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Esomeprazole's primary therapeutic role is to increase the production of stomach acid for digestive aid.
Answer: False
Explanation: Esomeprazole functions to decrease, not increase, stomach acid production by inhibiting the proton pump.
Esomeprazole is a different drug entirely from omeprazole, with no structural relationship.
Answer: False
Explanation: Esomeprazole is the S-enantiomer of omeprazole, meaning they are structurally related, with esomeprazole being a purified form of one of omeprazole's isomers.
Esomeprazole reduces stomach acid by inhibiting the proton pump in parietal cells.
Answer: True
Explanation: Esomeprazole is a proton pump inhibitor (PPI) that works by blocking the H+/K+-ATPase enzyme system in gastric parietal cells, thereby reducing acid secretion.
Esomeprazole belongs to the drug class known as Proton Pump Inhibitors (PPIs).
Answer: True
Explanation: Esomeprazole is classified as a Proton Pump Inhibitor (PPI), a class of drugs that reduce gastric acid secretion.
Esomeprazole is a racemic mixture containing both S and R enantiomers.
Answer: False
Explanation: Omeprazole is a racemic mixture, while esomeprazole is the purified S-enantiomer.
What is the primary role of esomeprazole in the body?
Answer: To reduce the amount of acid secreted by the stomach.
Explanation: Esomeprazole functions as a proton pump inhibitor, significantly reducing gastric acid secretion.
What is the relationship between esomeprazole and omeprazole?
Answer: Esomeprazole is the S-enantiomer of omeprazole.
Explanation: Omeprazole is a racemic mixture, and esomeprazole is the purified S-enantiomer of this mixture.
What cellular mechanism does esomeprazole use to reduce stomach acid?
Answer: Inhibiting the H+/K+-ATPase (proton pump) in parietal cells.
Explanation: Esomeprazole directly inhibits the proton pump, the final step in gastric acid secretion, located on the surface of parietal cells.
What is a key difference between esomeprazole and omeprazole based on their chemical structure?
Answer: Omeprazole is a racemic mixture, while esomeprazole is the purified S-enantiomer.
Explanation: Omeprazole is composed of both R- and S-enantiomers, whereas esomeprazole is specifically the S-enantiomer.
Gastroesophageal reflux disease (GERD) and peptic ulcer disease are among the conditions treated by esomeprazole.
Answer: True
Explanation: Esomeprazole is indicated for the treatment of GERD, peptic ulcer disease, and other acid-related gastrointestinal disorders.
Esomeprazole is used to treat duodenal ulcers caused by Helicobacter pylori infection.
Answer: True
Explanation: Esomeprazole is part of combination therapy used to eradicate H. pylori infections, which are a common cause of duodenal ulcers.
Esomeprazole is administered alongside antibiotics like clarithromycin and amoxicillin to treat duodenal ulcers.
Answer: True
Explanation: This combination therapy is standard for eradicating H. pylori, a common cause of duodenal ulcers.
Studies indicate esomeprazole provides a significant advantage over all other proton pump inhibitors (PPIs) for all patient groups.
Answer: False
Explanation: While studies suggest esomeprazole may offer a modest benefit over other PPIs, particularly for severe conditions, it is not considered significantly advantageous for all patient groups or all conditions.
Vimovo is a medication containing only esomeprazole magnesium.
Answer: False
Explanation: Vimovo is a combination product containing both naproxen (an NSAID) and esomeprazole magnesium.
Vimovo is prescribed to prevent gastric ulcers in patients taking NSAIDs long-term.
Answer: True
Explanation: Vimovo combines an NSAID (naproxen) with a proton pump inhibitor (esomeprazole) specifically for this purpose.
Which of the following is NOT listed as a primary medical condition treated by esomeprazole?
Answer: Irritable Bowel Syndrome (IBS)
Explanation: Esomeprazole is indicated for conditions related to excess stomach acid like GERD and peptic ulcers, but not typically for Irritable Bowel Syndrome (IBS).
Which of the following is a specific use of esomeprazole mentioned in the source, besides GERD?
Answer: Prevention of gastric ulcers in chronic NSAID users
Explanation: Esomeprazole is indicated for the prevention of gastric ulcers in patients who require long-term NSAID therapy.
How does esomeprazole aid in the treatment of H. pylori infections?
Answer: It is used in combination with antibiotics to eradicate the infection.
Explanation: Esomeprazole is a component of multi-drug regimens used to eradicate H. pylori, enhancing the effectiveness of antibiotics.
