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systems- GI > Clinical Pharmacology of Alimentary > Flashcards

Clinical Pharmacology of Alimentary Flashcards

1
Q

drugs for acid suppression

A

antacids
h2 receptor antagonists
proton pump inhibitors

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2
Q

drugs effecting GI motility

A

anti emetics
anti-muscarinics
anti-motility

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3
Q

drugs for IBD

A

aminosalicylates
corticosteroids
immunisuppressants
biologics

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4
Q

drugs affecting intestinal secretions

A

bile acids sequestrants and ursodeoxycholic acid

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5
Q

what do antacids contain?

A

magnesium or aluminium

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6
Q

what do antacids do?

A

neutralise gastric acid

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7
Q

when should you take antacids?

A

when symptoms occur

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8
Q

what is the function of alginates?

A

forms a viscous gel that floats on stomach contents and reduces reflux

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9
Q

function of h2 receptor antagonists?

A

block histamine receptor thereby reducing acid secretion

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10
Q

function of proton pump inhibitors

A

block proton pump and thereby reduce acid secretion

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11
Q

does prokinetic agents increase or decrease gut motility and gastric emptying

A

increase

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12
Q

what is the mechanism of action of GI motility?

A

invoolved parasympathetic nervous system control of smooth muscle and sphincter tone

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13
Q

what is the mechanism of action for drugs that decrease motility?

A

via opiate receptors in GI tract to decrease ACh release

decrease smooth muscle contraction and increases anal sphincter tone

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14
Q

what are the three mechanisms of anti-spasmodics

A

Anti-cholinergic muscarinic antagonists (hyoscine buscopan, mebeverine)
inhibit smooth muscle constriction in the gut wall, producing muscle relaxation and reduction spasm.

Direct smooth muscle relaxants

Calcium-channel blockers (peppermint oil) reduce calcium required for smooth muscle contraction

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15
Q

what are the 4 types of laxatives?

A

bulk- isphagula
osmotic- lactulose
stimulant- senna
softners- arachis oil

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16
Q

issues of laxatives

A

obstruction

route of administration-oral or rectal

need for other measures

misuse

17
Q

concerns and contraindications for corticosteroids

A

Osteoporosis
Cushingoid features including weight gain, DM, HT,
Increased susceptibility to infection
Addisonian crisis with abrupt withdrawal

18
Q

function of immunosuppressants

A

prevents the formation of purines required for DNA synthesis so reduces immune cell proliferation

19
Q

contraindications of Infliximab

A

Current TB or other serious infection
Multiple sclerosis
Pregnancy/breast feeding

20
Q

adverse effects of Infliximab

A 
Risk of infection, particularly TB so all patients should be screened
Infusion reaction (fever, itch)
Anaemia, thrombocytopenia, neutropenia
?Demyelination
Malignancy
21
Q

drugs affecting biliary secretions

A

cholestryamine

ursodeoxycholic

22
Q

function of cholestryamine?

A

Reduces bile salts by binding with them in the gut and then excreting as insoluble complex

May affect absorption of other drugs so should be taken separately

May affect fat soluble vitamin absorption so may decrease vitamin K levels (affecting clotting and warfarin)

23
Q

what is ursodeoxycholic acid used to treat?

A

gallstones and primary biliary cirrhosis

24
Q

function of ursodeoxycholic acid?

A

Inhibits an enzyme involved in the formation of cholesterol, altering amount in bile and slowly dissolving non-calcified stones

25
Q

what processes can GI or liver disease affect?

A

absorption
distribution
metabolism
excretion

26
Q

what are the problems with distribution?

A

low albumin

27
Q

what are the problems with metabolism?

A

liver enzymes- toxicity
increased gut bacteria
gut wall metablism- disease may reduce first pass metabolism

28
Q

what are the problems with biliary excretion

A

biliary excretion

29
Q

what are the changes to gut bacteria from GI adverse effects

A

Mainly antibiotics
Loss of OCP activity
Reduced vitamin K absorption (increased prothrombin time)
Overgrowth of pathogenic bacteria (e.g. Clostridium difficile)

30
Q

what would be a type A ADR?

A

intrinsic hepatoxicity

31
Q

what would be a type B ADR?

A

idiosyncratic hepatoxicity

32
Q

risk factors for drug induced liver injury

A 
age
sex- female
alcohol consumption
genetic factors
malnourishment
33
Q

what drugs should you not give to patient with liver disease?

A

drugs which are hepatic
drugs which may worsen the non-liver aspectw of liver disease
drugs which can be toxic due to changes in pharmacokinetics

34
Q

what effect can aspirin and NSAIDs have with bleeding?

A

increase bleeding time

35
Q

what effect can have NSAIDs have on ascites?

A

worsen due to fluid retention

systems- GI (40 decks)

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