Okay, let's go on to some questions.
H2D2, these are not the drugs you are looking for.
Now if you don't get the joke, you probably have a social
life. Let's move on to the question.
The following statements pertain to H2 blockers.
Pick the false statement.
A, the H2 blockers are more potent and
more effective than the antacids.
B, cimetidine is the most tolerated and
widely used of the H2 blockers.
C, irreversibly inactivate the hydrogen-potassium ATPase pump.
D, cimetidine has antiandrogenic actions at high doses.
And E, inhibits absorption of drugs like ketoconazole.
So pick the false statement.
Good, you chose C. Remember that H2 blockers do not
irreversibly inactivate the hydrogen-potassium ATPase pump.
That distinction lies with the proton pump inhibitors.
Let's move on to another question. An 80 year old male with
chronic constipation presents with severe gastroesophageal
reflux after a large turkey dinner. The best
choice for acute treatment in this individual is?
Aluminium hydroxide? Magnesium oxide? Calcium carbonate?
Sodium bicarbonate? Or metoclopramide?
Good, you chose magnesium oxide. So when you are looking at
these agents, remember that aluminium oxide,
which is also known as Maalox, can be constipating. This guy
already has constipation so maybe it's not a great choice.
Calcium carbonate and sodium bicarb are weaker antacids.
Calcium carbonate is found in Tums for example,
and sodium bicarb is found in a lot of those effervescent
tablets that you buy over the counter.
Metoclopramide is a promotility agent, but not an effective
antacid. So it's not treating both problems.
The answer here is going to be B, magnesium oxide. It's
also called Milk of Magnesia. It has laxative effects,
anti-acid effects, and it's also quite
soothing on the elderly bowel.
Alright, let's look at another case here. A 55 year old male
has diabetic enteropathy with poor bowel function.
He was placed on some Domperidone. The following statements
are true except, so pick the false statement.
A, metoclopramide and domperidone are both D2 blockers.
B, domperidone crosses the blood brain barrier.
C, metoclopramide and domperidone may be used in the
gastroparesis of neurologic origin.
And D, metoclopramide may cause Parkinsonian symptoms.
Fabulous, you picked B, domperidone crosses
the blood brain barrier.
Remember that this is incorrect. Domperidone does not
cross the blood brain barrier,
metoclopramide crosses the blood brain barrier, and can
actually act as an anti-emetic.