Question 1

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?

Accepted Answer

Patients with kidney stones should be cautious with calcium carbonate antacids, as they can increase calcium levels and potentially worsen stone formation.

Question 2

Which of the following medications places a patient at increased risk of developing chronic kidney disease?

Accepted Answer

Omeprazole, a proton pump inhibitor (PPI), can increase the risk of chronic kidney disease. Long-term use of PPIs has been associated with an increased risk of kidney damage, including chronic kidney disease, by potentially causing acute interstitial nephritis, which can progress to chronic kidney disease if not recognized and managed.

Question 3

A 15-year-old patient presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is four pounds less than her last recorded weight. Besides intravenous (IV) fluids, the exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order?

Accepted Answer

Ondansetron (Zofran) is often the drug of choice for nausea and vomiting, especially in cases where the patient is unable to keep fluids down, due to its effectiveness and safety profile. It is commonly used in both adults and children, making it appropriate for a 15-year-old patient.

Question 4

A patient presents with complaints of heartburn that is minimally relieved with Tums (calcium carbonate) and is diagnosed as gastroesophageal reflux disease (GERD). An appropriate on-demand therapy would be:

Accepted Answer

The answer of A patient presents with complaints of heartburn...

Question 5

Patients taking antacids should be educated regarding these drugs, including letting them know that:

Accepted Answer

Antacids can cause gastrointestinal side effects such as constipation or diarrhea, many formulations are high in sodium which can be a concern for patients with hypertension or heart failure, and they can interfere with the absorption of other medications, hence the recommendation to separate their intake by at least one hour from other drugs.

Question 6

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:

Accepted Answer

Chronic use of proton pump inhibitors can lead to deficiencies in vitamin B12, calcium, and iron due to reduced stomach acid, which is necessary for the absorption of these nutrients.

Question 7

A 10-year-old patient presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

Accepted Answer

The answer of A 10-year-old patient presents with uncomfortable constipation....

Question 8

Bismuth subsalicylate (Pepto-Bismol) is a common over-the-counter (OTC) remedy for gastrointestinal complaints. Bismuth subsalicylate:

Accepted Answer

The answer of Bismuth subsalicylate (Pepto-Bismol) is a common over-the-counter...

Question 9

A 72-year-old patient takes omeprazole for their chronic GERD. Chronic long-term omeprazole use places them at increased risk for:

Accepted Answer

The answer of A 72-year-old patient takes omeprazole for their...

Question 10

An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:

Accepted Answer

Lactulose can cause electrolyte imbalances, including hypokalemia and hypernatremia, especially with long-term use, so monitoring electrolytes is important.

Question 11

A patient has diarrhea and is wondering if they can take loperamide (Imodium). Loperamide:

Accepted Answer

Loperamide works by slowing down the movement of the gut, which decreases the speed at which the contents pass through, allowing more time for water and electrolytes to be absorbed, thus reducing fluid and electrolyte loss from diarrhea.

Question 12

Methylnaltrexone is used to treat constipation in:

Accepted Answer

Methylnaltrexone is specifically used to treat opioid-induced constipation in patients who are receiving palliative care or those with chronic non-cancer pain, as it counteracts the constipating effects of opioids on the gut without affecting pain relief.

Question 13

A young adult will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:

Accepted Answer

Bismuth subsalicylate can be used prophylactically to reduce the risk of traveler's diarrhea by taking it before each meal and at bedtime.

Quiz 17: Drugs Affecting the Gastrointestinal System