1.
Decreased colonic activity may be due to:
Correct Answer(s)
A. Drugs
C. Depression, confusional states
D. Various local conditions including carcinoma
E. Old age, immobility
Explanation
Decreased colonic activity can be caused by various factors such as drugs, depression, confusional states, various local conditions including carcinoma, old age, and immobility. Drugs can have a suppressive effect on the colon, leading to decreased activity. Depression and confusional states can also affect the functioning of the colon. Various local conditions, including carcinoma (cancer), can disrupt the normal activity of the colon. Additionally, old age and immobility can contribute to decreased colonic activity.
2.
Drugs that cause obstipation:
Correct Answer(s)
A. Anticholinergic agents
B. Ca channel antagonists
C. Opioids
D. Tricyclic antidepressants
Explanation
The drugs listed in the question, including anticholinergic agents, Ca channel antagonists, opioids, and tricyclic antidepressants, can all cause obstipation. Obstipation refers to severe constipation or the inability to pass stool. These drugs can cause this side effect due to their impact on the gastrointestinal system. Anticholinergic agents and opioids can slow down bowel movements, while Ca channel antagonists and tricyclic antidepressants can affect the smooth muscle in the intestines, leading to constipation. Therefore, all of these drugs can contribute to obstipation.
3.
Plant fiber (a laxative, purgative)
Correct Answer(s)
A. Increases the bulk of the stools
C. Slowly distends the wall of the colon
E. Takes up water and swells
Explanation
Plant fiber acts as a laxative and purgative by increasing the bulk of the stools. This means that it adds more volume to the stool, making it easier to pass. Additionally, plant fiber slowly distends the wall of the colon, which helps stimulate bowel movements. It also takes up water and swells, further softening the stool and aiding in its passage. These effects combined contribute to the overall effectiveness of plant fiber as a natural remedy for constipation.
4.
Lactulose
Correct Answer(s)
C. Is broken down to unabsorbed organic anions which retain fluid
E. Is of particular value in the treatment of hepatic encepHalopathy
Explanation
Lactulose is a monosaccharide that is broken down in the small intestine by bacteria. During this breakdown process, it is converted into unabsorbed organic anions which have the ability to retain fluid. This property of lactulose makes it useful as a laxative, as it increases the water content in the stool, making it easier to pass. Additionally, lactulose is particularly valuable in the treatment of hepatic encephalopathy, a condition characterized by impaired brain function due to liver disease. Lactulose helps in the management of this condition by reducing the levels of ammonia in the blood, which is toxic to the brain.
5.
Lactulose is of particular value in the treatment of encephalopathy:
Correct Answer(s)
A. As it discourages the proliferation of ammonia producing organisms
B. As it decreases the absorption of ammonia
D. As it acidifies the stools
Explanation
Lactulose is of particular value in the treatment of encephalopathy because it discourages the proliferation of ammonia producing organisms, decreases the absorption of ammonia, and acidifies the stools. These actions help to reduce the levels of ammonia in the body, which is important in managing encephalopathy. By discouraging the growth of ammonia producing organisms and decreasing ammonia absorption, lactulose helps to prevent the buildup of ammonia in the bloodstream. Additionally, acidifying the stools can promote the excretion of ammonia through the feces. Overall, these effects of lactulose contribute to the improvement of CNS functions after absorption from the gastrointestinal tract.
6.
Magnesium sulfate
Correct Answer(s)
C. Increases the secretion of cholecystokinin
D. Increases gastric, intestinal and pancreatic secretion
E. Should be given in dilute solution to a fasting individual
Explanation
Magnesium sulfate increases the secretion of cholecystokinin, a hormone that stimulates the release of bile from the gallbladder. It also increases gastric, intestinal, and pancreatic secretion, which aids in digestion. When given in a dilute solution to a fasting individual, it can effectively act as a laxative within 1-2 days.
7.
Glycosides of senna:
Correct Answer(s)
A. Their laxative effect is limited mainly to the large intestine
C. After absorption they are secreted in the bile, breast milk and colon
D. Prior to absorption Senna glycosides are hydrolyzed to active principles
E. Their hydrolysis into the sennosides A and B is due to colonic bacteria
Explanation
Glycosides of senna have a limited laxative effect mainly in the large intestine. After being absorbed, they are secreted in the bile, breast milk, and colon. Before absorption, Senna glycosides are hydrolyzed to active principles. The hydrolysis of these glycosides into sennosides A and B is caused by colonic bacteria.
