Clinical pharmacology of the alimentary system

Question 1

3 types of acid suppression drugs

Answer 1

alginates (gaviscon)

H2 receptor antagonists (Ranitidine)

proton pump inhibitors (omeprazole)

Question 2

drugs affecting GI motility

Answer 2

anti-emetics

anti-muscarinics

anti-motility

Question 3

3 categories of alimentary drugs are

Answer 3

acid suppression

drugs affecting the GI motility

laxatives

IBD drugs

drugs affecting intestinal secretions

Question 4

drugs for IBD

Answer 4

aminosalicylates

corticosteroids

immunosuppressants

biologics

Question 5

acid suppression is done by 2 types of drugs

Answer 5

antacids (maalox)

alginates (gaviscon)

Question 6

antacids

Answer 6

continuous magnesium or aluminium to neutralise gastric acid

Question 7

alginates

Answer 7

form a viscous gel the floats on stomach contents and reduced reflux

Question 8

h 2 receptor antagonists

acid suppression

Answer 8

block histamine receptor thereby reducing acid secretion

used in GORD

Question 9

proton pump inhibitors

acid suppression

Answer 9

block proton pump and thereby reduce acid secretion

used in GORD

Question 10

pro kinetic agents increase what?

Answer 10

gut motility and gastric emptying

mechanism of action is unclear but the parasympathetic NS is involved

Question 11

vomitting centre is in the

Answer 11

medulla

Question 12

drugs that decrease motility in the gut have mechanisms of actions that operate via

Answer 12

opiate receptors in the GI tract to decrease ACh

Question 13

anti-spasmodics can be used to reduce symptoms due to…

Answer 13

IBS

renal colic

Question 14

three mechanisms of anti-spasmodics

Answer 14

anti-cholingeric muscarinic antagonists

direct smooth muscle relaxants

calcium-channel blockers

Question 15

4 types of laxative

Answer 15

bulk

osmotic

stimulant

softeners

Question 16

Aminosalicylates

Answer 16

anti-inflammatory effects

Question 17

corticosteriods

Answer 17

anti-inflammatory effects

Question 18

biologics (anti-TNFalpa antibodies)

Answer 18

prevents action of TNFalpha (which is a key cytokine in inflammatory response)

Question 19

other biologics

Answer 19

certolizumab

adalimumab

natalizumab

golimumab

vedolizumab

Question 20

drugs affecting biliary secretions act by

Answer 20

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

Question 21

GI or liver disease can affect the process of a drug (ADME)

Answer 21

absorption

distribution

metabolism

excretion

Question 22

distribution can be hindered when there is…

Answer 22

low albumin (decreased binding)

Question 23

metabolism of the drug can be hindered by

Answer 23

liver enzymes

increased gut bacteria

gut wall metabolism

Question 24

ulcer causation and increased GI bleeding can be the result of what drugs?

Answer 24

aspirin

NSAIDs

warfarin

Question 25

Type A adverse drug reaction can be

Answer 25

intrinsic hepatotoxicity

Question 26

idiosyncratic hepatotoxicity is a what?

Answer 26

Type B adverse drug reaction

Question 27

A common gastrointestinal adverse effect (from a drug) is

Answer 27

drug induced liver injury

Question 28

risk factors for Adverse drug reactions

Answer 28

age

sex

alcohol

genetic factors

malnourishment

Question 29

liver disease classification

Answer 29

child-pugh

Question 30

drugs dangerous to liver

Answer 30

warfarin/anti-coagulants (clotting factors are already low in the liver)

aspirin/NSAIDs (can increase bleeding time)

opiates (increases sedation)