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GI - Year 2 > Clinical Pharmacology of Alimentary > Flashcards

Clinical Pharmacology of Alimentary Flashcards

1
Q

What are the common drugs used for acid suppression?

A

Antacids
H2-receptor antagonists
Proton pump inhibitors

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2
Q

What are the drugs that affect GI motility?

A

Anti-emetics
Anti-muscarinics/other anti-spasmodics
Anti-motility

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3
Q

What are common drugs used for IBD?

A

Aminosalicyclates
Corticosteroids
Immunosuppressants
Biologics

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4
Q

What are drugs affecting intestinal secretions?

A

Bile acid sequestrants

Ursodeoxycholic acid

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5
Q

What role do antacids have in acid suppression?

A

Contain Mg or Al
Neutralise gastric acid
Taken when symptoms occur

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6
Q

What role do alginates have in acid suppression?

A

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

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7
Q

What role do H2-receptor antagonists have on acid suppression?

A

Block histamine receptor thereby reducing acid secretion
Indicated in GORD/peptic ulcer disease
GIven orally/IV

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8
Q

What role does proton pump inhibitor play in acid suppression?

A

Block proton pump and thereby reduce acid secretion
Indicated in GORD/peptic ulcer disease
Oral/IV

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9
Q

What effect does prokinetic agents have on gut motility?

A

Increases gut motility + gastric emptying

Involves PNS control of smooth muscle + sphincter tone (via ACh)

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10
Q

How does domperidone work?

A

Blocks dopamine receptors which inhibit post-synaptic cholinergic neurones

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11
Q

What causes stimulation of the vomiting centre in the medulla?

A

Cerebral cortex (sight, smell etc)
Vestibular nuclei (motion)
Pharynx + GIT (gastroenteritis/radiotherapy/drugs)
Chemoreceptor trigger zone (drugs/toxins)

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12
Q

How do drugs that decrease motility work?

A

Via opiate receptors in GIT to decrease ACh release

Decreases smooth muscle contraction + increases anal sphincter tone

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13
Q

Why does loperamide have few central opiate effects?

A

Not well absorbed across BBB

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14
Q

What are the 3 mechanisms of anti-spasmodics?

A

Anti-cholinergic muscarinic antagonists = inhibit smooth muscle constriction in gut wall
Direct smooth muscle relaxants
CCBs reduce Ca required for smooth muscle contraction

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15
Q

What are 4 types of laxatives?

A 
Bulk
Osmotic
Stimulant
Softeners
Either work by increasing bulk or drawing fluid into gut
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16
Q

What are the issues of laxatives?

A

Obstruction
Route of administration (oral or rectal)
Need for other measures = osmotic laxatives will not work without adequate fluid intake
Misuse

17
Q

What are aminosalicylates?

A

Anti-inflammatory
Oral or rectal administration
Adverse effects - GI upset, blood dyscrasias, renal impairment

18
Q

What are corticosteroids?

A

Anti-inflammatory effects
Given orally/IV/rectally
Concerns = osteoporosis, Cushingoid features, increased chance of infection, Addisonian crisis with abrupt withdrawal
Cannot be used long term

19
Q

What are immunosuppressants?

A

Prevents formation of purines needed for DNA synthesis = reduces immune cell proliferation
Adverse effects = bone marrow suppression, azathioprine hypersensitivity, organ damage

20
Q

What are biologics?

A

Prevents action of TNFa (cytokine in inflammatory response

Addresses inflammatory response but not underlying disease

21
Q

What are the cautions/contraindications of Infliximab?

A

Current TB or other serious infection
MS
Pregnancy/breast feeding

22
Q

What are the adverse effects of infliximab?

A

Risk of infection
Infusion reaction (fever, itch)
Anaemia, thrombocytopenia, neutropenia
Malignancy

23
Q

What is cholestyramine?

A

Reduces bile salts by binding with them in the gut and the excreting as insoluble complex
May affect absorption of other drugs (taken separately)
May decrease Vitamin K

24
Q

What is Ursodeoxycholic acid?

A

Used to treat gallstones and primary biliary cirrhosis

Inhibits enzyme involved in formation of cholesterol, alters bile level and slowly dissolves non-calcified stones

25
Q

What drug processes can be affected by GI or liver disease?

A

Absorption
Distribution
Metabolism
Excretion

26
Q

What causes diarrhoea/constipation?

A

Acute/chronic

Drugs (NSAIDs, antimicrobials etc)

27
Q

What causes GI bleeding/ulceration?

A

Low dose aspirin/NSAIDs

28
Q

What are changes to gut bacteria caused by? + effects

A

Mainly antibiotics
Loss of OCP activity
Reduced vitamin K absorption
Overgrowth of pathogenic bacteria

29
Q

What is type A ADR in drug induced liver injury?

A

Intrinsic hepatotoxicity

Predictable, dose-dependent, acute)

30
Q

What is type B ADR in drug induced liver injury?

A

Idiosyncratic hepatotoxicity
Unpredictable, not dose dependent
May occur at any time

31
Q

What are the risk factors for ADR?

A 
Age (elderly at risk)
Sex (females at risk)
Alcohol consumption
Genetic factors
Malnourishment

GI - Year 2 (39 decks)

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