Deck 8: Gastrointestinal Agents

Question 1

Which of the following counseling points concerning Tums tablets is FALSE?

A) Patients should consult their doctors if symptoms persist for longer than 2 weeks.
B) Patients should not take more than 7,000 mg of calcium carbonate daily.
C) Tums may be taken at the same time as ciprofloxacin.
D) Tablets should be chewed before swallowing.

Answer 1

C

Question 2

What is the correct indication for simethicone?

A) Acid reflux
B) Diarrhea
C) Gas
D) Nausea

Answer 2

C

Question 3

All of the following serious adverse effects are associated with loperamide, EXCEPT:

A) Ileus
B) Necrotizing enterocolitis
C) Toxic megacolon
D) Vancomycin-resistant enterococcus (VRE) superinfection

Answer 3

D

Question 4

All of the following are dosage forms of psyllium, EXCEPT:

A) Capsules
B) Liquid
C) Powder
D) Wafers

Question 5

Which of the following brand: generic name pairs do NOT match?

A) Bentyl: Dicyclomine
B) Prilosec: Esomeprazole
C) Reglan: Metoclopramide
D) Tagamet: Cimetidine

Question 6

Which of the following medications require adjustment for renal insufficiency?

A) Loperamide
B) Ondansetron
C) Pantoprazole
D) Ranitidine

Question 7

Which of the following drug class: medication pairs are CORRECT?

A) Bismuth subsalicylate: Bulk-forming laxative
B) Cimetidine: Anticholinergic
C) Metoclopramide: Prokinetic agent
D) Rabeprazole: H₂ Antagonist

Question 8

What is the mechanism of action of Bentyl?

A) Acts peripherally on opioid receptors
B) Blocks H⁺/K⁺-ATPase in the gastric parietal cells
C) Blocks the action of acetylcholine at parasympathetic sites
D) Competitively inhibits histamine at H₂ receptors

Question 9

Which of the following is a contraindication to polyethylene glycol therapy?

A) Aspirin allergy
B) Baseline QT prolongation
C) Bone marrow depression
D) Bowel obstruction

Question 10

All of the following are indications of prochlorperazine, EXCEPT:

A) Anxiety
B) Nausea/vomiting
C) Peptic ulcer
D) Schizophrenia

Question 11

Prochlorperazine has fallen out of favor due to a high incidence of adverse effects. Which of the following adverse effects has been associated with prochlorperazine?

A) Drug-induced Parkinson's syndrome
B) Extrapyramidal effects
C) Tardive dyskinesia
D) All of the above

Question 12

Anticholinergic side effects of Bentyl include all of the following, EXCEPT:

A) Blurry vision
B) Diarrhea
C) Dry mouth
D) All of the above

Question 13

Which of the following proton pump inhibitors is available as a prescription only?

A) Esomeprazole
B) Lansoprazole
C) Omeprazole
D) Rabeprazole

Question 14

Which of the following agents may be used as a prokinetic agent in patients with diabetic gastroparesis and as an antiemetic for chemotherapy-induced nausea and vomiting?

A) Dicyclomine
B) Metoclopramide
C) Prochlorperazine
D) Simethicone

Question 15

Which of the following counseling points regarding MiraLAX is FALSE?

A) Adverse GI effects such as gas and bloating are considerably more common with MiraLAX than other laxatives.
B) Results may not be seen for 2-4 days.
C) MiraLAX may be used safely for up to 6 months in patients with chronic constipation.
D) Mix 1 tablespoon of MiraLAX powder with 4-8 oz of water and drink.

Question 16

A patient approaches the pharmacy counter to ask for advice regarding over-the-counter laxatives. He recently had surgery and has been taking chronic opioid analgesics for the past 3 weeks. His last bowel movement was 7 days ago, he is not passing any gas, and complains of abdominal pain and distension; he is concerned that he may have a bowel obstruction. What is the best recommendation for this patient?

A) Metamucil
B) Metoclopramide
C) MiraLAX
D) Refer him to a physician

Question 17

Which of the following agents is an antidiarrheal?

A) Bismuth subsalicylate
B) Calcium carbonate
C) Magnesium hydroxide/aluminum hydroxide
D) Simethicone

Question 18

Which of the following counseling statements regarding antacids is/are true?

A) Aluminum containing compounds may accumulate in patients with renal dysfunction.
B) Contact a physician if prolonged use (greater than 2 weeks) is required.
C) Patients should separate administration of antacids from other medications by 1-2 hours.
D) All of the above.

