Chapter 59: Drugs Used in Gastrointestinal Disorders
A 55-year-old woman with type 1 diabetes of 40 years’ duration complains of severe bloating and abdominal distress, especially after meals. Evaluation is consistent with diabetic gastroparesis. Which of the following is a prokinetic drug that could be used in this situation?
Of the drugs listed, only metoclopramide is considered a prokinetic agent (ie, one that increases propulsive motility in the gut). The answer is D. Alosetron is a 5HT3 receptor blocker, cimetidine is a H2 receptor blocker, loperamide is an opioid, and sucralfate forms a protective layer over an ulcer.
A patient who is taking verapamil for hypertension and angina has become constipated. Which of the following drugs is an osmotic laxative that could be used to treat the patient’s constipation?
A laxative that mildly stimulates the gut would be most suitable in a patient taking a smooth muscle relaxant drug such as verapamil. By holding water in the intestine, magnesium hydroxide provides additional bulk and stimulates increased contractions. A helpful mnemonic is magnesium “magnifies” stool, aluminum hALts the stool. The answer is C. Diphenoxylate is an opioid receptor agonist, metoclopramide is a prokinetic agent, ranitidine is a H2 receptor blocker.
A 40-year-old male CEO came to the emergency department with severe burning chest pain radiating to his neck. His electrocardiogram was normal and test for troponin was negative. A diagnosis of GERD was made and he was sent home with a prescription for a drug that inhibits stomach acid. Which of the following is a drug that irreversibly inhibits the H+/K+ ATPase in the parietal cells?
Esomeprazole, the (S) isomer of omeprazole, is a prodrug converting spontaneously in the parietal cell canaliculus to a sulfonamide that irreversibly inactivates the proton pump. The answer is C.
A 25-year-old college student went to student health care center for severe cramps, diarrhea, ...