioning properly, the drug may not be eliminated effectively, leading to higher levels in the body. Therefore, in severe renal failure, the use of sucralfate should be carefully monitored to avoid potential accumulation and associated hazards.

Sucralfate is used in the treatment of gastric and duodenal ulceration and chronic gastritis. It is a basic aluminum salt of sucrose octasulfate. In the presence of acid, it becomes a sticky adherent paste that retains antacid efficacy. This adherent paste coats the floor of ulcer craters, exerting its acid-neutralizing properties locally.

The correct answer is repeat endoscopy and biopsy is recommended to exclude malignancy in the case of gastric ulcer. This is because repeat endoscopy allows for a visual examination of the ulcer to assess its healing progress. Additionally, a biopsy is necessary to rule out the possibility of malignancy, as gastric ulcers can sometimes be a symptom of stomach cancer. Monitoring AST, ALT, creatininemia, and natremia levels would not provide specific information about the healing of the ulcer or the presence of malignancy.

Bismuth chelate precipitates at acid pH to form a layer over the mucosal surface and ulcer base. This layer acts as a protective barrier against acid and pepsin digestion, helping to prevent further damage to the ulcer. Additionally, bismuth chelate may chelate with pepsin, which can help speed up the healing process of the ulcer. However, it is important to note that bismuth chelate is not as effective as cimetidine in healing duodenal and gastric ulcers after 4-8 weeks of treatment.

Glycerol in the form of rectal suppositories is useful if a rapid effect is required because it can be absorbed quickly through the rectal mucosa. It acts as a rectal stimulant due to its local irritant action, which helps to stimulate bowel movements. Rectal suppositories promote colonic evacuation in 30 minutes, providing a relatively fast relief for constipation. However, it does not exert severe diarrhea with loss of water and electrolytes, making it a safer option compared to some other laxatives.

Decreased colonic activity can be caused by various factors such as drugs, depression, confusional states, various local conditions including carcinoma, old age, and immobility. Drugs can have a suppressive effect on the colon, leading to decreased activity. Depression and confusional states can also affect the functioning of the colon. Various local conditions, including carcinoma (cancer), can disrupt the normal activity of the colon. Additionally, old age and immobility can contribute to decreased colonic activity.

Helicobacter pylori is a bacterium that is strongly associated with the development of gastric ulcers. It is typically found in the gastric antrum, which is a specific area of the stomach. The bacterium is a common cause of antral gastritis, which is inflammation of the antrum. Interestingly, it has been observed that H. pylori infection may actually alleviate symptoms in dyspeptic patients, although the exact mechanism for this is not fully understood.

The correct answer includes the information that at least 4 weeks' treatment is required to achieve healing, when the drug is discontinued, relapse may occur, and the drugs cimetidine, ranitidine, and famotidine are included in the treatment. This suggests that these drugs are used for a condition that requires a prolonged treatment period for healing, and there is a risk of relapse if the treatment is stopped. Cimetidine, ranitidine, and famotidine are commonly used for conditions such as gastric ulcers or gastroesophageal reflux disease (GERD), where long-term treatment is often necessary for symptom relief and healing.

Codeine and morphine are opioids that act on the mu-opioid receptors in the gastrointestinal tract, leading to an increase in intestinal transit time. This means that they slow down the movement of food through the intestines, resulting in a longer time for digestion and absorption of nutrients. Loperamide and diphenoxylate are both anti-diarrheal medications that also work by slowing down intestinal transit time. They do this by inhibiting the muscle contractions in the intestines, reducing the movement of stool and increasing the time it takes for it to pass through the digestive system. Fysostigmine, on the other hand, is not known to increase intestinal transit time and is therefore not included in the list of drugs that do so.

Misoprostol is a synthetic analog of prostaglandin E1, which means it has a similar structure and function to prostaglandin E1. It inhibits gastric acid secretion, which can help in treating conditions like ulcers. It also causes vasodilatation in the submucosa, which means it relaxes and widens the blood vessels in the inner lining of the digestive tract. This can help in improving blood flow and reducing inflammation. However, it is important to note that misoprostol is indicated especially in pregnancy for purposes like inducing labor or preventing and treating postpartum hemorrhage.

In the treatment of acute diarrhea, antibiotics are best avoided in non-pathogenic diarrhea and viral gastroenteritis because these conditions are usually caused by viruses or non-pathogenic bacteria that do not respond to antibiotics. Oral rehydration should be used for initial therapy because it helps replace the lost fluids and electrolytes due to diarrhea. Additionally, electrolytes and glucose should be supplemented for initial therapy to maintain the body's electrolyte balance and provide energy. This is particularly important in children and the elderly who are more susceptible to dehydration.

