DRUGS FOR GI DISEASE Flashcards
What are the local GI tract causes of constipation?
Low dietary fibre Diverticular disease Malignancy Irritable bowel disease Anorectal conditions
What are the more systemic causes of constipation?
Hypothyroidism Hypercalcaemia Hypokalaemia Drugs Dehydration Depression Pregnancy Neurological - Parkinsonism, autonomic neuropathy (diabetes)
What is diverticular disease of the colon?
High pressures in the colon cause
Which drugs can cause constipation?
Opiates Calcium channel blockers (verapamil) Anticholinergics (benzhexol) Iron supplements Lithium
How do you manage someone with constipation?
Treat underlying cause More exercise Drink more water More fibre Some drugs
How much fibre do you need a day?
18 grams
What contains a lot of fibre?
Figs, all bran
What are the four classes of pharmacological treatment option for constipation?
Bulk forming laxatives (e.g. bran, ispaghula husk)
Osmotic laxatives (e.g. magnesium salts, lactulose)
Stimulants (e.g. senna) - most useful with opiates
Stool softeners (e.g. arachis oil)
How long does senna take to work?
6-8 hours
How long do osmotic laxatives take to work?
1-3 hours
How long do bulk forming laxatives take to work?
1-3 days
What are the local GI tract causes of diarrhoea?
Gastroenteritis Inflammatory bowel disease Diverticular disease Irritable bowel disease Malignancy Malabsorption
What are the systemic causes of diarrhoea?
Hyperthyroidism
Drugs
Anxiety
Autonomic neuropathy
If there is pain in the abdomen, is the diagnosis more likely to be a local or systemic cause?
Local
What are the microorganisms most likely to cause diarrhoea?
Rotavirus, noroviurs adenovirus, HIV, HSV,
E. coli Salmonella Campylobacter Shigella C diff S aureus
Amoebic dysentery
Giardia
Cryptosporidium
