Clinical pharmacology of Alimentary

Question 1

What kinds of drugs are used for acid suppression?

Answer 1

Antacids
H2 receptor antagonists
Proton pump inhibitors

Question 2

What are some different kinds of antiemetic?

Answer 2

Dopamine antagonists (metoclopramide)
Antihistamines (cyclizine)
Serotonin-5HT3 antagonists (Ondansetron)

Question 3

How do anti-muscarinics work?

Answer 3

Reduce colonic motility by inhibiting parasympathetic stimulation of the myenteric and submucosal neural plexuses
Inhibit gastric emptying

Question 4

What are some drugs used to treat IBD?

Answer 4

Corticosteroids
Immunosuppressants
Biologics
Aminosalicylates

Question 5

How do antacids work?

Answer 5

Contain magnesium or aluminium

Neutralise gastric acid

Question 6

How do alginates like gaviscon work?

Answer 6

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

Question 7

How does ranitidine work?

Answer 7

H2 receptor antagonist

Block histamine receptor to reduce acid secretion

Question 8

How does omeprazole work?

Answer 8

Proton pump inhibitor

Blocks proton pumps to reduce acid secretion

Question 9

How do CCBs affect GI motility?

Answer 9

Decrease it by reducing calcium available for smooth muscle contraction

Question 10

What are the 4 kinds of laxative?

Answer 10

Bulk (ishphagula)
Osmotic (Lactulose)
Stimulant (Senna)
Softeners (Arachis oil)

Question 11

How do laxatives work?

Answer 11

Increasing bulk or drawing fluid into gut

Question 12

What are some adverse side effects of aminosalicylates like like mesalazine?

Answer 12

GI upset

Renal impairment

Question 13

What are some contraindications for corticosteroids?

Answer 13

Osteoporosis

Question 14

Why must corticosteroids be withdrawn gradually?

Answer 14

Risk of Addisonian crisis with abrupt withdrawal

Question 15

How does Infliximab work?

Answer 15

Prevents action of TNFα (key cytokine in inflammatory response)
Biologic

Question 16

What are some contraindications to infliximab?

Answer 16

Current TB or other serious infections
MS
Pregnancy/breast feeding

Question 17

What are some adverse effects of infliximab?

Answer 17

Infection like TB so all patients should be screened
Anaemia
Thrombocytopenia
Neutropenia
Malignancy

Question 18

What does cholestyramine do?

Answer 18

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

Question 19

How does ursodeoxycholic acid work?

Answer 19

Inhibits enzyme involved in formation of cholesterol, altering amount in bile and slowly dissolving non-calcified stones
Used to treat gallstones and Primary Biliary Cirrhosis

Question 20

Are men more or less likely to suffer from drug induced liver injury?

Answer 20

Less

Women are more at risk

Question 21

What are some risk factors for drug induced liver injury?

Answer 21

Age
Female
Alcohol
Genetic factors
Malnourishment

Question 22

Which classification is used to measure severity of liver disease?

Answer 22

Child-Pugh classification
<7=A
7-9=B
>9=C

Question 23

Are methotrexate and azathioprine hepatotoxic?

Answer 23

Yes

Question 24

How do NSAIDs affect ascites?

Answer 24

Can make it worse due to fluid retention