Question 19

Palonosetron is only available in which of the following dosage forms?

A) Injection
B) Oral solution
C) Orally disintegrating tablet
D) Rectal suppository

Question 20

Which of the following agents would not require a dosage adjustment in an 86-year-old woman with a CrCl < 30 ml/min?

A) Pepcid
B) Reglan
C) Imodium
D) Zantac

Question 21

Ondansetron is available in all of the following dosage forms, EXCEPT:

A) Injection
B) Oral solution
C) Orally disintegrating tablet
D) Rectal suppository

Question 22

Which of the following products contains polyethylene glycol 3350?

A) HalfLytely Bowel Prep Kit
B) MiraLAX
C) MoviPrep
D) All of the above

Question 23

Lubiprostone is the first agent in a new class of drugs used to treat what condition?

A) Gastroesophageal reflux
B) Irritable bowel syndrome with constipation
C) Motion sickness
D) NSAID-induced ulcers

Question 24

A physician calls the pharmacy asking for a recommendation to help treat a patient with mild GERD. While talking to the physician, you learn that the patient is on hemodialysis three times a week. Which of the following H₂ receptor antagonists requires a dosing adjustment?

A) Tagamet
B) Pepcid
C) Zantac
D) All of the above

Question 25

How soon after taking Senna should a patient expect to have a bowel movement?

A) 15-30 minutes
B) 1-2 hours
C) 6-12 hours
D) 24-48 hours

Question 26

A patient is picking up a new prescription for levothyroxine at the pharmacy counter. You notice that she is also purchasing Maalox from the OTC section. What counseling points are appropriate for this patient?

A) Maalox may decrease the efficacy of levothyroxine; recommend Tums.
B) Maalox may increase the efficacy of levothyroxine; recommend Tums.
C) Separate Maalox from the dose of levothyroxine by at least two hours.
D) Separate Maalox from the dose of levothyroxine by at least 30 minutes.

Question 27

Which of the following agents is indicated for bowel evacuation prior to colonoscopy?

A) HalfLytely
B) Phosphorated carbohydrate solution
C) Psyllium
D) Senna

Question 28

Which of the following is/are true regarding Emetrol?

A) Emetrol contains a high amount of sugar.
B) Emetrol is available by prescription only.
C) Emetrol should be diluted with 4-8 oz of water prior to consumption.
D) All of the above.

Question 29

Which of the following proton pump inhibitors is available intravenously?

A) Lansoprazole
B) Pantoprazole
C) Rabeprazole
D) All of the above

Question 30

Which of the following medication: drug class pairs is CORRECT?

A) Bismuth subsalicylate: Bulk-forming laxative
B) Cimetidine: Anticholinergic
C) Metoclopramide: Prokinetic agent
D) Rabeprazole: H₂ Antagonist

Question 31

All of the following are indications of prochlorperazine, EXCEPT:

A) Anxiety
B) Nausea/vomiting
C) Peptic ulcer disease
D) Schizophrenia

Question 32

Which of the following side effects have NOT been associated with PPI use?

A) Clostridium difficile infection
B) Hypomagnesemia
C) Osteoporosis-related bone fracture
D) QT-prolongation

Question 33

Which of the following dosing instructions regarding Nexium is FALSE?

A) Oral/IV: 20-40 mg 1 to 2 times daily (dose- and frequency-dependent on indication)
B) 17 g of powder (1 capful filled to line) dissolved in 4-8 oz. of water daily; speak to a physician regarding use > 7 days
C) IV infusion: 80 mg bolus, followed by 8 mg/hour for 72 hours; convert to oral form thereafter
D) Hepatic dosage adjustment: In cases of severe hepatic impairment (Child-Pugh Class C), maximum dose is 20 mg per day

Question 34

Anticholinergic side effects of dicyclomine include all of the following, EXCEPT:

A) Blurry vision
B) Diarrhea
C) Dry mouth
D) All of the above

Question 35

All of the following statements regarding bisacodyl are false, EXCEPT:

A) Bisacodyl is frequently used as part of a bowel preparation regimen prior to colonoscopy.
B) Bisacodyl is recommended as a first-line agent for treatment of constipation in the elderly.
C) Bisacodyl is recommended for chronic use in patients with persistent constipation.
D) Bisacodyl is better at preventing constipation than treating acute episodes.