8.
Senna alkaloids (anthraquinones, the sennosides A and B)
Correct Answer(s)
A. Act directly on the intramucosal plexus of the gut wall
C. Should not be given to pregnant women
D. Should not be given to nursing mothers
E. Can induce diarrhea with excessive loss of water and electrolytes
Explanation
Senna alkaloids, specifically anthraquinones and sennosides A and B, have a direct effect on the intramucosal plexus of the gut wall. This means that they act directly on the nerves and cells within the gut wall, leading to their laxative effects. Pregnant women and nursing mothers should not be given senna alkaloids because they can potentially harm the developing fetus or pass into breast milk. Additionally, senna alkaloids can induce diarrhea, which can result in excessive loss of water and electrolytes.
9.
Glycerol (in the form of rectal suppositories)
Correct Answer(s)
A. Is useful if a rapid effect is required
B. Acts as a rectal stimulant due to local irritant action
D. Rectal suppositories promote colonic evacuation in 30 minutes
Explanation
Glycerol in the form of rectal suppositories is useful if a rapid effect is required because it can be absorbed quickly through the rectal mucosa. It acts as a rectal stimulant due to its local irritant action, which helps to stimulate bowel movements. Rectal suppositories promote colonic evacuation in 30 minutes, providing a relatively fast relief for constipation. However, it does not exert severe diarrhea with loss of water and electrolytes, making it a safer option compared to some other laxatives.
10.
Changes after prolonged use of laxatives:
Correct Answer(s)
A. The colon becomes dilated and atonic
C. Sodium depletion can be induced (hypotension, secondary aldosteronism)
E. Changes are due to prolonged use of stimulant laxatives
Explanation
Prolonged use of laxatives can cause the colon to become dilated and atonic, meaning it becomes stretched out and loses its muscle tone. This can lead to decreased activity in the colon. Additionally, the use of laxatives can induce sodium depletion, which can result in symptoms such as hypotension and secondary aldosteronism. Another potential effect of prolonged laxative use is the induction of hyperkalemia, which can cause weakness and increased urine production. These changes specifically occur when stimulant laxatives are used over a long period of time.
11.
In the treatment of acute diarrhea
Correct Answer(s)
A. Antibiotics are best avoided in non-pathogenic diarrhea
B. Antibiotics are best avoided in viral gastroenteritis
C. Oral rehydration should be used for initial therapy
D. Electrolytes and glucose should be supplemented for initial therapy
E. Oral rehydration and electrolytes supplementation are required particularly in children and in the elderly
Explanation
In the treatment of acute diarrhea, antibiotics are best avoided in non-pathogenic diarrhea and viral gastroenteritis because these conditions are usually caused by viruses or non-pathogenic bacteria that do not respond to antibiotics. Oral rehydration should be used for initial therapy because it helps replace the lost fluids and electrolytes due to diarrhea. Additionally, electrolytes and glucose should be supplemented for initial therapy to maintain the body's electrolyte balance and provide energy. This is particularly important in children and the elderly who are more susceptible to dehydration.
12.
In patients with diarrhea the following can be used:
Correct Answer(s)
A. Antibiotics to treat systemic illness
B. Antibiotics in evidence of bacterial infection
D. Antidiarrheal drugs increasing bulk and viscosity of the gut contents
E. Opioids, antimuscarinics
Explanation
The given answer suggests that in patients with diarrhea, antibiotics can be used to treat systemic illness and in evidence of bacterial infection. Additionally, antidiarrheal drugs that increase the bulk and viscosity of the gut contents can be used, along with opioids and antimuscarinics. This implies that antibiotics are appropriate for treating both systemic illness and bacterial infections, while antidiarrheal drugs, opioids, and antimuscarinics can help manage the symptoms of diarrhea by increasing bulk and viscosity or by targeting specific receptors in the gut.
13.
