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Questions and Case Studies: H2 Blockers, GERD Medication and Domperidone

by Pravin Shukle, MD
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    00:01 Okay, let's go on to some questions. H2D2, these are not the drugs you are looking for.

    00:08 Now if you don't get the joke, you probably have a social life. Let's move on to the question.

    00:12 The following statements pertain to H2 blockers. Pick the false statement.

    00:18 A, the H2 blockers are more potent and more effective than the antacids.

    00:23 B, cimetidine is the most tolerated and widely used of the H2 blockers.

    00:30 C, irreversibly inactivate the hydrogen-potassium ATPase pump.

    00:38 D, cimetidine has antiandrogenic actions at high doses.

    00:44 And E, inhibits absorption of drugs like ketoconazole.

    00:51 So pick the false statement.

    00:54 Good, you chose C. Remember that H2 blockers do not irreversibly inactivate the hydrogen-potassium ATPase pump.

    01:04 That distinction lies with the proton pump inhibitors.

    01:10 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.

    01:51 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.

    02:05 Metoclopramide is a promotility agent, but not an effective antacid. So it's not treating both problems.

    02:12 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.

    02:25 Alright, let's look at another case here. A 55 year old male has diabetic enteropathy with poor bowel function.

    02:33 He was placed on some Domperidone. The following statements are true except, so pick the false statement.

    02:41 A, metoclopramide and domperidone are both D2 blockers.

    02:46 B, domperidone crosses the blood brain barrier.

    02:50 C, metoclopramide and domperidone may be used in the gastroparesis of neurologic origin.

    02:57 And D, metoclopramide may cause Parkinsonian symptoms.

    03:02 Fabulous, you picked B, domperidone crosses the blood brain barrier.

    03:07 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.

    03:17 Domperidone doesn't.


    About the Lecture

    The lecture Questions and Case Studies: H2 Blockers, GERD Medication and Domperidone by Pravin Shukle, MD is from the course Gastrointestinal Pharmacology. It contains the following chapters:

    • Question: H2 Blockers
    • Case Study 1: GERD Medication
    • Case Study 2: Domperidone

    Author of lecture Questions and Case Studies: H2 Blockers, GERD Medication and Domperidone

     Pravin Shukle, MD

    Pravin Shukle, MD


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