Compared to other PPIs, esomeprazole's efficacy is described as:
Answer: Modestly beneficial, especially for severe disease.
Explanation: Studies suggest esomeprazole offers a modest benefit over other PPIs, particularly in healing esophageal conditions and managing severe disease.
Esomeprazole can only be administered orally.
Answer: False
Explanation: Esomeprazole is available for both oral and intravenous administration.
Peak plasma concentrations of esomeprazole are typically reached within 1 to 4 hours after oral administration.
Answer: True
Explanation: Following oral administration, peak plasma levels of esomeprazole are generally observed within 1 to 4 hours.
Intravenous administration of esomeprazole generally results in lower peak plasma levels compared to oral doses.
Answer: False
Explanation: Intravenous administration typically leads to higher peak plasma levels compared to equivalent oral doses.
Esomeprazole is primarily eliminated from the body through feces.
Answer: False
Explanation: The majority of esomeprazole metabolites are excreted via the kidneys, not primarily through feces.
Esomeprazole is available as delayed-release capsules, tablets, and a sodium salt for injection/infusion.
Answer: True
Explanation: These are the common dosage forms available for esomeprazole administration.
Oral formulations of esomeprazole are often enteric-coated to protect them from stomach acid.
Answer: True
Explanation: The enteric coating prevents the acidic environment of the stomach from degrading the esomeprazole, ensuring it reaches the small intestine for absorption.
A multiple-unit pellet system (MUPS) involves a single large pellet of esomeprazole.
Answer: False
Explanation: A MUPS formulation consists of multiple small, enteric-coated pellets, not a single large one.
The MUPS formulation is beneficial for patients who have difficulty swallowing.
Answer: True
Explanation: The MUPS formulation, containing multiple small pellets, is easier to administer to patients with dysphagia or those receiving nutrition via nasogastric tubes.
Esomeprazole is primarily metabolized by the CYP1A2 and CYP2D6 liver enzymes.
Answer: False
Explanation: Esomeprazole is primarily metabolized by the CYP2C19 and CYP3A4 liver enzymes, not CYP1A2 and CYP2D6.
The elimination half-life of esomeprazole is typically around 10-12 hours.
Answer: False
Explanation: The elimination half-life of esomeprazole is typically much shorter, around 1 to 1.5 hours.
The enteric coating on esomeprazole protects it from degradation by bile salts in the small intestine.
Answer: False
Explanation: The enteric coating protects esomeprazole from the acidic environment of the stomach, not from bile salts in the small intestine.
How can esomeprazole be administered?
Answer: Orally or intravenously.
Explanation: Esomeprazole is available in both oral formulations (capsules, tablets) and intravenous preparations.
Why are oral esomeprazole capsules typically enteric-coated?
Answer: To protect the drug from stomach acid.
Explanation: The enteric coating is designed to prevent the degradation of esomeprazole by the highly acidic environment of the stomach.
Which liver enzymes are primarily responsible for metabolizing esomeprazole?
Answer: CYP2C19 and CYP3A4
Explanation: Esomeprazole undergoes hepatic metabolism primarily via the cytochrome P450 enzymes CYP2C19 and CYP3A4.
What is the typical elimination half-life of esomeprazole?
Answer: 1 - 1.5 hours
Explanation: The elimination half-life of esomeprazole is generally reported to be between 1 and 1.5 hours.
How is the majority of esomeprazole excreted from the body?
Answer: Primarily via the kidneys.
Explanation: Approximately 80% of esomeprazole and its metabolites are excreted via the kidneys.
What is the significance of the enteric coating on oral esomeprazole formulations?
Answer: It prevents the drug from being destroyed by stomach acid.
Explanation: The enteric coating protects esomeprazole from degradation in the acidic environment of the stomach, allowing it to be absorbed in the less acidic small intestine.
Which formulation of esomeprazole is designed for easier administration via nasogastric tubes?
Answer: Multiple-unit pellet system (MUPS)
Explanation: The MUPS formulation, consisting of small pellets, is suitable for administration through nasogastric tubes.
Headache and constipation are considered serious adverse effects requiring immediate medical attention when taking esomeprazole.
Answer: False
Explanation: Headache and constipation are common, generally mild side effects of esomeprazole, not typically considered serious adverse effects requiring immediate attention.
Long-term use of esomeprazole is associated with an increased risk of hip fractures and C. difficile infection.
Answer: True
Explanation: Research has linked prolonged use of proton pump inhibitors, including esomeprazole, to an increased risk of fractures (e.g., hip) and infections such as Clostridioides difficile.
