Billiary Disorders + Obesity

Question 1

What is not a classical symptom of cholestasis?
Fatigue
Pruritis
Dark urine
Pale stools
Dark stools
Jaundice

Answer 1

Dark stools

Question 2

What is the basic MOA of colestyramine?

Answer 2

Forms an insoluble complex in intestines with bile acids and other compounds which reduces excess deposition in dermal tissues alleviating pruritus

Question 3

What they drugs are used in cholesteric pruritus?

Answer 3

Ursodeoxycholic
Rifampicin
Sertraline, naltrexone (unlicensed, limited use due to SE)

Question 4

Intrahepatic cholestasis usually occurs in late pregnancy and is associated with adverse fetal outcomes, what is the recommended treatment for this pruritis associated with cholestasis?

Answer 4

Ursodeoxycholic acid

Question 5

What drug treatment is used to cure gallstones?

Answer 5

None. Required surgical removement, analgesia follwing pain ladder, diclofenac or opioids can be given IM. Ursedeoxycholic acid has been used but there is no evidence to support its use.

Question 6

What is cholic acid used for?

Answer 6

Licensed for treatment of diseases in which liver does not produce enough primary bile acids due to enzyme deficiencies. Is the predominant primary bile scid in humans

Question 7

What BMI is considered obese?

Answer 7

> 30kg/m^2

Question 8

Although unlicensed what is the rationale for the use of methylcellulose and sterculia in obesity?

Answer 8

Appetite control as can produce a feeling of satiety

Question 9

What is the MOA of orlistat?

Answer 9

Lipase inhibitor, reduces absorption of dietary fats. Look out for deficiency of fat soluble vitamins.