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Chapter 8: Gastrointestinal Drugs Multiple Choice Questions 1. Which of the following is NOT an area where a peptic ulcer can form? a. duodenum b. esophagus c. colon d. stomach Answer: c. colon Correct Feedback: Feedback: A peptic ulcer is an ulcer located anywhere in the esophagus, stomach, or duodenum. Ulcers do form in the colon, but this is known as ulcerative colitis, not peptic ulcers. a. duodenum Incorrect Feedback: Peptic ulcers can form in the duodenum. b. esophagus Incorrect Feedback: Peptic ulcers can form in the esophagus. d. stomach Incorrect Feedback: Peptic ulcers can form in the stomach. 2. Antacid drugs are weak _____. a. acids that exert a therapeutic effect by neutralizing hydrochloric acid b. acids that exert a therapeutic effect by neutralizing pepsin c. bases that exert a therapeutic effect by neutralizing hydrochloric acid d. bases that exert a therapeutic effect by neutralizing pepsin Answer: c. bases that exert a therapeutic effect by neutralizing hydrochloric acid Correct Feedback: Antacid drugs are weak bases that exert a therapeutic effect by neutralizing hydrochloric acid. This raises the pH of the stomach contents. a. acids that exert a therapeutic effect by neutralizing hydrochloric acid Incorrect Feedback: Antacid drugs neutralize acid, so they would not be acids themselves. b. acids that exert a therapeutic effect by neutralizing pepsin Incorrect Feedback: Antacid drugs neutralize acids, so they would not be acids themselves. d. bases that exert a therapeutic effect by neutralizing pepsin Incorrect Feedback: Antacid drugs neutralize hydrochloric acid, not pepsin. 3. Which of the following statements is FALSE? a. H2 blocker drugs block histamine receptors on the parietal cells of the stomach. b. The parietal cells of the stomach release H. pylori. c. The parietal cells of the stomach release hydrochloric acid. d. Both a and c are true. Answer: b. The parietal cells of the stomach release H. pylori. Correct Feedback: Histamine, a natural chemical produced by the body, activates special histamine receptors (H2 receptors) located on the parietal cells of the stomach. This causes the release of hydrochloric acid, not H. pylori. Drugs that block these receptors and prevent the release of acid are known as H2 blocker drugs. a. H2 blocker drugs block histamine receptors on the parietal cells of the stomach. Incorrect Feedback: This statement is true. c. The parietal cells of the stomach release hydrochloric acid. Incorrect Feedback: This statement is true. d. Both a and c are true. Incorrect feedback: This statement is true. 4. Antidiarrheal drugs produce a therapeutic effect by _______. a. absorbing extra water from diarrhea stools b. slowing peristalsis in the intestinal tract c. absorbing extra water from diarrhea stools or slowing peristalsis in the intestinal tract d. using osmotic pressure to attract water into the stool Answer: c. absorbing extra water from diarrhea stools or slowing peristalsis in the intestinal tract Correct Feedback: Antidiarrheal drugs produce a therapeutic effect by slowing peristalsis in the intestinal tract (anticholinergic drugs) or by absorbing extra water from diarrhea stools (absorbent drugs). a. absorbing extra water from diarrhea stools Incorrect Feedback: This is true, but it is not the entire answer. b. slowing peristalsis in the intestinal tract Incorrect Feedback: This is true, but it is not the entire answer. d. using osmotic pressure to attract water into the stool Incorrect Feedback: This describes the action of a laxative drug, not an antidiarrheal drug. 5. The generic drug aminosalicylic acid _______. a. decreases intestinal inflammation by blocking the production of hydrochloric acid b. decreases intestinal inflammation by blocking the production of prostaglandins c. increases intestinal peristalsis by blocking the production of hydrochloric acid d. decrease intestinal peristalsis by blocking the production of prostaglandins Answer: b. decreases intestinal inflammation by blocking the production of prostaglandins Correct Feedback: Aminosalicylic acid (ASA) decreases intestinal inflammation by blocking the production of prostaglandins. a. decreases intestinal inflammation by blocking the production of hydrochloric acid Incorrect Feedback: Aminosalicylic acid does not block the production of hydrochloric acid. c. increases intestinal peristalsis by blocking the production of hydrochloric acid Incorrect Feedback: Aminosalicylic acid does not increase intestinal peristalsis. d. decrease intestinal peristalsis by blocking the production of prostaglandins Incorrect Feedback: Aminosalicylic acid does not decrease intestinal peristalsis. 6. Gastric stimulant drugs maintain normal peristalsis in the gastrointestinal (GI) tract, by enhancing the natural action of ______. a. acetylcholine b. dopamine c. hydrochloric acid d. pepsin Answer: a. acetylcholine Correct Feedback: Gastric stimulant drugs enhance the natural action of acetylcholine, a neurotransmitter that maintains normal peristalsis in the GI tract. b. dopamine Incorrect Feedback: Gastric stimulant drugs do not enhance the action of dopamine. c. hydrochloric acid Incorrect Feedback: Gastric stimulant drugs do not enhance the action of hydrochloric acid. d. pepsin Incorrect Feedback: Gastric stimulant drugs do not enhance the action of pepsin. 7. Some antiemetic drugs, such as prochlorperazine (Compazine) and trimethobenzamide (Tigan), block __________ from activating receptors in the GI tract and in the chemoreceptor trigger zone and vomiting center in the brain. a. acetylcholine b. dopamine c. hydrochloric acid d. pepsin Answer: b. dopamine Correct Feedback: Some antiemetic drugs used to treat nausea and vomiting block dopamine from activating receptors in the wall of the GI tract and in the chemoreceptor trigger zone and vomiting center in the brain. a. acetylcholine Incorrect Feedback: Antiemetic drugs do not block acetylcholine. c. hydrochloric acid Incorrect Feedback: Antiemetic drugs do not block hydrochloric acid. d. pepsin Incorrect Feedback: Antiemetic drugs do not block pepsin. 