There is no known link between prolonged esomeprazole use and an increased risk of gastric cancer.
Answer: False
Explanation: Studies suggest a potential increased risk of gastric cancer with prolonged proton pump inhibitor use, particularly in patients treated for H. pylori infections.
Acute tubulointerstitial nephritis is unrelated to esomeprazole use.
Answer: False
Explanation: Acute tubulointerstitial nephritis is recognized as a potential adverse reaction associated with the use of proton pump inhibitors, including esomeprazole.
Esomeprazole can increase the levels of drugs like warfarin that are metabolized by the CYP2C19 enzyme.
Answer: True
Explanation: Esomeprazole inhibits the CYP2C19 enzyme, which can lead to elevated plasma concentrations of other drugs metabolized by this enzyme, such as warfarin and diazepam.
Esomeprazole enhances the anti-platelet effectiveness of clopidogrel (Plavix).
Answer: False
Explanation: Esomeprazole can decrease the effectiveness of clopidogrel by inhibiting the CYP2C19 enzyme required for clopidogrel's activation.
Esomeprazole does not affect the absorption of other medications.
Answer: False
Explanation: By altering gastric pH, esomeprazole can affect the absorption of other drugs; some may be less absorbed (requiring acidity) and others more absorbed (degraded by acid).
The FDA has issued warnings regarding potential kidney problems associated with Vimovo.
Answer: True
Explanation: The FDA has updated labeling for Vimovo to include warnings about potential kidney issues, such as acute interstitial nephritis.
According to the source, which is a common side effect of esomeprazole?
Answer: Abdominal pain
Explanation: Abdominal pain is listed as a common side effect associated with esomeprazole use, unlike angioedema, pneumonia, or C. difficile infection which are less common or more serious.
Long-term use of esomeprazole has been associated with an increased risk of which of the following?
Answer: Hip fractures
Explanation: Prolonged use of PPIs like esomeprazole has been linked to an increased risk of bone fractures, particularly of the hip.
What potential risk is linked to prolonged PPI use, particularly after H. pylori treatment?
Answer: Increased risk of gastric cancer
Explanation: Prolonged PPI use, especially following H. pylori eradication therapy, has been associated with an elevated risk of gastric cancer.
Esomeprazole's inhibition of the CYP2C19 enzyme can lead to:
Answer: Higher levels of diazepam.
Explanation: By inhibiting CYP2C19, esomeprazole can increase plasma concentrations of drugs like diazepam, potentially leading to enhanced effects.
Which of the following is a potential adverse effect related to kidney function associated with Vimovo, according to FDA warnings?
Answer: Acute interstitial nephritis
Explanation: FDA warnings for Vimovo include the risk of acute interstitial nephritis, a kidney-related adverse effect.
How does esomeprazole's interaction with CYP2C19 affect clopidogrel?
Answer: It decreases clopidogrel's conversion to its active form.
Explanation: Esomeprazole's inhibition of CYP2C19 reduces the metabolic activation of clopidogrel, potentially diminishing its antiplatelet effect.
Which of the following is identified as a potential adverse reaction to esomeprazole use?
Answer: Acute tubulointerstitial nephritis
Explanation: Acute tubulointerstitial nephritis is a recognized potential adverse reaction associated with esomeprazole and other proton pump inhibitors.
Esomeprazole was patented in 1993 and approved for medical use around the year 2010.
Answer: False
Explanation: Esomeprazole was patented in 1993 and approved for medical use in the year 2000.
Esomeprazole is exclusively available as a prescription-only medication.
Answer: False
Explanation: While prescription formulations exist, lower-dose esomeprazole is available over-the-counter in several countries, and generic versions are widely accessible.
In 2023, esomeprazole was one of the most prescribed medications in the United States, with tens of millions of prescriptions.
Answer: False
Explanation: In 2023, esomeprazole ranked as the 147th most prescribed medication in the United States, with over 3 million prescriptions, not tens of millions.
Esomeprazole has consistently ranked among the top ten most prescribed medications in Australia between 2017 and 2023.
Answer: True
Explanation: Data indicates that esomeprazole has been among the top ten most prescribed medications in Australia during the period of 2017 to 2023.
Lower-dose esomeprazole formulations require a prescription in all countries where they are sold.
Answer: False
Explanation: Lower-dose formulations of esomeprazole are available over-the-counter in several countries, including the United States, the United Kingdom, Australia, Canada, and New Zealand.
