Clinical 6.1 Drugs for the bowel Flashcards

1
Q

What drugs can you use to decrease gastric secretions and give an example of each

A

PPI: omeprazole
H2 receptor antagonists: ranitadine
Antacids: Magnesium and aluminium salts, NaHCO3, Calcium salts, Alginate

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2
Q

What do you have to be careful with when giving H2 receptor antagonists?

A

drug interactions with cimetidine

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3
Q

What are the side effects of PPIs and what do you have to be careful of?

A

Generally well tolerated but can ave nausea, vomiting, diarrhoea and constipation

May increase the risk of C.difficile

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4
Q

How do PPIs have a long lasting effect with a short t1/2?

A

They are a suicide inhibitor - consume and destroy so the duration of effect relates to the ability of regeneration of the enzymes

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5
Q

What is the treatment for H.pylori infection

A

triple therapy of PPI and two antibiotics (clarithromycin and amoxicillin)

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6
Q

What are the drugs that protect the mucosa and how do they work?

A

Sucralfate (forms a protective barrier at ulcer site)

Misoprostol (prostaglandin E1 analogue which stimulates secretion of gastric mucus and HCO3 in the duodenum)

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7
Q

What type and give an example of drugs for motion sickness and gastric irritants

A

H1 antagonists: promethazine (morning sickness too)

M antagonist: scopolamine

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8
Q

What type and give an example of drugs for post operative vomiting

A

D2 antagonists: Phenothiazines and metoclopramide

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9
Q

What type and give an example of drugs for chemotherapy and radiotherapy vomiting

A

5-HT3 antagonists: ondansatron

NK-1 antagonists: Aprepitant

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10
Q

How can you minimise constipation with opioid use and give an example?

A

Use an opioid receptor antagonist for example oxycodone with naloxone

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11
Q

What is an example of an anti diarrhoeal drug and how does it work?

A

Loperamide (immodium) and codeine which are opioid receptor antagonists

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12
Q

What drug classes can be used to UC and Chron’s and give examples

A

5-aminosalicylic acid derivatives: sulfasalazine
Immunosuppressants: Azathioprine
Glucocorticoids: Prednisolone
TNF-a antagonists: Ifliximab

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13
Q

How does sulfasalazine work?

A

activates PPAR-gamma which decreases inflammation in local bowel mucosa

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14
Q

What kind of drug is infliximab?

A

Monoclonal IgG

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