8. Which drug acts topically on the actual surface of the ulcer, forming a protective layer or “bandage” that allows a peptic ulcer to heal? a. esomeprazole (Nexium) b. misoprostol (Cytotec) c. rabeprazole (Aciphex) d. sucralfate (Carafate) Answer: d. sucralfate (Carafate) Correct Feedback: The drug sucralfate (Carafate) acts topically on the actual surface of the ulcer because it is attracted to areas of mucous membrane that are damaged or draining fluid that is high in protein. This drug binds directly to these areas, forming a protective layer or “bandage” over the ulcer, allowing it to heal. a. esomeprazole (Nexium) Incorrect Feedback: Nexium does not work topically on peptic ulcers. b. misoprostol (Cytotec) Incorrect Feedback: Cytotec does not work topically on peptic ulcers. c. rabeprazole (Aciphex) Incorrect Feedback: Aciphex is not used to treat peptic ulcers. 9. Successful treatment of an H. pylori infection involves the use of a combination of antibiotic drugs, antiprotozoal drugs, bismuth, and _______. a. either a laxative drug or a stool softener b. an antacid drug or an antispasmodic drug c. an anticholinergic drug or an absorbent drug d. an H2 blocker drug or a proton pump inhibitor drug Answer: d. an H2 blocker drug or a proton pump inhibitor drug Correct Feedback: Successful treatment of an H. pylori infection involves the use of a combination of antibiotic drugs, antiprotozoal drugs, bismuth, and either an H2 blocker drug or a proton pump inhibitor drug. a. either a laxative drug or a stool softener Incorrect Feedback: Laxative and stool softeners are used to treat constipation, not H. pylori infection. b. an antacid drug or an antispasmodic drug Incorrect Feedback: Antacid drugs are used to treat peptic ulcers, and antispasmodic drugs are used to treat GI spasm, not H. pylori infection. c. an anticholinergic drug or an absorbent drug Incorrect Feedback: Anticholinergic drugs are used to treat GI spasm, and absorbent drugs are used to treat diarrhea, not H. pylori infection. 10. GERD is treated with _______. a. antacid drugs and drugs used to dissolve gallstones b. appetite suppressant drugs and antacid drugs c. narcotic drugs and antibiotic drugs d. proton pump inhibitor drugs and gastric stimulant drugs Answer: d. proton pump inhibitor drugs and gastric stimulant drugs Correct Feedback: GERD is treated with proton pump inhibitor drugs and gastric stimulant drugs. a. antacid drugs and drugs used to dissolve gallstones Incorrect Feedback: Antacid drugs are used to treat ulcers, and drugs used to dissolve gallstones are not used to treat GERD. b. appetite suppressant drugs and antacid drugs Incorrect Feedback: Appetite suppressant drugs are used to treat diarrhea, and antacid drugs are used to treat peptic ulcer disease, not GERD. c. narcotic drugs and antibiotic drugs Incorrect Feedback: Narcotic drugs are used to treat diarrhea, and antibiotic drugs are used to treat H. pylori infection, not GERD. 11. Acetylcholine stimulates cholinergic receptors and causes them to do all of the following EXCEPT ______. a. slow peristalsis in the GI tract b. stimulate peristalsis to move food through the GI tract c. stimulate muscular contractions of the GI tract d. stimulate the release of hydrochloric acid in the stomach Answer: a. slow peristalsis in the GI tract Correct Feedback: The neurotransmitter acetylcholine acts on cholinergic receptors to stimulate the release of hydrochloric acid, to stimulate muscular contractions, and to begin peristalsis to move food through the GI tract. It is antidiarrheal drugs that slow peristalsis in the GI tract. b. stimulate peristalsis to move food through the GI tract Incorrect Feedback: This is a true statement. c. stimulate muscular contractions of the GI tract Incorrect Feedback: This is a true statement. d. stimulate the release of hydrochloric acid in the stomach Incorrect Feedback: This is a true statement. 12. Which category of laxative drug has the most natural and the safest action of all the laxative drugs? a. bulk-producing laxative drugs b. chloride channel laxative drugs c. osmotic laxative drugs d. stool softener laxative drugs Answer: a. bulk-producing laxative drugs Correct Feedback: Bulk-producing laxative drugs contain indigestible dietary fiber and other substances that absorb and hold water in the intestines to soften the stool. This action is the most natural and safest of all the laxative drugs. b. chloride channel laxative drugs Incorrect Feedback: Chloride channel laxative drugs do not have the most natural and safest action of all laxative drugs. c. osmotic laxative drugs Incorrect Feedback: Osmotic laxative drugs do not have the most natural and safest action of all laxative drugs. d. stool softener laxative drugs Incorrect Feedback: Stool softener laxative drugs do not have the most natural and safest action of all laxative drugs. 13. Chloride channel laxative drugs, such as Amitiza, stimulate chloride channels in the mucosa of the intestinal wall. This causes ______. a. the release of hydrochloric acid in the stomach b. fluid to flow out of the intestines to harden the stool c. fluid to flow into the intestines to soften the stool d. lipase in the diet to be excreted in the stool rather than absorbed Answer: c. fluid to flow into the intestines to soften the stool Correct Feedback: Chloride channel laxative drugs stimulate chloride channels in the mucosa of intestinal wall. This causes fluid to flow into the intestines to soften the stool. a. the release of hydrochloric acid in the stomach Incorrect Feedback: Chloride channel laxative drugs do not cause the release of hydrochloric acid. b. fluid to flow out of the intestines to harden the stool Incorrect Feedback: Softening, not hardening, the stool is the goal of laxative