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Core Conditions Year 3 and 4 > **ACC (Y4)** Abdominal: Drugs > Flashcards

**ACC (Y4)** Abdominal: Drugs Flashcards

1
Q

Drug names of Alginates and antacids?

A

GAVISCON (Sodium alginate with calcium carbonate and sodium bicarbonate)

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2
Q

Mechanism of action Alginates and antacids?

A

Antacids work by buffering stomach acids.

Alginates increase the viscosity of stomach contents.

After reacting with stomach acid they form a floating ‘raft’, which separates gastric contents from the gastro-oesophageal junction to prevent mucosal damage.

There is some evidence to suggest they also inhibit pepsin production.

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3
Q

Indications of Alginates and antacids

A
  1. GORD (for symptomatic relief of heartburn)

2. Dyspepsia (for short term relief of indigestion).

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4
Q

Contra-indications Alginates and antacids

A

should not be given in combination with thickened milk preparations (infants)

renal failure

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5
Q

Side-effects of Alginates and antacids

A

Magnesium alginates can cause diarrhoea

aluminium alginates can cause constipation

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6
Q

Possible interactions (and mechanism) of Alginates and antacids

A
  • ACEI
  • some antibiotics (e.g. cephalosporins, ciprofloxacin and tetracyclines),
  • bisphosphonates
  • digoxin
  • levothyroxine
  • proton pump inhibitors

NB: By increasing the alkalinity of urine, antacids can increase the excretion of aspirin and lithium.

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7
Q

Elimination of Alginates and antacids

A

Primarily eliminated in urine

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8
Q

are alginates and antacids safe during pregnancy?

A

yes

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9
Q

are alginates and antacids safe for infants?

A

yes

  • but compound alginates should not be given in combination with thickened milk preparations as they can lead to excessively thick stomach contents that cause bloating and abdominal discomfort.
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10
Q

how are Alginates and antacids administered?

A
  • oral suspension or chewable tablets

- taken following mealsbefore bedtime and/or when symptoms occur.

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11
Q

Drug names of H2 receptor antagonists?

A

RANITIDINE

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12
Q

Mechanism of action H2 receptor antagonists?

A

Histamine H2-receptor antagonists (‘H2-blockers’) reduce gastric acid secretion.

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13
Q

Indications of H2 receptor antagonists?

A
  1. peptic ulcer disease.

2. GORD.

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14
Q

Contra-indications H2 receptor antagonists?

A

high risk of gastric cancer (may mask symptoms of gastric cancer)

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15
Q

Side-effects of H2 receptor antagonists?

A

generally well tolerated with few side effects.

Most common among these are; bowel disturbance (diarrhoea or, less often, constipation), headache and dizziness.

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16
Q

Possible interactions (and mechanism) of H2 receptor antagonists?

A

Ranitidine has no major drug interactions.

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17
Q

Elimination of H2 receptor antagonists?

A

Excreted via urine; 30% of orally administered dose present

Half-life ~3 hours

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18
Q

are H2 receptor antagonists available over the counter?

A

yes

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19
Q

how are H2 receptor antagonists administered?

A

Oral preparations can be taken before, with or after food.

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20
Q

Drug names of Proton pump inhibitors?

A

lansoprazole
omeprazole
pantroprazole

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21
Q

Mechanism of action Proton pump inhibitors?

A

Proton pump inhibitors (PPIs) reduce gastric acid secretion. They act by irreversibly inhibiting H+/K+-ATPase in gastric parietal cells.

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22
Q

Indications of Proton pump inhibitors?

A
  • peptic ulcer disease
  • dyspepsia
  • GORD
  • Eradication Helicobacter pylori infection, in which they are used
    in combination with antibiotic therapy.
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23
Q

Contra-indications Proton pump inhibitors?

A
  • PPIs may disguise symptoms of gastric cancer.

- Osteoporosis (inc risk of fracture)

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24
Q

Side-effects of Proton pump inhibitors?

A

gastrointestinal disturbances and headache (common)

NB: Prolonged treatment with PPIs can cause hypomagnesaemia, which if severe can lead to tetany and ventricular arrhythmia.

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25
Q

Possible interactions (and mechanism) of Proton pump inhibitors?

A
  • clopidogrel (reduce the antiplatelet effect)
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26
Q

Elimination of Proton pump inhibitors?

A

Most of the dose (about 77%) was eliminated in urine. The remainder of the dose was found in the feces.

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27
Q

are Proton pump inhibitors

available over the counter?

A

no

28
Q

how are Proton pump inhibitors administered?

A

Oral and injectable preparations are available.

Oral preparations can be taken with food or on an empty stomach. They are best taken in the morning.

29
Q

Drug names of anti-diarhoeal agents?

A

Loperamide

30
Q

Mechanism of action anti-diarhoeal agents?

A
  • agonist of the opioid μ-receptors in the gastrointestinal tract.
  • educes propulsive (peristaltic) contractions
31
Q

Indications of anti-diarhoeal agents?

A

a symptomatic treatment for diarrhoea, usually in the context of irritable bowel syndrome or viral gastroenteritis

32
Q

Contra-indications anti-diarhoeal agents?

A
  • acute ulcerative colitis (where inhibition of peristalsis may increase the risk of megacolon and perforation)
  • C.diff colitis
  • acute bloody diarrhoea (dysentery) because this may signify bacterial infection.
33
Q

Side-effects of anti-diarhoeal agents?

A

safe drug with few adverse effects.

These are mostly gastrointestinal effects (e.g. constipation, abdominal cramping and flatulence).

34
Q

Possible interactions (and mechanism) of anti-diarhoeal agents?

A

There are no clinically significant interactions.

35
Q

Elimination of anti-diarhoeal agents?

A

Excretion of the unchanged loperamide and its metabolites mainly occurs through the feces.

36
Q

are anti-diarhoeal agents

available over the counter?

A

Loperamide may be purchased over the counter without prescription.

37
Q

how are anti-diarhoeal agents administered?

A

Loperamide is usually taken as a capsule or tablet. A syrup form is available, which may be useful in children (over 4 years old) with acute viral gastroenteritis.

38
Q

What are the two types of laxative?

A

stimulant (e.g. Senna), osmotic

39
Q

what type of laxative is Senna?

A

stimulant

40
Q

Mechanism of action stimulant laxatives?

A

increase water and electrolyte secretion from the colonic mucosa, thereby increasing volume of colonic content and stimulating peristalsis.

41
Q

Indications of stimulant laxatives?

A
  1. constipation

2. as suppositories for faecal impaction

42
Q

Contra-indications stimulant laxatives?

A
  • intestinal obstruction
  • intestinal perforation
  • rectal preparations should be avoided if there are haemorrhoids or anal fissures present.
43
Q

Side-effects of stimulant laxatives?

A

Abdominal pain or cramping, diarrhoea

44
Q

Possible interactions (and mechanism) of stimulant laxatives?

A

There are no clinically significant adverse drug interactions with stimulant laxatives.

45
Q

how are stimulant laxatives administered?

A

Stimulant laxatives are usually administered orally, unless treating faecal impaction when glycerol suppositories may be administered rectally.

46
Q

what type of drug is gaviscon?

A

antacid

47
Q

what type of drug is ranitidine?

A

h2 antagonist

48
Q

what type of drug is omeprazole?

A

proton pump inhibitor

49
Q

what type of drug is loperamide?

A

anti-diarrhoeal agent

50
Q

what type of drug is senna?

A

laxative

51
Q

what type of drug is Mesalazine?

A

Aminosalicylates

52
Q

what type of drug is Metoclopramide?

A

antiemetics (dopamine D2-receptor antagonist)

53
Q

Drug names of Aminosalicylates?

A
  1. mesalazine (ulcerative colitis)

2. sulfasazine (rheumatoid arthritis)

54
Q

Mechanism of action Aminosalicylates?

A

In ulcerative colitis (UC), mesalazine and sulfasalazine both exert their therapeutic effects by releasing 5-aminosalicylic acid (5-ASA). - anti-inflammatory and immunosuppressive effects

55
Q

Indications of Aminosalicylates?

A
  1. mesalazine (ulcerative colitis)

2. sulfasazine (rheumatoid arthritis)

56
Q

Contra-indications Aminosalicylates?

A

Mesalazine and sulfasalazine are salicylates, like aspirin. Patients who have aspirin hypersensitivity should not take these drugs.

57
Q

Side-effects of Aminosalicylates?

A

gastrointestinal upset (e.g. nausea, dyspepsia) and headache, renal impairment, nduce a reversible decrease in the number of sperm (oligospermia)

58
Q

Possible interactions (and mechanism) of Aminosalicylates?

A

interact with drugs that alter gut pH. For example, proton pump inhibitors increase gastric pH so may cause the coating to be broken down prematurely.

59
Q

Elimination of Aminosalicylates?

A

renal / urine

60
Q

how are Aminosalicylates administered?

A
  • rectal enema
  • suppository
  • oral tablet
61
Q

Mechanism of action antiemetics?

A

promotes relaxation of the stomach and lower oesophageal sphincter and inhibits gastroduodenal coordination – promoting gastric emptying – and reduced gut motility

62
Q

Indications of antiemetics?

A

nausea and vomiting (anti-sickness)

63
Q

Contra-indications antiemetics?

A
  • GI obstruction

- perforation

64
Q

Side-effects of antiemetics?

A
  • diarrhoea

NB side effects are more common in: children, young adults

65
Q

Possible interactions (and mechanism) of antiemetics?

A
  • antipsychotics

- dopaminergic agents for Parkinson’s disease

66
Q

Elimination of antiemetics?

A

renal / urine

67
Q

how are antiemetics administered?

A

IV injections

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