Drugs increasing intestinal transit time are:
Correct Answer(s)
A. Codeine (an opioid)
B. MorpHine (an opioid)
C. Loperamide
D. DipHenoxylate
Explanation
Codeine and morphine are opioids that act on the mu-opioid receptors in the gastrointestinal tract, leading to an increase in intestinal transit time. This means that they slow down the movement of food through the intestines, resulting in a longer time for digestion and absorption of nutrients. Loperamide and diphenoxylate are both anti-diarrheal medications that also work by slowing down intestinal transit time. They do this by inhibiting the muscle contractions in the intestines, reducing the movement of stool and increasing the time it takes for it to pass through the digestive system. Fysostigmine, on the other hand, is not known to increase intestinal transit time and is therefore not included in the list of drugs that do so.
14.
Peptic ulcer disease
Correct Answer(s)
A. Is a chronic disorder
B. Characterized by frequent recurrences
C. Comprises duodenal and peptic ulcers
Explanation
Peptic ulcer disease is a chronic disorder that is characterized by frequent recurrences. It comprises both duodenal and peptic ulcers. The incidence of duodenal ulcers is four to five times lower than that of gastric ulcers. This condition affects approximately 50% of the population.
15.
These are major factors of known importance for the etiology of ulceration:
Correct Answer(s)
A. Acid-pepsin secretion
B. Mucosal resistance to attack by acid and pepsin
D. Effects of non-steroidal anti-inflammatory drugs
E. The presence of Helicobacter pylori
Explanation
The major factors of known importance for the etiology of ulceration include acid-pepsin secretion, mucosal resistance to attack by acid and pepsin, effects of non-steroidal anti-inflammatory drugs, and the presence of Helicobacter pylori. These factors contribute to the development of ulcers by either increasing the acidity and aggressiveness of gastric secretions (acid-pepsin secretion), weakening the protective barrier of the stomach lining (mucosal resistance to attack), causing damage to the stomach lining (non-steroidal anti-inflammatory drugs), or by the presence of the bacteria Helicobacter pylori, which can lead to chronic inflammation and ulceration.
16.
Acid secretion
Correct Answer
B. Is stimulated by gastrin
Explanation
Acid secretion in the stomach is primarily stimulated by the hormone gastrin. Gastrin is produced by endocrine cells in the gastric antrum and acts on the parietal cells of the stomach to increase the production and release of gastric acid. Acetylcholine and histamine, on the other hand, inhibit acid secretion. Prostaglandin E, a hormone-like substance, also stimulates acid secretion in the stomach. Therefore, the correct answer is that acid secretion is stimulated by gastrin.
17.
Prostaglandin E2
Correct Answer(s)
A. Is the principal prostaglandin synthesized in the stomach
B. Is an important gastroprotective mediator
C. Inhibits secretion of acid
Explanation
Prostaglandin E2 is the principal prostaglandin synthesized in the stomach and is an important gastroprotective mediator. It helps protect the stomach lining by inhibiting the secretion of acid and promoting the secretion of protective mucus. This helps to maintain the balance of acid production and protection in the stomach, preventing damage to the stomach lining.
18.
Mucus layer is impaired by
Correct Answer(s)
C. Bile
D. Ethanol
E. Salicylates
Explanation
The mucus layer in the body is impaired by bile, ethanol, and salicylates. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats. When there is an excessive amount of bile in the body, it can damage the mucus layer. Ethanol, which is found in alcoholic beverages, can also impair the mucus layer. Salicylates, a type of medication commonly found in pain relievers, can have a similar effect. These substances can disrupt the protective barrier of the mucus layer, making the body more susceptible to infections and damage.
19.
Helicobacter pylori
Correct Answer(s)
A. Is a bacterium strongly linked to the development of gastric ulcer
B. Is usually found in the gastric antrum
D. Is a common cause of antral gastritis
E. May alleviate symptoms in dyspeptic patients
Explanation
Helicobacter pylori is a bacterium that is strongly associated with the development of gastric ulcers. It is typically found in the gastric antrum, which is a specific area of the stomach. The bacterium is a common cause of antral gastritis, which is inflammation of the antrum. Interestingly, it has been observed that H. pylori infection may actually alleviate symptoms in dyspeptic patients, although the exact mechanism for this is not fully understood.
20.
Helicobacter pylori
Correct Answer(s)
B. Clearance of H.pylori in ulcer patients is accompanied by a reduced rate of relapse
C. Its reappearance is associated with recurrent ulceration
D. Antral gastritis (caused by H.p.) is closely associated with duodenal ulcer
Explanation
The presence of Helicobacter pylori in the stomach of patients with duodenal ulcer is closely associated with antral gastritis and recurrent ulceration. When H. pylori is cleared in ulcer patients, there is a reduced rate of relapse. This suggests that H. pylori plays a significant role in the development and recurrence of duodenal ulcers. Antibiotics are unable to completely eradicate H. pylori, indicating that alternative treatment strategies may be needed to effectively manage this infection.