The major factors of known importance for the etiology of ulceration include acid-pepsin secretion, mucosal resistance to attack by acid and pepsin, effects of non-steroidal anti-inflammatory drugs, and the presence of Helicobacter pylori. These factors contribute to the development of ulcers by either increasing the acidity and aggressiveness of gastric secretions (acid-pepsin secretion), weakening the protective barrier of the stomach lining (mucosal resistance to attack), causing damage to the stomach lining (non-steroidal anti-inflammatory drugs), or by the presence of the bacteria Helicobacter pylori, which can lead to chronic inflammation and ulceration.

The mucus layer in the body is impaired by bile, ethanol, and salicylates. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats. When there is an excessive amount of bile in the body, it can damage the mucus layer. Ethanol, which is found in alcoholic beverages, can also impair the mucus layer. Salicylates, a type of medication commonly found in pain relievers, can have a similar effect. These substances can disrupt the protective barrier of the mucus layer, making the body more susceptible to infections and damage.

Senna alkaloids, specifically anthraquinones and sennosides A and B, have a direct effect on the intramucosal plexus of the gut wall. This means that they act directly on the nerves and cells within the gut wall, leading to their laxative effects. Pregnant women and nursing mothers should not be given senna alkaloids because they can potentially harm the developing fetus or pass into breast milk. Additionally, senna alkaloids can induce diarrhea, which can result in excessive loss of water and electrolytes.

Pirenzepine is classified as an M1 muscarinic receptor antagonist, meaning it blocks the action of acetylcholine at M1 muscarinic receptors. This can lead to certain side effects such as mild difficulty with accommodation (the ability of the eye to focus on near objects) and dry mouth. Additionally, pirenzepine has the potential to affect the absorption rate of other drugs if taken at the same time. However, the use of pirenzepine is not recommended in patients with concomitant glaucoma, pyloric stenosis, or prostatic enlargement.

Cimetidine inhibits cytochrome P 450 activity, which can result in high plasma concentrations of theophylline and opioid analgesics. Additionally, it binds to androgen receptors, which can lead to impotence and gynecomastia. Cimetidine is also effective in treating both duodenal and gastric ulcers.

The drugs listed in the question, including anticholinergic agents, Ca channel antagonists, opioids, and tricyclic antidepressants, can all cause obstipation. Obstipation refers to severe constipation or the inability to pass stool. These drugs can cause this side effect due to their impact on the gastrointestinal system. Anticholinergic agents and opioids can slow down bowel movements, while Ca channel antagonists and tricyclic antidepressants can affect the smooth muscle in the intestines, leading to constipation. Therefore, all of these drugs can contribute to obstipation.

The presence of Helicobacter pylori in the stomach of patients with duodenal ulcer is closely associated with antral gastritis and recurrent ulceration. When H. pylori is cleared in ulcer patients, there is a reduced rate of relapse. This suggests that H. pylori plays a significant role in the development and recurrence of duodenal ulcers. Antibiotics are unable to completely eradicate H. pylori, indicating that alternative treatment strategies may be needed to effectively manage this infection.

Prostaglandin E2 is the principal prostaglandin synthesized in the stomach and is an important gastroprotective mediator. It helps protect the stomach lining by inhibiting the secretion of acid and promoting the secretion of protective mucus. This helps to maintain the balance of acid production and protection in the stomach, preventing damage to the stomach lining.

Cisapride is a medication that is used in the treatment of gastroesophageal reflux, dyspepsia, and delayed gastric emptying. It helps to relieve symptoms such as heartburn, indigestion, and stomach discomfort by increasing the movement of the digestive system. By promoting motility of the gastrointestinal tract, cisapride can help to decrease the rate of gastric emptying, which can be beneficial in these conditions. However, it is important to note that cisapride has been withdrawn from the market in many countries due to safety concerns, so it may not be widely available.

Ranitidine (ZANTAC) has a lower affinity for cytochrome P 450 than cimetidine. This means that it is less likely to interact with other medications that are metabolized by cytochrome P 450, reducing the risk of drug-drug interactions. Additionally, ranitidine is preferable to cimetidine in the elderly, possibly due to its lower potential for adverse effects and drug interactions. Furthermore, ranitidine has a similar profile of action to cimetidine, meaning that it works in a similar way to reduce stomach acid production.

Plant fiber acts as a laxative and purgative by increasing the bulk of the stools. This means that it adds more volume to the stool, making it easier to pass. Additionally, plant fiber slowly distends the wall of the colon, which helps stimulate bowel movements. It also takes up water and swells, further softening the stool and aiding in its passage. These effects combined contribute to the overall effectiveness of plant fiber as a natural remedy for constipation.

Omeprazol inhibits the proton pump which secretes H ions into the gastric lumen. This means that it reduces the production of stomach acid, which can help with conditions like acid reflux and ulcers. It is taken once daily for optimal effectiveness. Additionally, Omeprazol degrades in the presence of moisture, so it is supplied in special containers to protect it from moisture and maintain its stability.