drugs. d. lipase in the diet to be excreted in the stool rather than absorbed Incorrect Feedback: This is the description of a lipase inhibitor drug used to treat obesity, not a chloride channel laxative drug. 14. Proton pump inhibitor drugs can be used to treat all of the following GI diseases EXCEPT ______. a. GERD b. heartburn and peptic ulcers c. obesity d. H. pylori infections Answer: c. obesity Correct Feedback: Proton pump inhibitor drugs are used to treat heartburn and peptic ulcers. The proton pump inhibitor drugs esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec) are indicated for the treatment of H. pylori infections. All proton pump inhibitor drugs are used to treat esophagitis and GERD. Proton pump inhibitor drugs are not used to treat obesity. a. GERD Incorrect Feedback: Proton pump inhibitor drugs are used to treat GERD. b. heartburn and peptic ulcers Incorrect Feedback: Proton pump inhibitor drugs are used to treat heartburn and peptic ulcers. d. H. pylori infections Incorrect Feedback: Proton pump inhibitor drugs are used to treat H. pylori infections. 15. Appetite suppressant drugs are also known as ________ drugs. a. proton pump inhibitor b. absorbent c. antacid d. anorexiant Answer: d. anorexiant Correct Feedback: Appetite suppressant drugs are also known as anorexiant drugs. a. proton pump inhibitor Incorrect Feedback: Appetite suppressant drugs are not known as proton pump inhibitor drugs. b. absorbent Incorrect Feedback: Appetite suppressant drugs are not known as absorbent drugs. c. antacid Incorrect Feedback: Appetite suppressant drugs are not known as antacid drugs. 16. All of the drugs below irritate the stomach and can cause an ulcer EXCEPT _____. a. aspirin b. NSAIDs c. antiemetic drugs d. alcohol and caffeine Answer: c. antiemetic drugs Correct Feedback: Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and caffeine also irritate the mucous membranes and can contribute to ulcer formation. Antiemetic drugs are used to treat nausea and vomiting; they do not cause an ulcer. a. aspirin Incorrect Feedback: Aspirin can cause an ulcer. b. NSAIDs Incorrect Feedback: Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause an ulcer. d. alcohol and caffeine Incorrect Feedback: Alcohol and caffeine are drugs that can cause an ulcer. 17. A drawback to the use of the antacid drug sodium bicarbonate, Alka-Seltzer, or baking soda is their ______. a. ineffectiveness b. cost c. inability to neutralize acid d. high sodium content Answer: d. high sodium content Correct Feedback: Baking soda (sodium bicarbonate) dissolved in water is an old home remedy for indigestion and heartburn. Although sodium bicarbonate neutralizes acid, it is not recommended as a long-term treatment for heartburn because the large amounts of sodium it contains are absorbed systemically. a. ineffectiveness Incorrect Feedback: These are effective antacid drugs. b. cost Incorrect Feedback: These are home remedies or over-the-counter drugs that are not expensive. c. inability to neutralize acid Incorrect Feedback: These drugs do neutralize acid. 18. All of the following trade names are antiemetic drugs EXCEPT ______. a. Compazine b. Dramamine c. Antivert d. Librax Answer: d. Librax Correct Feedback: Librax is a combination antispasmodic drug that contains clidinium and chlordiazepoxide). a. Compazine Incorrect Feedback: Compazine is an antiemetic drug. b. Dramamine Incorrect Feedback: Dramamine is an antiemetic drug specifically used for motion sickness or vertigo. c. Antivert Incorrect Feedback: Antivert is an antiemetic drug specifically used for vertigo. 19. All of the following are bulk-producing laxative drugs EXCEPT ______. a. Fiberall b. Metamucil c. Mylanta d. Perdiem Answer: c. Mylanta Correct Feedback: Mylanta is a combination antacid drug that contains aluminum and magnesium. a. Fiberall Incorrect Feedback: Fiberall is a bulk-producing laxative drug. b. Metamucil Incorrect Feedback: Metamucil is a bulk-producing laxative drug. d. Perdiem Incorrect Feedback: Perdiem is a bulk-producing laxative drug. 20. The suffix –tidine is common to generic _______ drugs. a. antacid b. antidiarrheal c. H2 blocker d. stool softener laxative Answer: c. H2 blocker Correct Feedback: The suffix -tidine is common to generic H2 blocker drugs. a. antacid Incorrect Feedback: The suffix –tidine is not common to antacid drugs. b. antidiarrheal Incorrect Feedback: The suffix –tidine is not common to antidiarrheal drugs. d. stool softener laxative Incorrect Feedback: The suffix –tidine is not common to stool softener laxative drugs. 21. Which of the following statements is FALSE? a. Zantac is available in a 150 mg dose both as a prescription drug and as an OTC drug. b. The HB in Tagamet HB stands for histamine blocker. c. The AC in Pepcid AC stands for the Latin phrase ante cibum. d. Histamine, released in the stomach because of an allergic reaction, stimulates the production of hydrochloric acid. Answer: d. Histamine, released in the stomach because of an allergic reaction, stimulates the production of hydrochloric acid. Correct Feedback: Prescription Zantac is available in 300 mg and 150 mg doses; OTC Zantac is available in 150 mg and 75 mg doses. The HB in Tagamet HB stands for heartburn. The AC in Pepcid AC stands for the Latin phrase ante cibum, which means before meals, as Pepcid AC is taken before meals. Histamine is released in the stomach, where it stimulates the production of hydrochloric acid, and this is not related to any allergic reaction. a. Zantac is available in a 150 mg dose both as a prescription drug and as an OTC drug. Incorrect Feedback: This is a true statement. b. The HB in Tagamet HB stands for histamine blocker. Incorrect Feedback: This is a true statement. c. The AC in Pepcid AC stands for the Latin phrase ante cibum. Incorrect Feedback: This is a true statement. 