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Pharmacy > 301 Fundamentals on therapeutics: GIT > Flashcards

301 Fundamentals on therapeutics: GIT Flashcards

1
Q

Conditions affecting GIT

A
  • Oral cavity conditions (mouth ulcers, oral thrush, gingivitis)
  • Dyspepsia stomach acid (heartburn)
  • Gastritis
  • Malabsorption
  • Pancreatitis
  • Hepatitis
  • Biliary colic
  • IBD
  • IBS
  • Diverticulitis
  • Appendicitis
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2
Q

Common symptoms of GI conditions

A
  • Abdominal pain & discomfort
  • N + V
  • Diarrhoea
  • Constipation
  • Blood in stools, weight changes, bloating etc.
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3
Q

SOCRATES - abdominal pain questions

A

Site
Onset
Character
Radiation
Associated symptoms
Timing
Exacerbating and relieving factors
Severity

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4
Q

What is IBS?

A

Functional bowel disorder (absence of abnormality)
Affects twice as many women and 10-20% of pop. in western world

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5
Q

Symptoms of IBS

A

Abdominal pain and discomfort - affecting LLQ - symptom relief on defecation
Altered bowel habits - diarrhoea/constipation
Bloating
IBS above 6 months of symptoms

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6
Q

Causes of IBS

A

No known cause - multifactorial
Motility dysfunction
Diet
Genetics
Psychological factors

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7
Q

RED flag symptoms in IBS

A

Blood in stools - suggestive in IBD
Fever
N + V
Severe abdominal pain
Children under 16 - rare
Patients 45+ - changes in bowel habits - refer - cancer
Steatorrhoea - malabsorption problems

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8
Q

IBS management

A

Diet - FODMAPS avoid fats
Lifestyle - reduce stress
Antispasmodics - ‘ine’ (mebeverine, alverine, hyoscine and peppermint oil) - take before food
Treat intermittent diarrhoea and constipation
Low dose TCAs (amitriptyline) - abdominal pain
SSRI (fluoxetine) for refractory pain
Herbal medicines and probiotics - effective (limited evidence)

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9
Q

When should you refer with suspected IBS?

A

Fever
Blood in stools
Weight loss

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10
Q

Why does IBS occur?

A

Gut wall becomes sensitive and excitable, occurring too quickly (less water absorbed: diarrhoea) or too slowly (more water absorbed: constipation)

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11
Q

IBS triggers

A

Stress and emotion
Infections like gastroenteritis
Medications (affecting how NS interacts with gut)

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12
Q

What is diarrhoea?

A

Passage of 3+ loose or liquid stools per day

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13
Q

How many cases of diarrhoea per year?

A

17 million

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14
Q

3 types of diarrhoea

A

Acute: lasting <14 days (bacteria or viral infection)
Persistent: lasting >14 days
Chronic: lasting >4 weeks (caused by IBD, coeliac disease and bowel cancer)

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15
Q

Causes of diarrhoea

A

Viruses (norovirus)
Bacteria (food poisoning)
Parasitic causes
Drugs
IBS
IBD
Coeliac disease

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16
Q

What drugs cause diarrhoea?

A

Laxatives
Magnesium containing antacids
Metformin

17
Q

RED flag symptoms of diarrhoea

A
  • Changes in bowel habits (long-term) over 50s
  • Diarrhoea following travel
  • > 2-3 day duration in children/elderly/patients unable to drink fluid
  • Presence of blood/mucous in stool
  • Severe abdominal pain
  • Steatorrhoea
18
Q

Why is diarrhoea following travel a RED flag?

A

Giardiasis (intestinal infection caused by parasite)

19
Q

Why is diarrhoea a concern in children, the elderly and patients unable to drink fluid

A

Dehydration risk

20
Q

Diarrhoea management

A
  • Oral rehydration solution (ORS) (glucose)
  • Rice based ORS
  • Loperamide (not 1st line as diarrhoea is body’s response to something wrong)
21
Q

What set of patients benefit from rice based ORS over ORS?

A

Diabetics as ORS contains glucose

22
Q

What is coeliac disease?

A

Chronic immune-mediated systemic disorder in genetically pre-disposed people
Spectrum condition ranging from gluten insensitivity to coeliac

23
Q

What is coeliac disease triggered by?

A

Response to dietary gluten
Gluten is main protein in wheat, barley and rye

24
Q

What does coeliac disease do?

A

Gluten absorbed from dietary sources and induces auto-immune response of GI cells causing damage to small intestine, causes inflammation of SI villi, reducing vitamins and mineral absorption

25
Q

What does coeliac usually result in?

A

B12 deficiency

26
Q

Symptoms of coeliac disease

A

Bloating
Diarrhoea
Nausea
Flatulence
Constipation
Tiredness
Headaches
Sudden weight loss
Hair loss
Anaemia
Osteoporosis
Rash (dermatitis herpetiformis)
Neurological disorders

27
Q

What is dermatitis herpetiformis?

A

Symptom of coeliac
Itchy bumps and blisters on skin due to gluten sensitivity

28
Q

Coeliac disease management

A

Adherence to gluten-free diet
Treat with antihistamines for symptoms (as autoimmune and not GI pain)

Pharmacy (23 decks)

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