21.
Principles of ulcer management:
Correct Answer(s)
A. Symptomatic relief
B. Promotion of ulcer healing
C. Prevention of recurrence once healing has occurred
D. Prevention of complication
Explanation
The principles of ulcer management include providing symptomatic relief, promoting ulcer healing, preventing recurrence once healing has occurred, and preventing complications. These principles focus on addressing the symptoms of the ulcer, facilitating the healing process, ensuring that the ulcer does not reoccur, and minimizing any potential complications that may arise. By following these principles, healthcare professionals can effectively manage ulcers and improve the patient's overall well-being.
22.
General management of peptic ulcer disease:
Correct Answer(s)
B. Stopping smoking
C. Avoidance of strong coffee or tea
D. Avoidance of alcohol and non-steroid antiinflammatory drugs
E. Drug therapy of peptic ulcer
Explanation
The general management of peptic ulcer disease includes various measures to alleviate symptoms and promote healing. Stopping smoking is important because smoking can worsen symptoms and delay healing. Avoiding strong coffee or tea is recommended as they can stimulate acid production and irritate the stomach lining. Alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided as they can increase the risk of developing ulcers and hinder the healing process. Drug therapy is also an essential part of treating peptic ulcers, as medications like proton pump inhibitors or H2 blockers can help reduce stomach acid production and promote healing.
23.
Healing of ulcers should be confirmed by:
Correct Answer(s)
B. Repeat endoscopy
E. Biopsy is recommended to exclude malignancy in the case of gastric ulcer.
Explanation
The correct answer is repeat endoscopy and biopsy is recommended to exclude malignancy in the case of gastric ulcer. This is because repeat endoscopy allows for a visual examination of the ulcer to assess its healing progress. Additionally, a biopsy is necessary to rule out the possibility of malignancy, as gastric ulcers can sometimes be a symptom of stomach cancer. Monitoring AST, ALT, creatininemia, and natremia levels would not provide specific information about the healing of the ulcer or the presence of malignancy.
24.
Antacids:
Correct Answer(s)
A. React with gastric acid to form a neutral salt
B. Produce prompt pain relief
C. Are very effective at healing duodenal ulcer
Explanation
Antacids are substances that react with gastric acid in the stomach to form a neutral salt. This helps to neutralize the excess acid and reduce symptoms such as heartburn and indigestion. Additionally, antacids are known to provide prompt pain relief by reducing the acidity in the stomach. They are particularly effective at healing duodenal ulcers, which are sores that develop in the first part of the small intestine. However, it is important to note that antacids may not be as effective in healing gastric ulcers, which are sores that develop in the stomach lining. Lastly, the effect of antacids on acid secretion can last for a long duration, typically around 5 hours.
25.
Antacids involve:
Correct Answer(s)
A. Sodium bicarbonate
B. Magnesium salts (oxide, trisilicate, hydroxide)
E. Aluminum salts (hydroxide, pHospHate, glycinate)
Explanation
The correct answer includes sodium bicarbonate, magnesium salts (oxide, trisilicate, hydroxide), and aluminum salts (hydroxide, phosphate, glycinate). These substances are commonly used in antacids to help neutralize excess stomach acid and provide relief from heartburn and indigestion. Sodium bicarbonate acts as a quick-acting antacid, while magnesium salts and aluminum salts have a longer-lasting effect. They work by reacting with the acid in the stomach to form water and salt, reducing the acidity and relieving symptoms.
26.
Sodium bicarbonate (an antacid)
Correct Answer(s)
C. Produces carbon monoxide by reacting with hydrochloric acid
D. Causes belching and distension of the stomach
Explanation
The correct answer is "produces carbon monoxide by reacting with hydrochloric acid" and "causes belching and distension of the stomach". Sodium bicarbonate reacts with hydrochloric acid in the stomach to produce carbon dioxide gas, which can cause belching and distension of the stomach. It does not produce carbon monoxide. Sodium intake should be considered in patients with hypertension or heart failure as excessive sodium intake can worsen these conditions.
27.