22. All of the following are laxative drugs EXCEPT ______. a. milk of magnesia b. Imodium c. ProctoFoam NS d. Perdiem Answer: c. ProctoFoam NS Correct Feedback: Over-the-counter topical drugs used to treat hemorrhoids include anesthetic drugs to relieve pain (benzocaine, dibucaine, lidocaine, pramoxine); pramoxine trade names include ProctoFoam NS and Tronolane. a. milk of magnesia Incorrect Feedback: Milk of magnesia is a laxative drug. b. Imodium Incorrect Feedback: Imodium is a laxative drug. d. Perdiem Incorrect Feedback: Perdiem is a laxative drug. 23. Another trade name for the laxative drug docusate (Colace) is _____. a. Surfak b. Actigall c. GoLYTELY d. Tums Answer: a. Surfak Correct Feedback: Stool softener drugs are emulsifiers that allow fat in the stool to mix with water to soften the stool: docusate (Colace, Surfak) b. Actigall Incorrect Feedback: Actigall is not a laxative drug. c. GoLYTELY Incorrect Feedback: GoLYTELY is a bowel evacuant/enema, not a laxative drug. d. Tums Incorrect Feedback: Tums is an antacid drug, not a laxative drug. 24. All of the following are H2 blocker drugs EXCEPT ______. a. Zantac b. Pepcid c. Transderm-Scōp d. Axid Answer: c. Transderm-Scōp Correct Feedback: Scopolamine (Transderm-Scōp) is manufactured as a small transdermal patch that is worn behind the ear. It is used to treat motion sickness. a. Zantac Incorrect Feedback: Zantac is an H2 blocker drug. b. Pepcid Incorrect Feedback: Pepcid is an H2 blocker drug. d. Axid Incorrect Feedback: Axid is an H2 blocker drug. 25. Cimetidine is the generic name for the trade name drug _____. a. Maalox b. Nexium c. opium d. Tagamet Answer: d. Tagamet Correct Feedback: Cimetidine (Tagamet) is an H2 blocker drug used to treat peptic ulcer disease. a. Maalox Incorrect Feedback: Maalox is a trade name combination drug that contains aluminum, magnesium, and simethicone, not cimetidine. b. Nexium Incorrect Feedback: Nexium is the trade name drug for esomeprazole, not cimetidine. c. opium Incorrect Feedback: Opium is not a trade name drug. 26. Which of the following statements is FALSE? a. Simethicone is available as an individual drug or in combination with antacid drugs. b. Simethicone is used to treat flatulence and gas. c. Simethicone changes the surface tension of air bubbles trapped in the GI tract. d. Simethicone is used to treat diarrhea. Answer: d. Simethicone is used to treat diarrhea. Correct Feedback: Some of these combination drugs also contain simethicone to relieve flatulence and gas; simethicone acts by changing the surface tension of air bubbles trapped in the GI tract and allows them to be expelled. Simethicone is available as an individual drug to treat gas or is combined with antacid drugs, but it has no antacid action of its own. Simethicone is not used to treat diarrhea. a. Simethicone is available as an individual drug or in combination with antacid drugs. Incorrect Feedback: This is a true statement. b. Simethicone is used to treat flatulence and gas. Incorrect Feedback: This is a true statement. c. Simethicone changes the surface tension of air bubbles trapped in the GI tract. Incorrect Feedback: This is a true statement. 27. Di-Gel, Amphojel, and Riopan are all examples of ______. a. H2 blocker drugs b. irritant laxative drugs c. antacid drugs d. antiemetic drugs Answer: c. antacid drugs Correct Feedback: The antacid drug Amphojel contains aluminum as its active ingredient. Di-Gel and Riopan are combination antacid drugs. a. H2 blocker drugs Incorrect Feedback: These drugs are not examples of H2 blocker drugs. b. irritant laxative drugs Incorrect Feedback: These drugs are not examples of irritant laxative drugs. d. antiemetic drugs Incorrect Feedback: These drugs are not examples of antiemetic drugs. 28. Which of the following statements is TRUE? a. Proton pump inhibitor drugs are used to treat diarrhea. b. The proton pump is located in the gallbladder. c. Proton pump inhibitor drugs are the drug of choice for appetite suppression and weight loss. d. The proton pump is an enzyme system that blocks the production of acid. Answer: d. The proton pump is an enzyme system that blocks the production of acid. Correct Feedback: Proton pump inhibitor drugs decrease gastric acid by blocking the final step of acid production within the gastric parietal cell. This final step involves an enzyme system known as the proton pump, hence the name of this drug category. Proton pump inhibitor drugs are used to treat heartburn and peptic ulcers. a. Proton pump inhibitor drugs are used to treat diarrhea. Incorrect Feedback: This statement is false. b. The proton pump is located in the gallbladder. Incorrect Feedback: This statement is false. c. Proton pump inhibitor drugs are the drug of choice for appetite suppression and weight loss. Incorrect Feedback: This statement is false. 29. The suffix –prazole is common to generic ______. a. proton pump inhibitor drugs b. appetite suppressant drugs c. antacid drugs d. bulk-producing laxative drugs Answer: a. proton pump inhibitor drugs Correct Feedback: The suffix –prazole is common to proton pump inhibitor drugs. b. appetite suppressant drugs Incorrect Feedback: The suffix –prazole is not common to generic appetite suppressant drugs. c. antacid drugs Incorrect Feedback: The suffix –prazole is not common to generic antacid drugs. d. bulk-producing laxative drugs Incorrect Feedback: The suffix –prazole is not common to generic bulk-producing laxative drugs. 30. Gastric stimulant drugs ______. a. are used to treat GERD b. include metoclopramide (Maxolon, Reglan) c. increase the rate of gastric emptying d. all of the above Answer: d. all of the above Correct Feedback: This GI stimulant drug increases the rate of gastric emptying in order to keep excess acid from accumulating in the stomach and refluxing into the esophagus: metoclopramide (Maxolon, Reglan). a. are used to treat GERD Incorrect Feedback: This is true, but it is not the only correct answer. b. include metoclopramide (Maxolon, Reglan) Incorrect Feedback: This is true, but it is not the only correct answer. c. increase the rate of gastric emptying Incorrect Feedback: This is true, but it is not the only correct answer. 