Lactulose is of particular value in the treatment of encephalopathy because it discourages the proliferation of ammonia producing organisms, decreases the absorption of ammonia, and acidifies the stools. These actions help to reduce the levels of ammonia in the body, which is important in managing encephalopathy. By discouraging the growth of ammonia producing organisms and decreasing ammonia absorption, lactulose helps to prevent the buildup of ammonia in the bloodstream. Additionally, acidifying the stools can promote the excretion of ammonia through the feces. Overall, these effects of lactulose contribute to the improvement of CNS functions after absorption from the gastrointestinal tract.

Sucralfate, bismuth chelate, and carbenoxolone are drugs that enhance mucosal resistance in the stomach. Sucralfate forms a protective barrier over the ulcer or damaged area, preventing further damage from stomach acid. Bismuth chelate has antimicrobial properties and can help reduce inflammation in the stomach lining. Carbenoxolone also forms a protective barrier and has anti-inflammatory effects. These drugs can be used to treat conditions such as peptic ulcers and gastritis by promoting healing and reducing symptoms.

Peptic ulcer disease is a chronic disorder that is characterized by frequent recurrences. It comprises both duodenal and peptic ulcers. The incidence of duodenal ulcers is four to five times lower than that of gastric ulcers. This condition affects approximately 50% of the population.

Beta-blockers are a class of medications primarily used to manage cardiovascular conditions such as hypertension and arrhythmias. They work by blocking the effects of adrenaline on the heart and blood vessels. The other options, PPIs, H2 receptor antagonists, and antacids, are commonly used in the treatment of GI disorders. PPIs reduce gastric acid secretion, H2 receptor antagonists block histamine-induced acid production, and antacids neutralize stomach acid.

Prolonged use of laxatives can cause the colon to become dilated and atonic, meaning it becomes stretched out and loses its muscle tone. This can lead to decreased activity in the colon. Additionally, the use of laxatives can induce sodium depletion, which can result in symptoms such as hypotension and secondary aldosteronism. Another potential effect of prolonged laxative use is the induction of hyperkalemia, which can cause weakness and increased urine production. These changes specifically occur when stimulant laxatives are used over a long period of time.

Magnesium sulfate increases the secretion of cholecystokinin, a hormone that stimulates the release of bile from the gallbladder. It also increases gastric, intestinal, and pancreatic secretion, which aids in digestion. When given in a dilute solution to a fasting individual, it can effectively act as a laxative within 1-2 days.

Glycosides of senna have a limited laxative effect mainly in the large intestine. After being absorbed, they are secreted in the bile, breast milk, and colon. Before absorption, Senna glycosides are hydrolyzed to active principles. The hydrolysis of these glycosides into sennosides A and B is caused by colonic bacteria.

The given answer suggests that in patients with diarrhea, antibiotics can be used to treat systemic illness and in evidence of bacterial infection. Additionally, antidiarrheal drugs that increase the bulk and viscosity of the gut contents can be used, along with opioids and antimuscarinics. This implies that antibiotics are appropriate for treating both systemic illness and bacterial infections, while antidiarrheal drugs, opioids, and antimuscarinics can help manage the symptoms of diarrhea by increasing bulk and viscosity or by targeting specific receptors in the gut.

Magnesium and aluminum salts do not undergo absorption, which means they are not absorbed into the bloodstream. This property makes them effective locally, as they stay in the area where they are applied or ingested. Additionally, these salts can reduce the rate and extent of absorption of other drugs, potentially affecting their effectiveness. It is important to use aluminum salts with caution in individuals with renal compromise, as they may not be properly eliminated from the body. Lastly, magnesium and aluminum salts are typically taken 1-3 hours after meals and at bedtime to optimize their efficacy.

Antacids are substances that react with gastric acid in the stomach to form a neutral salt. This helps to neutralize the excess acid and reduce symptoms such as heartburn and indigestion. Additionally, antacids are known to provide prompt pain relief by reducing the acidity in the stomach. They are particularly effective at healing duodenal ulcers, which are sores that develop in the first part of the small intestine. However, it is important to note that antacids may not be as effective in healing gastric ulcers, which are sores that develop in the stomach lining. Lastly, the effect of antacids on acid secretion can last for a long duration, typically around 5 hours.

The correct answer is "produces carbon monoxide by reacting with hydrochloric acid" and "causes belching and distension of the stomach". Sodium bicarbonate reacts with hydrochloric acid in the stomach to produce carbon dioxide gas, which can cause belching and distension of the stomach. It does not produce carbon monoxide. Sodium intake should be considered in patients with hypertension or heart failure as excessive sodium intake can worsen these conditions.

Lactulose is a monosaccharide that is broken down in the small intestine by bacteria. During this breakdown process, it is converted into unabsorbed organic anions which have the ability to retain fluid. This property of lactulose makes it useful as a laxative, as it increases the water content in the stool, making it easier to pass. Additionally, lactulose is particularly valuable in the treatment of hepatic encephalopathy, a condition characterized by impaired brain function due to liver disease. Lactulose helps in the management of this condition by reducing the levels of ammonia in the blood, which is toxic to the brain.