Gastroesophageal Reflux Disease, Laryngopharyngeal Reflux, and Peptic Ulcer Disease

All of the following medications can cause an ulcer to develop except _____.

a. acetylsalicylic acid

b. diflunisal (DOLOBID)

c. misoprostol

d. prednisone

c. misoprostol

An example of a mucosal protectant that decreases the susceptibility of epithelial cells that line the stomach and small intestine to damage by gastric acids, pepsin, and H. pylori is _____.

a. pantoprazole

b. misoprostol

c. metoclopramide

d. rabeprazole

b. misoprostol

_____ drugs are used for the treatment of GERD and LPR because they increase peristalsis.

a. Mucosal protectant

b. Proton pump inhibitors

c. H2 receptor antagonists

d. Prokinetic

d. Prokinetic

For which of the following GI disease states are antimicrobials prescribed?

a. GERD

b. LPR

c. PUD

d. PID

c. PUD

How do salicylates increase the risk of PUD?

a. Salicylates contain an enzyme that H. pylori feed on, increasing bacteria in the gastrointestinal (GI) tract.

b. Salicylates block prostaglandins from forming, reducing the protective mucosal lining of the GI tract.

c. Salicylates increase production of histamine in the stomach, increasing acid in the GI tract.

d. Salicylates interfere with the formation of acid, reducing enzymes in the GI tract.

b. Salicylates block prostaglandins from forming, reducing the protective mucosal lining of the GI tract.

How would taking an H2 receptor antagonist help prevent peptic ulcers?

a. Increases the production of the digestive enzyme pepsin, increasing its stomach protection abilities

b. Eliminates production of the digestive enzyme pepsin in the stomach, decreasing its exposure

c. Decreases acidity in stomach, decreasing chronic exposure to the digestive enzyme pepsin

d. Binds to the digestive enzyme pepsin in the stomach, decreasing its availability

c. Decreases acidity in stomach, decreasing chronic exposure to the digestive enzyme pepsin

_____ is currently the only prokinetic drug approved by the FDA.

a. Torsemide

b. Furosemide

c. Metoclopramide

d. Indapamide

c. Metoclopramide

Taking a PPI on an empty stomach is recommended because _____.

a. it will have time to work by the time a meal is eaten

b. it is easily broken down and destroyed by acid in the stomach

c. absorption of the drug is inhibited by food

d. taking it with food decreases the likelihood of the drug causing side effects

b. it is easily broken down and destroyed by acid in the stomach

What is the main indication of misoprostol?

a. Prevention of NSAID-induced peptic ulcers

b. Maintenance of NSAID-induced peptic ulcers

c. Prevention of duodenal ulcers

d. Maintenance of duodenal ulcers

a. Prevention of NSAID-induced peptic ulcers

What is the main indication of sucralfate?

a. Prevention of NSAID-induced peptic ulcers

b. Maintenance of NSAID-induced peptic ulcers

c. Prevention of duodenal ulcers

d. Maintenance of duodenal ulcers

d. Maintenance of duodenal ulcers

Which condition may increase the risk of developing asthma?

a. COPS

b. GERD

c. PUD

d. LPR

b. GERD

Which of the following best explains why LPR occurs?

a. Ingestion of H. pylori bacteria eats away at esophagus lining.

b. LPR is passed down genetically.

c. An immature digestive system causes reflux and delayed gastric emptying.

d. The ability of natural reflux barriers to work properly becomes damaged.

d. The ability of natural reflux barriers to work properly becomes damaged.

Which of the following drugs is used to treat GERD, LPR, and PUD?

a. Desloratadine

b. Nizatidine

c. Diphenhydramine

d. Cholestyramine

b. Nizatidine

Which of the following explains how sucralfate works?

a. It stimulates production of bicarbonate in the stomach.

b. It increases regeneration of parietal cells in the stomach.

c. It forms a protective barrier over an ulcer to protect it from gastric acid.

d. It stimulates the production of gastric acids in the stomach to form a barrier.

c. It forms a protective barrier over an ulcer to protect it from gastric acid.

Which of the following H2 receptor antagonists can cause the development of gynecomastia in men and inhibit several cytochrome P450 metabolic enzymes?

a. Cimetidine

b. Famotidine

c. Nizatidine

d. Ranitidine

a. Cimetidine

Which of the following is a proton pump inhibitor?

a. Fluconazole

b. Metronidazole

c. Pantoprazole

d. Miconazole

c. Pantoprazole

Which of the following is available as an over-the-counter (OTC) proton pump inhibitor?

a. Lansoprazole

b. Pantoprazole

c. Rabeprazole

d. Dexlansoprazole

a. Lansoprazole

Which of the following is not characteristic of an ulcer?

a. Open sore

b. Open wound

c. Can occur anywhere in the body

d. Limited to the digestive system

d. Limited to the digestive system

Which of the following must be dispensed in the manufacturer's original container?

a. Sucralfate

b. Misoprostol

c. Omeprazole

d. Metoclopramide

b. Misoprostol

Which of the following pairs of antacids can cause constipation?

a. Calcium and aluminum

b. Magnesium and sodium

c. Calcium and magnesium

d. Sodium and calcium

a. Calcium and aluminum

Which of the following warning labels should be placed on a H2 receptor antagonist?

a. May cause dizziness or drowsiness.

b. May cause vomiting.

c. May cause jaundice.

d. May cause dark yellow or brown urine

a. May cause dizziness or drowsiness.

Which of the following warning labels should be placed on a PPI prescription?

a. May decrease libido.

b. May cause depression.

c. May cause breast tenderness.

d. May cause nausea.

d. May cause nausea.

Which of the following warning labels should be placed on a prescription for metoclopramide?

a. May cause confusion.

b. May cause leg cramps.

c. May cause breast tenderness.

d. Do not take with antacids.

b. May cause leg cramps.

Which of the following warning labels should be placed on a prescription for misoprostol?

a. Take on an empty stomach.

b. Avoid pregnancy.

c. May cause discoloration of urine or feces.

d. Store in refrigerator.

b. Avoid pregnancy.

Which of the following would not be classified as a H2 receptor antagonist?

a. Cimetidine

b. Ranitidine

c. Famotidine

d. Amantadine

d. Amantadine

Which of the following would the pharmacist not counsel a patient with GERD to avoid?

a. Smoking

b. Alcohol

c. Exercise

d. Diet

c. Exercise

Why is it important to include the warning label "Avoid alcohol" on a prescription for GERD and PUD?

a. Alcohol stimulates stomach acid production, irritating an existing ulcer.

b. Alcohol is a gastric irritant.

c. Alcohol interferes with the elimination of drugs used for GERD and PUD.

d. Alcohol inhibits protective enzymes from forming, causing additional ulcers.

b. Alcohol is a gastric irritant.

Why might nonsteroidal anti-inflammatory drugs (NSAIDs) worsen GERD?

a. Increase gastric acids

b. Decrease protective mucosal lining

c. Impair peristalsis

d. Decrease natural reflux barriers

b. Decrease protective mucosal lining