31. Gastric ulcers can be caused by all of the following EXCEPT _______. a. bacterial infection caused by H. pylori b. stones in the gallbladder c. excessive amounts of hydrochloric acid d. drugs, alcohol, and caffeine that irritate the mucous membranes Answer: b. stones in the gallbladder Correct Feedback: All peptic ulcers (including gastric ulcers) are caused by irritation of the mucous membranes that line the gastrointestinal tract. This irritation is caused by excessive amounts of hydrochloric acid, which strip away the protective mucus of the mucous membrane. Aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), alcohol, and caffeine also irritate the mucous membranes and can contribute to ulcer formation. Gastric ulcers can also be caused by a bacterial infection due to Helicobacter pylori. a. bacterial infection caused by H. pylori Incorrect Feedback: Gastric ulcers can be caused by H. pylori. c. excessive amounts of hydrochloric acid Incorrect Feedback: Gastric ulcers can be caused by excessive amounts of hydrochloric acid. d. drugs, alcohol, and caffeine that irritate the mucous membranes Incorrect Feedback: Gastric ulcers can be caused by irritation from drugs, alcohol, and caffeine. 32. A unique characteristic of Transderm-Scōp is that it is ______. a. the first FDA-approved weight loss drug b. worn as a patch behind the ear c. effective for both heartburn and motion sickness d. given orally Answer: b. worn as a patch behind the ear Correct Feedback: All antiemetic drugs are given orally with the exception of scopolamine (Transderm-Scōp), which is manufactured as a small transdermal patch that is worn behind the ear. a. the first FDA-approved weight loss drug Incorrect: Alli is the first over-the-counter FDA-approved weight loss drug, not Transderm-Scōp. c. effective for both heartburn and motion sickness Incorrect Feedback: This drug is not used to treat heartburn. d. given orally Incorrect Feedback: This drug is not given orally. 33. The trade name of the drug cimetidine is ______. a. Nexium b. Preparation H c. Meridia d. Tagamet Answer: d. Tagamet Correct Feedback: H2 blocker drugs are prescription drugs, but some are also available over the counter, including cimetidine (Tagamet). a. Nexium Incorrect Feedback: The trade name of cimetidine is not Nexium. b. Preparation H Incorrect Feedback: The trade name of cimetidine is not Preparation H. c. Meridia Incorrect Feedback: The trade name of cimetidine is not Meridia. 34. Which of the following is a combination drug that contains an anti-infective drug, an antibiotic drug, and an antiprotozoal drug and is used to treat H. pylori infection of the stomach? a. Xenical b. Helidac c. AcipHex d. Actigall Answer: b. Helidac Correct Feedback: Helidac is a combination drug that contains the anti-infective drug bismuth, the antiprotozoal drug metronidazole, and the antibiotic drug tetracycline. It is used to treat H. pylori infection. a. Xenical Incorrect Feedback: Xenical is not used to treat H. pylori infection. c. AcipHex Incorrect Feedback: AcipHex is not used to treat H. pylori infection. d. Actigall Incorrect Feedback: Actigall is not used to treat H. pylori infection. 35. All of the following are proton pump inhibitor drugs EXCEPT ______. a. Lomotil b. Prilosec c. Nexium d. Prevacid Answer: a. Lomotil Correct Feedback: Lomotil is a combination drug used to treat diarrhea. b. Prilosec Incorrect Feedback: Prilosec is a proton pump inhibitor drug. c. Nexium Incorrect Feedback: Nexium is a proton pump inhibitor drug. d. Prevacid Incorrect Feedback: Prevacid is a proton pump inhibitor drug. 36. Which of the following antidiarrheal drugs contains the Schedule III drug opium? a. paregoric b. Pepto-Bismol c. bismuth d. Lomotil Answer: a. paregoric Correct Feedback: Antidiarrheal drugs that contain opium, a narcotic drug, are classified as controlled substances (Schedule III drugs); paregoric contains opium b. Pepto-Bismol Incorrect Feedback: Pepto-Bismol does not contain opium. c. bismuth Incorrect Feedback: Bismuth is an anti-infective drug, not an antidiarrheal drug. d. Lomotil Incorrect Feedback: Lomotil does not contain opium. 37. Chenix, Actigall, and Moctanin are all trade name drugs used to treat ______. a. peptic ulcers b. indigestion c. ulcerative colitis d. gallstones Answer: d. gallstones Correct Feedback: Patients who are unable to undergo surgery to remove gallstones from the gallbladder can be given drugs to help dissolve the stones: chenodiol (Chenix), monoctanoin (Moctanin), and ursodiol (Actigall). a. peptic ulcers Incorrect Feedback: These drugs are not used to treat peptic ulcers. b. indigestion Incorrect Feedback: These drugs are not used to treat indigestion. c. ulcerative colitis Incorrect Feedback: These drugs are not used to treat ulcerative colitis. 38. All of the following are aminosalicylic acid drugs used to treat ulcerative colitis EXCEPT ______. a. Rowasa b. Asacol c. Azulfidine d. Cortifoam Answer: d. Cortifoam Correct Feedback: Hydrocortisone (Cortifoam) is a corticosteroid drug, not an aminosalicylic acid drug, that is used to treat ulcerative colitis. a. Rowasa Incorrect Feedback: Rowasa is an aminosalicylic acid drug that is used to treat ulcerative colitis. b. Asacol Incorrect Feedback: Asacol is an aminosalicylic acid drug that is used to treat ulcerative colitis. c. Azulfidine Incorrect Feedback: Sulfasalazine (Azulfidine) is an aminosalicylic acid drug that is used to treat ulcerative colitis. 