Magnesium and aluminum salts
Correct Answer(s)
A. Do not undergo absorption so are effective locally
C. Can reduce the rate and extent of absorption of other drugs
D. Aluminum salts should be used with caution with any renal compromise
E. Magnesium and aluminum salts are taken 1-3 hours after meals and at bedtime.
Explanation
Magnesium and aluminum salts do not undergo absorption, which means they are not absorbed into the bloodstream. This property makes them effective locally, as they stay in the area where they are applied or ingested. Additionally, these salts can reduce the rate and extent of absorption of other drugs, potentially affecting their effectiveness. It is important to use aluminum salts with caution in individuals with renal compromise, as they may not be properly eliminated from the body. Lastly, magnesium and aluminum salts are typically taken 1-3 hours after meals and at bedtime to optimize their efficacy.
28.
H2 lytics:
Correct Answer(s)
A. At least 4 weeks´ treatment is required to achieve healing
C. When the drug is discontinued, relapse may occur
D. Include cimetidine, ranitidine, famotidine
Explanation
The correct answer includes the information that at least 4 weeks' treatment is required to achieve healing, when the drug is discontinued, relapse may occur, and the drugs cimetidine, ranitidine, and famotidine are included in the treatment. This suggests that these drugs are used for a condition that requires a prolonged treatment period for healing, and there is a risk of relapse if the treatment is stopped. Cimetidine, ranitidine, and famotidine are commonly used for conditions such as gastric ulcers or gastroesophageal reflux disease (GERD), where long-term treatment is often necessary for symptom relief and healing.
29.
Cimetidine (BELOMET, TAGAMET)
Correct Answer(s)
A. Inhibits cytochrome P 450 activity
B. Action on cytochrome P450 results in high plasma concentrations of theopHylline and opioid analgesic
C. Binds to androgen receptors and so can cause impotence and gynecomastia
E. Is effective in treatment both of duodenal and gastric ulcers
Explanation
Cimetidine inhibits cytochrome P 450 activity, which can result in high plasma concentrations of theophylline and opioid analgesics. Additionally, it binds to androgen receptors, which can lead to impotence and gynecomastia. Cimetidine is also effective in treating both duodenal and gastric ulcers.
30.
Ranitidine (ZANTAC)
Correct Answer(s)
A. Has lower affinity for cytochrome P 450 than cimetidine
C. Is preferable to cimetidine in the elderly
D. Has a similar profile of action to cimetidine
Explanation
Ranitidine (ZANTAC) has a lower affinity for cytochrome P 450 than cimetidine. This means that it is less likely to interact with other medications that are metabolized by cytochrome P 450, reducing the risk of drug-drug interactions. Additionally, ranitidine is preferable to cimetidine in the elderly, possibly due to its lower potential for adverse effects and drug interactions. Furthermore, ranitidine has a similar profile of action to cimetidine, meaning that it works in a similar way to reduce stomach acid production.
31.
Pirenzepine
Correct Answer(s)
A. Is an M1 muscarinic receptor antagonist
B. Can cause mild difficulty with accommodation and dry mouth
C. Can alter the rate of absorption of other drugs if given concurrently
Explanation
Pirenzepine is classified as an M1 muscarinic receptor antagonist, meaning it blocks the action of acetylcholine at M1 muscarinic receptors. This can lead to certain side effects such as mild difficulty with accommodation (the ability of the eye to focus on near objects) and dry mouth. Additionally, pirenzepine has the potential to affect the absorption rate of other drugs if taken at the same time. However, the use of pirenzepine is not recommended in patients with concomitant glaucoma, pyloric stenosis, or prostatic enlargement.
32.
Omeprazol
Correct Answer(s)
C. Inhibits the proton pump which secretes H ions into the gastric lumen
D. Is taken once daily
E. Degrades in the presence of moisture. Capsules are supplied in special containers
Explanation
Omeprazol inhibits the proton pump which secretes H ions into the gastric lumen. This means that it reduces the production of stomach acid, which can help with conditions like acid reflux and ulcers. It is taken once daily for optimal effectiveness. Additionally, Omeprazol degrades in the presence of moisture, so it is supplied in special containers to protect it from moisture and maintain its stability.
33.
