Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > drugs in GI > Flashcards

drugs in GI Flashcards

1
Q

what factors affect absorption in the GI tract? (9 things)

A
  • Gut motility – if quick movement, less time for drug absorption
  • Gastric emptying
  • Surface area – rate greatest in SI
  • Gut pH – some drugs will denature in the acidity
  • Blood flow
  • Presence of food and fluid: eg tetracycline – reduced if diary in gut as it will collate. Rivaroxaban – have with food
  • Antacids- may neutralise other drugs
  • Drug composition and site of administration- IV/ oral/ topical/ nasal/ inhalation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define constipation

A

defection that is unsatisfactory because of infrequent stool, difficulty in passing stools or sensation of incomplete emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how many bowel movements weekly define constipation?

A

less than 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is faecal impaction?

A

retention of faeces - can vomit it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are symptoms of constipation?

A

loss of appetite, hard stools, painful bowel movement, possible bleeding, stomach distension/ bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

name some medications that can cause constipation

A
  • Opioids
  • Iron
  • Antipsychotics including clozapine
  • Diuretics
  • Verapamil – CCB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what medical conditions can pre-dispose to constipation?

A
  • Coeliac – can cause diarrhoea
  • Depression
  • GI obstruction – carcinoma, ilueus, ovarian/ uterine tumours
  • Electrolyte imbalances
  • MS/ parkinsons
  • Damage to pelvic floor – childbirth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is overflow?

A

diarrhoea can squeeze past blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what do bulk forming laxatives do?

A

act by retaining fluid within stool and increasing faecal mass, stimulating peristalsis
eg ispaghula husk – fibre gel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are side effects of bulk forming laxatives?

A

flatulence and bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the action of osmotic gel laxative?

A

increase amount of fluid in large bowel producing distension of peristalsis and stool softener

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

name some osmotic gel laxatives

A
  • Macrogol, lactulose (takes a few days to work), phosphate enema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the side effects of osmotic gel laxatives?

A

abdo cramps, bloating, flatulence, nausea, vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the action of stimulant laxatives - senna?

A

cause peristalsis by stimulation of colonic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the action of stimulant laxatives like bisacodyl or sodium picosulphate?

A

stimulating colonic pr rectal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are side effects of senna laxatives?

A

: abdo cramps, diarrhoea, nausea/ vomiting, senna may cause yellow- brown colour urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

name some bowel cleansing agents?

A

citamag moviprep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the action of prucalopride laxative?

A

prokinetic laxative, stimulating intestinal motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when would prucalopride laxatives be used?

A

end stage - specialist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how do you manage constipation (3 mths >)

A

: lifestyle – fruit/ veg increase, aim for 30g daily of fibre, increase fluid, exercise. Bulk forming, osmotic (hard stool hard to pass), stimulant (soft stool but difficult to pass)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how do you manage opioid induced constipation?

A

: lifestyle, NO BULK FORMING, osmotic + stimulant, then gradually reduce laxative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how can palliative care cause constipation?

A

medications may contribute (antimuscarinics, opioid analgesics, antacids), secondary effect of disease, direct effect of malignancy causing bowel obstruction, hypercalcaemia, nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how is palliative care constipation managed?

A
  • Aim to alleviate contributing factor, stimulant and softener (senna and lactulose), titrate and add macrogol
  • If faecal impaction/ loading enema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the issue with macrogol (osmotic gel laxative)