39. Which of the following statements is FALSE? a. The weight loss drug Alli can cause fatty stools that pass involuntarily. b. The prescription drug Xenical contains the same drug as the over-the-counter drug Alli. c. Alli belongs to the appetite suppressant drug category. d. Alli was the first over-the-counter FDA-approved weight loss drug. Answer: c. Alli belongs to the appetite suppressant drug category. Correct Feedback: Lipase inhibitor drugs chemically bond to the enzyme lipase so that it cannot break down dietary fat in the intestines. Orlistat (Alli, Xenical) is the only drug in this category. a. The weight loss drug Alli can cause fatty stools that pass involuntarily. Incorrect Feedback: This statement is true. b. The prescription drug Xenical contains the same drug as the over-the-counter drug Alli. Incorrect Feedback: This statement is true. d. Alli was the first over-the-counter FDA-approved weight loss drug. Incorrect Feedback: This statement is true. 40. All of the following categories of drugs are used to treat Crohn’s disease EXCEPT ______. a. monoclonal antibody drugs b. oral corticosteroid drugs c. immunomodulator drugs d. appetite suppressant drugs Answer: d. appetite suppressant drugs Correct Feedback: These drugs are only used to treat Crohn’s disease: Adalimumab, infliximab, and natalizumab are monoclonal antibody drugs. Budesonide is an oral corticosteroid drug. Certolizumab is an anti-tumor necrosis factor drug. Etanercept is an immunomodulator drug. a. monoclonal antibody drugs Incorrect Feedback: Monoclonal antibody drugs are used to treat Crohn’s disease. b. oral corticosteroid drugs Incorrect Feedback: Oral corticosteroid drugs are used to treat Crohn’s disease. c. immunomodulator drugs Incorrect Feedback: Immunomodulator drugs are used to treat Crohn’s disease. 41. Janie Wallace is taking an appetite suppressant drug. She should be aware of which of these statements? a. Appetite suppressant drugs should be used in conjunction with dietary restrictions. b. Appetite suppressant drugs should be taken only on a short-term basis. c. Appetite suppressant drugs affect dopamine and serotonin levels in the satiety center of the brain. d. All of the above statements are true. Answer: d. All of the above statements are true. Correct Feedback: Appetite suppressant drugs suppress the appetite by affecting dopamine or serotonin levels in the satiety center of the brain. The use of these drugs is limited to short-term treatment of obesity, in conjunction with dietary restrictions. a. Appetite suppressant drugs should be used in conjunction with dietary restrictions. Incorrect Feedback: This is true, but it is not the only correct answer. b. Appetite suppressant drugs should be taken only on a short-term basis. Incorrect Feedback: This is true, but it is not the only correct answer. c. Appetite suppressant drugs affect dopamine and serotonin levels in the satiety center of the brain. Incorrect Feedback: This is true, but it is not the only correct answer. 42. All of the following statements are true EXCEPT ______. a. Helicobacter pylori are helical (spiral) bacteria. b. Helicobacter pylori have flagella (thin, whip-like tails). c. Helicobacter pylori are the cause of some gastric ulcers. d. Helicobacter pylori infections are treated with lipase inhibitor drugs. Answer: d. Helicobacter pylori infections are treated with lipase inhibitor drugs. Correct Feedback: Helicobacter pylori are helical (spiral) bacteria that have flagella (thin, whip-like tails). They live in the gastric or duodenal mucosa and are the cause of some peptic ulcers. Successful treatment of an H. pylori infection involves the use of a combination of antibiotic drugs, antiprotozoal drugs, bismuth, and either an H2 blocker drug or a proton pump inhibitor drug. a. Helicobacter pylori are helical (spiral) bacteria. Incorrect Feedback: This statement is true. b. Helicobacter pylori have flagella (thin, whip-like tails). Incorrect Feedback: This statement is true. c. Helicobacter pylori are the cause of some gastric ulcers. Incorrect Feedback: This statement is true. 43. Irritable bowel syndrome, characterized with cramping and diarrhea alternating with constipation, is treated with all of the following categories of drugs EXCEPT ______. a. antianxiety drugs b. lipase inhibitor drugs c. antispasmodic drugs d. antidiarrheal drugs and laxative drugs Answer: b. lipase inhibitor drugs Correct Feedback: Irritable bowel syndrome is a chronic disease of the colon that is characterized by severe spasms, cramping, abdominal pain, bloating, excessive mucus secretion, and diarrhea alternating with constipation. Irritable bowel syndrome is treated with the antispasmodic drugs, as well as with antianxiety, antidiarrheal, and laxative drugs. Lipase inhibitor drugs are used to treat obesity. a. antianxiety drugs Incorrect Feedback: Irritable bowel syndrome is treated with antianxiety drugs. c. antispasmodic drugs Incorrect Feedback: Irritable bowel syndrome is treated with antispasmodic drugs. d. antidiarrheal drugs and laxative drugs Incorrect Feedback: Irritable bowel syndrome is treated with both antidiarrheal drugs and laxative drugs. 44. Gastric stimulant drugs, such as metoclopramide (Maxolon, Reglan) are used in all of the following ways EXCEPT ______. a. to treat nausea and vomiting b. to empty the intestines prior to an x-ray c. to prevent abdominal distention after major abdominal surgery d. to treat gastroparesis (delayed gastric emptying in diabetic patients) Answer: a. to treat nausea and vomiting Correct Feedback: Gastric stimulant drugs are used to treat gastroparesis (delayed gastric emptying in diabetic patients), to facilitate emptying of the intestines prior to x-rays, to facilitate excretion of barium after an x-ray, or to prevent distention and paralytic ileus from developing after major abdominal surgery. b. to empty the intestines prior to an x-ray Incorrect Feedback: This is a true statement. c. to prevent abdominal distention after major abdominal surgery Incorrect Feedback: This is a true statement. d. to treat gastroparesis (delayed gastric emptying in diabetic patients) Incorrect Feedback: This is a true statement. 45. Ulcerative colitis is a chronic disease of the esophagus and stomach. Answer: False Feedback: Ulcerative colitis is a chronic disease of the colon and rectum. 