Misoprostol
Correct Answer(s)
A. Is a synthetic analog of prostaglandin E1
B. Inhibits gastric acid secretion
C. Causes vasodilatation in the submucosa
Explanation
Misoprostol is a synthetic analog of prostaglandin E1, which means it has a similar structure and function to prostaglandin E1. It inhibits gastric acid secretion, which can help in treating conditions like ulcers. It also causes vasodilatation in the submucosa, which means it relaxes and widens the blood vessels in the inner lining of the digestive tract. This can help in improving blood flow and reducing inflammation. However, it is important to note that misoprostol is indicated especially in pregnancy for purposes like inducing labor or preventing and treating postpartum hemorrhage.
34.
Drugs enhancing mucosal resistance in the stomach are:
Correct Answer(s)
C. Sucralfate
D. Bismuth chelate
E. Carbenoxolone
Explanation
Sucralfate, bismuth chelate, and carbenoxolone are drugs that enhance mucosal resistance in the stomach. Sucralfate forms a protective barrier over the ulcer or damaged area, preventing further damage from stomach acid. Bismuth chelate has antimicrobial properties and can help reduce inflammation in the stomach lining. Carbenoxolone also forms a protective barrier and has anti-inflammatory effects. These drugs can be used to treat conditions such as peptic ulcers and gastritis by promoting healing and reducing symptoms.
35.
Bismuth chelate
Correct Answer(s)
A. Precipitates at acid pH to form a layer over the mucosal surface and ulcer base
B. This coat is protective against acid and pepsin digestion
D. May chelate with pepsin thus speeding ulcer healing
Explanation
Bismuth chelate precipitates at acid pH to form a layer over the mucosal surface and ulcer base. This layer acts as a protective barrier against acid and pepsin digestion, helping to prevent further damage to the ulcer. Additionally, bismuth chelate may chelate with pepsin, which can help speed up the healing process of the ulcer. However, it is important to note that bismuth chelate is not as effective as cimetidine in healing duodenal and gastric ulcers after 4-8 weeks of treatment.
36.
Sucralfate
Correct Answer(s)
A. Is used in the treatment of gastric and duodenal ulceration and chronic gastritis
C. Is a basic aluminum salt of sucrose octasulfate
D. In the presence of acid becomes a sticky adherent paste that retains antacid efficacy
E. Adherent paste coats the floor of ulcer craters exerting its acid neutralizing properties locally
Explanation
Sucralfate is used in the treatment of gastric and duodenal ulceration and chronic gastritis. It is a basic aluminum salt of sucrose octasulfate. In the presence of acid, it becomes a sticky adherent paste that retains antacid efficacy. This adherent paste coats the floor of ulcer craters, exerting its acid-neutralizing properties locally.
37.
Sucralfate
Correct Answer
E. In severe renal failure accumulation is a potential hazard.
Explanation
Sucralfate is a medication that forms a protective barrier in the stomach to prevent and treat ulcers. However, in severe renal failure, the drug can accumulate in the body and potentially cause harm. This is because sucralfate is excreted by the kidneys, and when the kidneys are not functioning properly, the drug may not be eliminated effectively, leading to higher levels in the body. Therefore, in severe renal failure, the use of sucralfate should be carefully monitored to avoid potential accumulation and associated hazards.
38.
Cisapride
Correct Answer(s)
C. Is used in gastroesopHageal reflux
D. Is used in dyspepsia and delayed gastric emptying
Explanation
Cisapride is a medication that is used in the treatment of gastroesophageal reflux, dyspepsia, and delayed gastric emptying. It helps to relieve symptoms such as heartburn, indigestion, and stomach discomfort by increasing the movement of the digestive system. By promoting motility of the gastrointestinal tract, cisapride can help to decrease the rate of gastric emptying, which can be beneficial in these conditions. However, it is important to note that cisapride has been withdrawn from the market in many countries due to safety concerns, so it may not be widely available.
39.
Which of the following medications is NOT commonly used in the treatment of gastrointestinal (GI) disorders?
Correct Answer
D. Beta-blockers
Explanation
Beta-blockers are a class of medications primarily used to manage cardiovascular conditions such as hypertension and arrhythmias. They work by blocking the effects of adrenaline on the heart and blood vessels. The other options, PPIs, H2 receptor antagonists, and antacids, are commonly used in the treatment of GI disorders. PPIs reduce gastric acid secretion, H2 receptor antagonists block histamine-induced acid production, and antacids neutralize stomach acid.