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Alimentary System > Clinical Pharmacology > Flashcards

Clinical Pharmacology Flashcards

1
Q

What are the groups of drugs used to treat GI disease?

A 
Acid suppression 
Drugs affecting GI motility 
Laxatives 
Drugs for IBD 
Drugs affecting intestinal secretions
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2
Q

What are the acid suppression drugs?

A

Antacids
H2 receptor antagonists
Proton pump inhibitors

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3
Q

What are the drugs affecting GI motility?

A

Anti-emetics
Anti-muscarinics
Anti-motility

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4
Q

Which drugs are used to treat IBD?

A

Aminosalicylates
Corticosteroids Immunosuppressant’s
Biologics

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5
Q

What do anti acids contain?

A

Magnesium or aluminium

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6
Q

How do antiacids work?

A

Neutralise gastric acid

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7
Q

When should anti acids be used?

A

When symptoms occur

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8
Q

What is common example of a over the counter anti acid?

A

Rennie

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9
Q

What is an alginates?

A

A viscous gel that floats on stomach contents and reduces reflux

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10
Q

How do H2 receptor antagonists work?

A

Block histamine receptor thereby reducing acid secretion

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11
Q

When are H2 receptor A indicated?

A

In GORD or peptic ulcer disease

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12
Q

How are H2 receptor antagonists given?

A

Orally or IV

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13
Q

How do PPI work?

A

Block proton pump and thereby reduce acid secretion

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14
Q

When are PPI indicated?

A

GORD

Peptic ulcer disease

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15
Q

What do pro kinetic drugs do?

A

Increase gut motility and gastric emptying

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16
Q

What are pro kinetic drugs good for treating?

A

Vomiting

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17
Q

Why are prokinetic drugs good for relieving vomiting?

A

Because they empty the stomach

and once food has left the stomach it cannot reflux back up

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18
Q

What is the mechanism for prokinetic drugs?

A

Mechanism is unknown

but involves parasympathetic NS control of smooth muscle and sphincter tone

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19
Q

What is the mechanism of drugs that decrease GI motility?

A

Operate via opiate receptors in GI tract to decrease Ach release
Decreases smooth muscle contraction
Increases anal sphincter tone

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20
Q

Symptoms of which diseases can be treated with anti-spasmodics?

A

IBS

Renal colic

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21
Q

What are the 4 types of laxatives?

A

Bulk
Osmotic
Stimulant
Softeners

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22
Q

How do laxative work?

A

Work by increasing bulk or drawing fluid into the gut

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23
Q

What do osmotic laxatives require to work?

A

Adequate fluid intake

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24
Q

What are the two routes of admission for laxatives?

A

Oral

Rectal

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25
Q

What drugs are given to treat IBD?

A 
Aminosalicylates 
Corticosteroids 
Immunosuppressants 
Biologics 
Infliximab
26
Q

How do corticosteroids treat IBD?

A

Have anti-inflammatory effects to treat the inflammation in IBD

27
Q

How are corticosteroids given?

A

Orally
IV
Rectally

28
Q

What should you not do with any patient on long term steroid courses?

A

DO NOT withdraw them suddenly from treatment

29
Q

What do immunosuppressants prevent?

A

Immune cell proliferation

30
Q

What is required with the treatment with immunosuppressants?

A

Specialist use and close monitoring

31
Q

What is an example of a commonly used biologic?

A

Infliximab

32
Q

What do biologics reduce in IBD?

A

Inflammation

33
Q

Do biologics treat the undelying disease in IBD?

A

No

34
Q

What is the main adverse effect when using immunosuppressants?

A

Mainly related to bone marrow suppression

35
Q

What other conditions are biologics used in?

A

Psoriasis

Rheumatoid Arthritis

36
Q

What is the malignancy rate in the use of Infliximab?

A

1-2%

37
Q

What are the contraindications of the use of infliximab?

A 
MS
Current TB 
Current serious infection 
Pregnancy 
Breastfeeding
38
Q

What is the mechanism of cholestyramin?

A

Relieves itching from jaundice

39
Q

What is a side affect of cholestyramin?

A

Is highly bindable to other drugs

40
Q

What is ursodeoxycholic used to treat?

A

Gallstones and primary biliary cirrhosis

41
Q

How does ursodeoxycholic work?

A

Inhibits the enzyme that is involved in the formation of cholesterol

42
Q

What are the 4 stages of pharmacology?

A

Absorption
Distribution
Metabolism
Excretion

43
Q

Is diarrhoea and constipation an acute or chronic condition?

A

Can be either

44
Q

What is the most common cause of bowel changes?

A

Antibiotic treatment

45
Q

What is the most common cause of GI bleeding?

A

Low dose aspirin

46
Q

What is the 3rd most common cause of GI bleeding?

A

Warfarin

47
Q

What are changes in gut bacteria mainly due to?

A

Use of AB

48
Q

When using Ab and experiencing diarrhoea what can lose its effectiveness?

A

OCP

so use another form of contraception if taking the pill and on AB

49
Q

What are the risk factors for hepatotoxicity?

A

Age (older)
Sex (female)
Alcohol consumption Genetics
Malnourishment

50
Q

What is intrinsic hepatotoxicity?

A

Hepatotoxicity due to a predictable drug
Is dose dependant
Is an acute situation

51
Q

What is idiosyncratic hepatotoxicity?

A

Hepatotoxicity due to an unpredictable drug

Can occur at any time Not dose dependant

52
Q

What scoring system grades liver failure patients?

A

Child-Pugh classification

53
Q

What score qualifies for group A in Child-Pugh Classification?

A

<7

54
Q

What score qualifies for group b in Child-Pugh Classification?

A

7-9

55
Q

What score qualifies for group C in Child-Pugh Classification?

A

> 9

56
Q

What score is often used for liver transplantation scoring?

A

Child-Pugh Classification

57
Q

What drugs will worsen encephalopathy?

A

Diuretics

58
Q

What drugs should be avoided in liver disease?

A

Warfarin/anti-coagulants
Aspirin
NSAIDS
Opiates

59
Q

Where should you refer to for drug information?

A

BNF

60
Q

Why should opiate be avoided in liver disease patients?

A

may precipitate encephalopathy by increasing sedation

Alimentary System (29 decks)

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