46. All peptic ulcers are caused by excessive amounts of hydrochloric acid that irritate the mucous membrane. Answer: True Feedback: All peptic ulcers are caused by irritation of the mucous membranes that line the gastrointestinal tract. This irritation is caused by excessive amounts of hydrochloric acid. 47. Simethicone is available as a drug to treat gas and can be combined with other drugs because of its antacid properties. Answer: False Feedback: Simethicone is available as a drug to treat gas and is often combined with antacid drugs, but it has no antacid action of its own. 48. Narcotic drugs are most commonly used for pain relief, but have a common side effect of causing constipation which is used as the therapeutic effect in treating diarrhea. Answer: True Feedback: As a class of drugs, narcotic drugs are most commonly used for their pain-relieving properties. However, a common side effect of these drugs is constipation, so this side effect then becomes the therapeutic effect in treating diarrhea. 49. Aminosalicylic acid and topical corticosteroid drugs are both used to treat ulcerative colitis, but aminosalicylic acid has the more powerful anti-inflammatory effect. Answer: False Feedback: Topical corticosteroid drugs exert a more powerful antiinflammatory effect than aminosalicylic acid. 50. The chemotherapy drug methotrexate (Rhuematrex Dose Pack) is used to treat severe ulcerative colitis and Crohn’s disease. True Answer: True Feedback: Methotrexate is a chemotherapy drug that is used to treat severe ulcerative colitis and Crohn’s disease. 51. Patients who are unable to undergo surgery to remove gallstones from the gallbladder can be given drugs to help the gallstones dissolve. Answer: True Feedback: Patients who are unable to undergo surgery to remove gallstones from the gallbladder can be given drugs to help dissolve the stones. 52. Appetite suppressant drugs for obesity are chemically related to amphetamine drugs, but are less addictive than amphetamine drugs. Answer: True Feedback: Appetite suppressant drugs are similar in chemistry to amphetamine drugs, but with less addictive properties. 53. Patients who are actively vomiting and cannot take oral drugs can be given the antiemetic drug Compazine in the form of a rectal suppository. Answer: True Feedback: If the patient is vomiting frequently and cannot take an oral drug, Compazine is also available in a rectal suppository form. 54. Lipase inhibitor drugs chemically bond to the enzyme lipase so that it can act to break down dietary fat in the intestines. Answer: False Feedback: Lipase inhibitor drugs chemically bond to the enzyme lipase so that it cannot break down dietary fat in the intestines. 55. Patients taking appetite suppressant drugs for obesity may develop dependence and withdrawal symptoms if these drugs are discontinued abruptly, because these are Schedule III and Schedule IV drugs. Answer: True Feedback: Patients may develop drug dependence and experience withdrawal symptoms if appetite suppressant drugs are discontinued abruptly because these are Schedule III and Schedule IV drugs. 56. Cimetidine (Tagamet) was the first H2 blocker prescription drug to be approved by the FDA for over-the-counter use. Answer: False Feedback: All H2 blocker drugs originally were approved as prescription drugs. Then famotidine (Pepcid) became the first to be approved by the FDA for over-the-counter use. 57. An antagonist is another name for a drug, such as the H2 blocker drug famotidine (Pepcid), that blocks a receptor. Answer: True Feedback: An antagonist is another name for a drug that blocks a receptor. 58. The trade name AciPhex refers to the drug’s action on the production of hydrochloric acid in the stomach and the pH of the stomach. Answer: True Feedback: Proton pump inhibitor drugs decrease the production of hydrochloric acid in the stomach and raise the pH of the stomach contents. The trade name drug AcipHex refers to the drug’s action on the pH of the stomach. 59. Anticholinergic drugs are used to treat diarrhea because they decrease the rate of peristalsis in the GI tract. Answer: True Feedback: Antidiarrheal drugs produce a therapeutic effect by slowing peristalsis in the intestinal tract (anticholinergic drugs). 60. The antidiarrheal drug attapulgite is an absorbent drug that contains an aluminummagnesium compound taken from clay soil. Answer: True Feedback: Attapulgite is an aluminum-magnesium compound found in clay soil. 61. The trade name drugs Nupercainal, Anusol, Cortifoam, and ProctoFoam NS are all used to treat hemorrhoids. Answer: True Feedback: Drugs used to treat hemorrhoids include dibucaine (Nupercainal), hydrocortisone (Anusol, Cortifoam, Proctocort), and pramoxine (ProctoFoam NS, Tronolane). 62. Peptic ulcers in the stomach are specifically known as _______ ulcers. Answer: gastric Feedback: Peptic ulcers in the stomach are specifically known as gastric ulcers. 63. Spasms of the smooth muscles of the GI tract, which can cause abdominal pain, can be relieved by antispasmodic drugs, which are also known as __________ drugs. Answer: anticholinergic Feedback: Intestinal conditions, such as irritable bowel syndrome, spastic colon, diverticulitis, and even peptic ulcers, can be accompanied by abdominal pain due to spasms of the smooth muscle of the GI tract. These spasms can be relieved by antispasmodic drugs, which are also known as anticholinergic drugs. 64. ________ drugs are used to control the nausea and vomiting that is associated with many different diseases. Answer: Antiemetic Feedback: Antiemetic drugs are used to control nausea and vomiting associated with many different diseases. 65. Patients who are on long-term aspirin or nonsteroidal anti-inflammatory drug (NSAID) therapy can develop gastric ulcers because these drugs inhibit the formation of __________ that normally protect the gastric mucosa. Answer: prostaglandins Feedback: Patients on long-term therapy with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) can develop gastric ulcers. This is a common side effect because aspirin and NSAIDs inhibit the formation of prostaglandins. Prostaglandins normally protect the gastric mucosa. 