Esomeprazole generated over $20 billion in revenue for AstraZeneca between 2001 and 2005.
Answer: False
Explanation: Esomeprazole generated approximately $14.4 billion for AstraZeneca between 2001 and 2005.
AstraZeneca faced criticism for marketing esomeprazole as a superior drug to omeprazole through 'evergreening'.
Answer: True
Explanation: AstraZeneca was criticized for allegations of 'evergreening' and promoting esomeprazole (Nexium) as significantly superior to omeprazole, despite their close relationship.
Nexium (esomeprazole) is available over-the-counter in Canada.
Answer: False
Explanation: In Canada, esomeprazole is generally available by prescription only. It is available over-the-counter in countries like the USA and UK.
Injectable esomeprazole is used in veterinary medicine to protect animal gastrointestinal tracts.
Answer: True
Explanation: Injectable esomeprazole has applications in veterinary medicine for gastrointestinal protection in animals.
Esomeprazole has shown efficacy as a veterinary antiparasitic agent.
Answer: True
Explanation: Research indicates that esomeprazole possesses efficacy as an antiparasitic agent in veterinary contexts.
In Canada, esomeprazole is available over the counter without a prescription.
Answer: False
Explanation: In Canada, esomeprazole is generally available only by prescription.
When was esomeprazole patented and approved for medical use?
Answer: Patented 1993, Approved 2000
Explanation: Esomeprazole was patented in 1993 and received approval for medical use in the year 2000.
Which statement accurately describes the availability of esomeprazole?
Answer: It is available as a generic and over-the-counter in some countries.
Explanation: Esomeprazole is available in generic forms and over-the-counter in certain countries for lower-dose formulations.
In 2023, what was esomeprazole's approximate ranking among prescribed medications in the United States?
Answer: 147th
Explanation: In 2023, esomeprazole was ranked as the 147th most prescribed medication in the United States.
What controversy surrounded AstraZeneca's marketing of esomeprazole (Nexium)?
Answer: Allegations of 'evergreening' and overstating superiority to omeprazole.
Explanation: AstraZeneca faced criticism regarding the marketing of esomeprazole, with accusations of 'evergreening' and claims of superiority over omeprazole that were contested.
In which countries is Nexium (esomeprazole) available over-the-counter?
Answer: USA and UK
Explanation: Nexium (esomeprazole) is available over-the-counter in the United States and the United Kingdom.
Esomeprazole has shown efficacy in veterinary medicine for which purpose?
Answer: As an antiparasitic agent.
Explanation: Esomeprazole has demonstrated efficacy as a veterinary antiparasitic agent, in addition to its gastrointestinal uses.
What does the pregnancy category B3 for esomeprazole in Australia indicate?
Answer: It suggests potential risk, but benefits may outweigh risks.
Explanation: Pregnancy Category B3 indicates that while there is limited human data, animal studies suggest potential risk, but the benefits of use in pregnant women may outweigh the risks.
What was the approximate revenue generated by esomeprazole for AstraZeneca from 2001 to 2005?
Answer: $14.4 billion
Explanation: During the period of 2001 to 2005, esomeprazole generated approximately $14.4 billion in revenue for AstraZeneca.
In Australia, what is the pregnancy category assigned to esomeprazole?
Answer: B3
Explanation: In Australia, esomeprazole is classified under pregnancy category B3.
The chemical formula for esomeprazole is C17H19N3O3S.
Answer: True
Explanation: The molecular formula provided, C17H19N3O3S, correctly represents the chemical composition of esomeprazole.
The molar mass of esomeprazole is approximately 345.42 grams per mole.
Answer: True
Explanation: The calculated molar mass for esomeprazole based on its chemical formula is approximately 345.42 g/mol.
What is the chemical formula provided for esomeprazole?
Answer: C17H19N3O3S
Explanation: The chemical formula for esomeprazole is C17H19N3O3S.
Which of the following is a key identifier for esomeprazole in scientific databases?
Answer: CAS 119141-88-7
Explanation: The CAS Registry Number for esomeprazole is 119141-88-7, a unique identifier used in chemical databases.
What is the IUPAC name for esomeprazole?
Answer: (S)-5-Methoxy-2-[(4-methoxy-3,5-dimethylpyridin-2-yl)methylsulfinyl]-3H-benzoimidazole
Explanation: The IUPAC name for esomeprazole is (S)-5-Methoxy-2-[(4-methoxy-3,5-dimethylpyridin-2-yl)methylsulfinyl]-3H-benzoimidazole.