Drugs In Practice

Drugs for GERD and Peptic Ulcer Disease

QUICK RECAP: CME QUESTIONS ON "DRUGS IN PRACTICE" IN THIS ISSUE

1. Lifestyle modifications for treatment of gastroesophageal reflux disease (GERD) include: a. weight loss in patients who are overweight b. not lying down for at least 2 hours after eating or drinking c. elevating the head of the bed d. all of the above a. an H2-receptor antagonist (H2RA) b. a proton pump inhibitor (PPI) c. a magnesium-based antacid d. a calcium carbonate-based antacid

2. Which of the following is generally preferred for treatment of erosive esophagitis in GERD?

3. Compared to PPIs, H2RAs: a. have a faster onset of action b. have a longer duration of action c. are less likely to lose efficacy because of development of tolerance d. all of the above a. switch to twice-daily dosing of the PPI b. switch to an H2RA c. add an H2RA d. add sucralfate a. 15 mg b. 20 mg c. 36 mg d. 60 mg

4. A 36-year-old woman with erosive esophagitis taking a standard dose of a PPI once daily for the past 4 weeks still has symptoms. Which of the following should you recommend first?

5. A 20-mg dose of rabeprazole is equivalent to what dose of omeprazole?

6. The FDA has issued safety warnings about an association between long-term PPI use and: a. hypomagnesemia b. vitamin B12 deficiency c. all-cause mortality d. all of the above

7. All patients with peptic ulcer disease should be treated with: a. an antacid b. an H2RA c. a PPI d. sucralfate a. clarithromycin triple therapy b. bismuth quadruple therapy c. levofloxacin triple therapy d. metronidazole triple therapy a. its efficacy in eradicating H. pylori has been diminished by increasing antimicrobial resistance b. it has been associated with an increased risk of adverse cardiac effects in patients with coronary artery disease c. it can increase serum concentrations of drugs metabolized by CYP3A4 d. all of the above

8. Which of the following regimens is preferred for empiric treatment of Helicobacter pylori infection?

9. Which of the following statements about the use of clarithromycin is true?

10. Misoprostol can prevent and heal gastroduodenal ulcers in patients who must take NSAIDs chronically, but it: a. requires multiple daily doses b. can cause severe GI toxicity c. is an abortifacient d. all of the above