Antacids/Laxatives/Prokinetics

Welcome to your Antacids/Laxatives/Prokinetics

1. 
A 68-year old male comes into your office for a follow-up from a hospital discharge. He was admitted for new onset Atrial Fibrillation, which was controlled and a beta blocker. He is now on the anticoagulated Warfarin, with an optimal INR 2.0. Which of the patient’s current medications needs to have its dosing changed, or altogether changed for another drug because of its pharmacologic interaction with Warfarin?
2. 
A 43-year old female comes in complaining of chest pain. She has had this pain before for the last 6 months, more often at night and often wakes her up. When it first started, it felt like a “tickle,” but it has now gotten worse to it feels like a burning pain that radiates to her throat and stomach. She has noticed that drinking iced milk makes the pain better. Vitals stable. On physical exam, you do not appreciate any murmurs, and chest is nontender to palpation. What is the best treatment that will both treat the patient’s symptoms and prevent further episodes?
3. 
Loperamide is an opioid involved in diarrhea treatment that acts on this kind of opioid receptor:
4. 
A patient of yours comes into for 1-week follow-up after starting a new acne medication. He was started on doxycycline. He is complaining of persistence of symptoms with no change and wants a different drug as the “first one didn't work none.” You inquire about his habits at home, revealing that he has been having diarrhea and is taking a drug he got from his friend for that. Which diarrheal drug is he most likely taking?
5. 
How does lactulose work to treat hepatic encephalopathy?

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