66. GERD occurs when stomach acid flows back into the esophagus causing irritation, inflammation, and pain. The abbreviation GERD stands for _________. Answer: gastroesophageal reflux disease Feedback: Gastroesophageal reflux disease (GERD) occurs when stomach acid refluxes or flows back into the esophagus. 67. __________ is a sensation of lightheadedness, dizziness, and whirling caused by irritation or infection in the inner ear that upsets the balance and stimulates the vomiting center. Answer: Vertigo Feedback: Vertigo is a sensation of lightheadedness, dizziness, and whirling caused by irritation or infection in the inner ear that upsets the balance and stimulates the vomiting center. 68. The antacid drugs Alka-Mints, Chooz, Maalox Antacid Barrier, and Tums Ultra contain only __________ as their active ingredient. Answer: calcium Feedback: The antacid drugs Alka-Mints, Chooz, Maalox Antacid Barrier, and Tums Ultra contain only calcium as their active ingredient. 69. Define these abbreviations. MOM _______________ NSAID ______________ Answer: milk of magnesia, nonsteroidal anti-inflammatory drug 70. In 1977, the first H2 blocker drug was created. Its trade name, ___________ was formed from a combination of syllables from the words antagonist and cimetidine. Answer: Tagamet Feedback: In 1977, the first H2 blocker drug was created and given the generic name cimetidine. Syllables from antagonist and cimetidine were combined to make the drug’s trade name Tagamet. 71. Maggie Floyd informs you that she is taking “the purple pill” for her GERD, but she can’t remember the name of it. _______ is the trade name of the drug is she taking. Answer: Nexium Feedback: The prescription proton pump inhibitor drug Nexium is used to treat gastroesophageal reflux disease, esophagitis, and peptic ulcer disease. This drug is known by patients as “the purple pill.” 72. The laxative drug Ceo-Two is a suppository that releases foam that contains the gas _______ to soften the stool. Answer: carbon dioxide Feedback: Carbon dioxide gas is used as a foam softens the stool; Ceo-Two is a carbon dioxide-releasing suppository. 73. In the phrase antiemetic drug, the combining form emet/o- means to _____. Answer: vomit Feedback: The drug label states that it is an antiemetic drug. The prefix anti- means against, and the combining form emet/o- means to vomit. 74. 1. sibutramine (Meridia) A. anticholinergic drug 2. docusate (Colace, Surfak) B. antiemetic drug 3. adalimumab (Humira) C. bulk-producing laxative drug 4. loperamide (Imodium AD, K-Pek II) D. gastric stimulant drug 5. metoclopramide (Maxolon, Reglan) E. H2 blocker drug 6. methylcellulose (Citrucel) F. lipase inhibitor drug 7. omeprazole (Prilosec) G. monoclonal antibody drug 8. orlistat (Alli, Xenical) H. appetite suppressant drug 9. prochlorperazine (Compazine) I. proton pump inhibitor drug 10. ranitidine (Zantac) J. stool softener laxative drug Answer: H Answer: J Answer: G Answer: A Answer: D Answer: C Answer: I Answer: F Answer: B Answer: E Feedback: These drugs and their categories are found throughout the chapter. 75. Describe how peptic ulcers develop and some of the drug categories used to treat them. Answer: All peptic ulcers are caused by irritation of the mucous membranes lining the gastrointestinal tract. This irritation is caused by excessive amounts of hydrochloric acid, which strips away the protective mucus of the mucous membrane. Then the subsequent action of pepsin, a protein-digesting enzyme, begins to break down the underlying membrane. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and caffeine also irritate the mucous membranes and can contribute to ulcer formation. Treatment for peptic ulcer diseases includes antacid drugs, H2 blocker drugs, and proton pump inhibitor drugs. 76. There are six different classes of laxative drugs. Pick two and explain how they work. Answer: 1. Osmotic laxative drugs use osmosis and osmotic pressure to attract water from the blood into the intestine to soften the stool. 2. Bulk-producing laxative drugs contain indigestible fiber and other substances that absorb and hold water in the intestines to soften the stool. 3. Stool softener drugs are emulsifiers that allow fat in the stool to mix with water to make the stool soft. 4. Chloride channel laxative drugs stimulate chloride channels in the mucosa of the intestinal wall. This causes fluid to flow into the intestines to soften the stool. 5. Irritant/stimulant laxative drugs act directly on the intestinal mucosa to stimulate peristalsis. 77. Renee Alexander regularly gets heartburn. For this, she takes a calcium-containing antacid drug and it makes her stomach feel better. She reasons that it is also good for her bones, so she doesn’t see the need to drink milk or eat yogurt. What would you as a healthcare professional tell her? Answer: The use of calcium-containing antacid drugs should not take the place of adequate calcium intake in the diet. 78. Describe two of the four criteria that were met in order for the FDA to approve prescription H2 blocker drugs to be released as over-the-counter drugs. Answer: The FDA approves a prescription drug being reclassified as an OTC drug if the following criteria are met: 1. The indication for the drug’s OTC use is similar to its use as a prescription drug; 2. The patient can easily monitor his or her own condition when using the OTC drug; 3. The OTC drug has a low rate of side effects/toxicity and a low potential for abuse; and 4. Use of the OTC drug does not require the patient to have any special monitoring or ongoing tests. Over-the-counter H2 blocker drugs meet all of these requirements. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268

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