13.2 GI Drugs Flashcards

1
Q

How do you treat Peptic Ulcer Disease?

A

Test for H.pylori
Stop NSAIDS
Give PPI (and if HP - metronidazole/amoxicillin and clarithromycin)

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2
Q

What lifestyle advice would you give someone with an ulcer/reflux?

A
Stop Smoking
Stop Drinking
Lose Weight
Exercise
Eat Smaller, regular Meals
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3
Q

What would you start them with, if not acute?

A

Antacid - Rennies

Alginates

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4
Q

What are PPIs?

A

Prodrugs, converted by acid
Proton Pump inhibitor
Blocks secretion of HCl in the stomach
Irreversibly bind

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5
Q

PPI Pharmacokinetics?

A

Takes a while to work

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6
Q

When do you use PPIs?

Why good?

A
PUD
GORD
HP infection
Stress Ulcers
Zollinger Ellison Syndrome
Not for immediate relief
They are well tolerated
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7
Q

ADRs of PPIs

A

Anhydrochorosis

Diarrhoea

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8
Q

Examples of PPIs

A

Omeprazole

Lanzoprazile

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9
Q

PPI DDIs

A

Metabolised by CYP

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10
Q

What are H2 blockers?

A

Histamine receptor blockers on the Parietal Cell

Decrease acid production but not completely block

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11
Q

Examples of H2 Blockers?

How do you use them?

A

Ranitidine
Cimetodine

Take twice a day

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12
Q

Why use Ranitidine?

A

Cheap

Effective

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13
Q

Why not use cimetodine?

A

CYP interactions

Gynaecomastia

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14
Q

How do antacids work?

Examples?

A

They are weak bases which neutralise the acid (turn into water and salt)
Reduce Pepsin activity
Rennies

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15
Q

When do you use antacids?

A

for immediate relief

Fast Acting

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16
Q

How do alginates work

A

They line the stomach and protect it

17
Q

What is triple therapy?

A

PPI/H2 antagonist
Metronidazole/Amoxicillin
Clarithryomycin
For 6 Weeks

18
Q

How do you test for H Pylori?

A

Biopsy
Antigen Test (Blood or Stool)
Urease Breath Test

19
Q

When use alginates?

A

NOT with PPIs (need acid to work)
Well tolerated
Protect ulcer

20
Q

Why not use alginates?

A

Multiple drug interactions

Not with PPIs

21
Q

What surgery could you use in PUD?

A

Highly Selective Vagotomy - to reduce acid secretion

Anti Reflux Surgery