GI drugs: sucralfate: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · GI drugs: sucralfate

Sample item

A patient with duodenal ulcer is prescribed sucralfate along with an antacid taken at the same time. Why is this combination undesirable?

ASucralfate neutralises the antacidBAntacids make sucralfate toxicCSucralfate causes antacid malabsorptionDSucralfate needs an acidic pH to polymerise and bind the ulcer base, which antacids reduce

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Sucralfate needs an acidic pH to polymerise and bind the ulcer base, which antacids reduce

Sucralfate, an aluminium salt of sulfated sucrose, forms a viscous paste at acidic pH that adheres to the ulcer crater. Antacids, H2 blockers and PPIs raise the pH and reduce its effect, so doses are separated.

Option by option

A. Sucralfate neutralises the antacid
Sucralfate has no meaningful neutralising capacity.
B. Antacids make sucralfate toxic
There is no toxicity from this combination.
C. Sucralfate causes antacid malabsorption
The issue is lost efficacy of sucralfate, not antacid malabsorption.
D. Sucralfate needs an acidic pH to polymerise and bind the ulcer base, which antacids reduce (correct)
Correct. Reduced acidity impairs activation of sucralfate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Sucralfate needs an acidic pH to polymerise and bind the ulcer base, which antacids reduce. Sucralfate, an aluminium salt of sulfated sucrose, forms a viscous paste at acidic pH that adheres to the ulcer crater.

Why is "Sucralfate neutralises the antacid" not the answer?

Sucralfate has no meaningful neutralising capacity.

Why is "Antacids make sucralfate toxic" not the answer?

There is no toxicity from this combination.

Why is "Sucralfate causes antacid malabsorption" not the answer?

The issue is lost efficacy of sucralfate, not antacid malabsorption.

What concept does this question test?

It tests GI drugs: sucralfate in Pharmacology. Antacids, H2 blockers and PPIs raise the pH and reduce its effect, so doses are separated.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI drugs: sucralfate?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.