13.2 GI Drugs Flashcards
How do you treat Peptic Ulcer Disease?
Test for H.pylori
Stop NSAIDS
Give PPI (and if HP - metronidazole/amoxicillin and clarithromycin)
What lifestyle advice would you give someone with an ulcer/reflux?
Stop Smoking Stop Drinking Lose Weight Exercise Eat Smaller, regular Meals
What would you start them with, if not acute?
Antacid - Rennies
Alginates
What are PPIs?
Prodrugs, converted by acid
Proton Pump inhibitor
Blocks secretion of HCl in the stomach
Irreversibly bind
PPI Pharmacokinetics?
Takes a while to work
When do you use PPIs?
Why good?
PUD GORD HP infection Stress Ulcers Zollinger Ellison Syndrome Not for immediate relief They are well tolerated
ADRs of PPIs
Anhydrochorosis
Diarrhoea
Examples of PPIs
Omeprazole
Lanzoprazile
PPI DDIs
Metabolised by CYP
What are H2 blockers?
Histamine receptor blockers on the Parietal Cell
Decrease acid production but not completely block
Examples of H2 Blockers?
How do you use them?
Ranitidine
Cimetodine
Take twice a day
Why use Ranitidine?
Cheap
Effective
Why not use cimetodine?
CYP interactions
Gynaecomastia
How do antacids work?
Examples?
They are weak bases which neutralise the acid (turn into water and salt)
Reduce Pepsin activity
Rennies
When do you use antacids?
for immediate relief
Fast Acting
How do alginates work
They line the stomach and protect it
What is triple therapy?
PPI/H2 antagonist
Metronidazole/Amoxicillin
Clarithryomycin
For 6 Weeks
How do you test for H Pylori?
Biopsy
Antigen Test (Blood or Stool)
Urease Breath Test
When use alginates?
NOT with PPIs (need acid to work)
Well tolerated
Protect ulcer
Why not use alginates?
Multiple drug interactions
Not with PPIs
What surgery could you use in PUD?
Highly Selective Vagotomy - to reduce acid secretion
Anti Reflux Surgery