A

sachet that needs mixing into water
may be an issue in those that can not swallow - may need to drink alot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how do manage chronic constipation that induces faecal loading?
high dose oral macrogol, enemas, suppositories, disimpaction and oral laxatives in stepwise manner
26
how do manage constipation in pregnancy?
lifestyle and short term laxatives - Bulk, lactulose and senna
27
why do you want to quickly resolve constipation in pregnancy?
reduce strain on pelvis
28
how long is acute diarrhoea?
< 14 days
29
what usually causes acute diarrhoea?
bacterial, viral, food, anxiety
30
what is defined as chronic diarrhoea?
>4 weeks
31
what can cause chronic diarrhoea?
IBS, diet, coeliac, bowel cancer
32
what endocrine conditions can cause diarrhoea?
– hyperthyroidism, adrenal insufficiency, carcinoid tumours, medullary thyroid
33
what GI conditions can cause diarrhoea?
IBS, inflame BS, coeliac, ischaemic colitis, microscopic colitis, short bowel syndrome, malabsorption, bowel obstruction/ constipation with overflow, diverticulitis
34
what dietary intolerances can cause diarrhoea?
: lactose intolerance, fructose intolerance, gluten intolerance, food allergies
35
what medications can cause diarrhoea?
- Laxatives - Antacids with magnesium - Antibiotics - Chemo - PPI - Medicines suppressing immune system – mycophenolate - NSAIDs – used to treat pain and arthritis eg ibuprofen and naproxen - Colchine
36
how do you manage travellers diarrhoea?
ciproflaxin
37
what are the SICK day rules in diarrhoea?
stop any medications that can contribute to dehydration – remove NSAIDs, ACEi, diuretics
38
what are symptoms of c.diff?
fever, crampy abdo pain, diarrhoea
39
what toxins of c.diff can cause mucosal damage?
A and B
40
how do you manage C.diff?
- check AB/ PPIs - isolate and barrier nursing – find initial cause - fluid loss – replenish - vancomycin
41
how can C.diff survice in the stomach?
endospores can survivie pH and then hence invade intestines
42
what are risk factors of c.diff?
: age, frailty, previous history, underlying co-morbiditiess eg abdo surgery, IBS, immunosuppression
43
what are complications of c. diff?
severe and include pseudomonas, colitis, toxic megacolon (invaded whole colon), perforation of colon, sepsis and death
44
describe mild diarrhoea?
not associated with elevated WCC - < 3 episodes of loose stools
45
describe moderate diarrhoea?
– increased WCC - Associated with 3-5 loose stools per day
46
describe severe diarrhoea?
WCC> 15 x10^9 or increased creatinine - Temperature or severe colitis – abdo/ radiological signs
47
describe life threatening diarrhoea
hypotension, partial/ complete ileus (lack of normal muscle contractions), toxic megacolon, CT evidence of severe disease
48
what is GORD?
: chronic condition where reflux of gastric contents back into oesophagus causing heart burn and acid – endoscopy determined oesophagitis or reflux disease
49
what is oesophagitis?
inflammation and mucosal erosion
50
what is dsypepsia?
range of symptoms (not a diagnosis) – symptoms usually present > 4weeks including upper abdo pain, discomfort, heart burn, gastric reflux, nausea/ vomiting, NDSAIDs and h.pylori
51
what is barrets oesophagus?
lining of stomach damaged by stomach acid – risk of cancer
52
what is zollingers ellison sydrome?
condition where gastrin – secreting tumour or hyperplasia of the inslet cells in pancreas causes overproduction of gastric acid, resulting in peptic ulcers
53
what is a hiatus hernia?
: part of stomach moves up into the chest
54
what age does hiatus hernia become more common?
50+
55
what are the causes of depsia?
alcohol gastrisis, biliary disease, food sensivity (spicy food), H.pylori, hepatitis, medications, large hiatal hernia, pancreatic disorders, peptic ulcer disease
56
what is the management pathway of dsypepsia?
- Review medication, lifestyle advice  full dose PPI for a month  test and treat as accordingly (if relapse – low PPI dose as required, if no response use H2 for a month)  review
57
what medications cause dsypepsia?
NSAIDs, corticosteroids, CCB, nitrates, theophylline, bisphosphates (alendronate), combination of SRIs, NSAIDs/ aspirin increases persons risk of GI bleed
58
how do you manage dsypepsia in pregnancy?
- Antacids and alginates are first line – symptoms are relatively mild - If symptoms are severe or persist with antacid/ alginate then try with acid suppressing drug – omeprazole
59
name some PPIs?
- Eg – lansoprazole, pantaoprazole, omeprazole, esomeprazole, rabeprazole
60
what is the action of PPIs?
- Action: block proton pump in gastric parietal cells
61
how do you dose PPIs?
- Dosing: offer full dose for 8weeks but can be long term in those with severe oesophagitis, if NSAID induced stop NSAID if appropriate – full dose PPI for 8 weeks
62
what are the associated risks with PPIs?
- Increased risk of hip fracture - Low magnesium – prolonged use – MHRA warning - C.diff infections – inhibit gastric acid production leading to proliferation of spores and ability - Long term use associated with parietal cell hyperplasia – potential link to cancer
63
what is the action of H2 receptor antagonists?
heal gastric and duodenal ulcers by reducing acid output by blocking H2 receptors
64
how much basal acid secretion and pepsin production is reduced with H2 antagonists?
60%
65
name some H2 receptor antgaonists?
- Nitazatidine, famotidine
66
why is cimetidine (H2 receptor antagonists) not used in practice anymore?
higher risk of drug interactions due to inhibition of cytochrome P450
67
where does H. pylori?
antrum - lower part of stomach inflammation - ulcer – gastric inflammation may lead to duodenal or gastric ulcer- severe complications may include bleeding ulcer and perforated ulcer
68
how do you test for h.pylori?
- carbon 13 urea breath test or stool antigen test or lab based serology where its performance has been locally validated - redo carbon 13 breath test if stoop sample is inconclusive - leave a 2 week wash out period after PPI testing and antibiotics
69
how do you prescribe PPI with GORD?
: full dose PPI for 4 weeks to aid healing
70
how do you prescribe PPI with severe oesophagitis ?
full dose 8 weeks PPI or long term maintenance PPI
71
how do you treat a peptic ulcer if linked to NSAID?
full PPI dose for 8 weeks post NSAID - full NSAID review for at least 6mths - try lower dose ibuprofen and prescribe with PPI
72
how do you treat peptic ulcer with no NSAID use?
first line eradication therapy
73
what is the % hospital mortality with GI bleeding?
10
74
how to manage GI bleeding?
- High dose PPI (pantoprazole) to reduce risk of bleeding and need for surgery - Criticall ill: H2/ PPI oral/ IV to prevent stress upper GI bleeding
75
what are main causes for GI bleeding?
- Usually caused by peptic ulcer or esophagogastric varices
76
what does metoclopramide do?
encourages normal peristalsis in upper GI tract - Does not heal oesophagitis – acts as a 5HT3 blocker at higher doses - CNS side effects – blocks dopamine receptors
77
what are the acute dsytonia symptoms from metoclopramide?
acute dystonia- common in younger and elderly - Treat with procyclidine - Other symptoms: facial grimacing, involuntary upward eye movement, muscle spasms of tongue, face, neck and back, laryngeal spasms
78
what are the tarditive dsykinesia side effects from metoclopamide?
Traditive dyskinesia side effects: - Protrusion and rolling of tongue, sucking and smacking movements of lips, chewing motion, facial dyskinesia – gurning, involuntary movements of body and extremities
79
why does metoclopamide cause so many CNS symptoms?
it can cross brain blood barrier
80
what is the action of domperidone and who can use ?
- Action – block dopamine receptors – release more prolactin – lactation and gynecomastia is common can be used in 12+
81
what is antispasmodics used for?
use as required for abdo pain or spasm in IBS
82
what does meberverine antispasmodics do?
– direct acting smooth muscle relaxant

GI (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions