Gastro Drugs Flashcards
What are examples of PPIs?
Omeprazole
lansoprazole
When are PPIs used?
- Peptic ulcer disease- prevention and treatment
- Dyspepsia and GORD relief
- H Pylori eradication
What is the mechanism of action of PPIs?
Irreversibly inhibit H+/K+- ATPase in gastric parietal cells and inhibits the final stage of gastric acid production
What are the common side effects of PPIs?
Headache; dizziness; nausea; diarrhoea; constipation. Prolonged use can lead to bacterial overgrowth in the GI tract
When should PPIs be cautioned?
In osteoporosis- can increase fracture risk
May disguise gastro-oesphoageal cancer
What do PPIs interact with?
Can reduce the antiplatelet effects of clopidogrel
What patient information should be given with PPIs?
Take in the morning before food
Ensure they are aware of the length of the course
What monitoring is required with PPIs?
Symptomatic monitoring
What are examples of osmotic laxatives?
Macrogel, phosphate enema, lactulose
When are osmotic laxatives used?
Constipation and feacal impaction
Bowel preparation prior to surgery
Hepatic encephalopathy
What is the mechanism of action of lactulose/macrogel?
maintains the osmotic contents of the stool
hold water in the stool increasing volume and stimulating peristalisis
Lactulose can also reduce the amount of ammonia held in stool
What are the common side effects of lactulose/macrogel?
Flactulence
abdominal cramps
nausea
When shouldnt lactulose/macrogel be used?
In intestinal obstruction (risk of perforation)
use in caution in heart failure/ascites due to fluid shift
What patient info should be given with Lactulose/macrogel?
Should make stool softer and easier to pass
At least 6-8 glasses of water a day
what monitoring should be done with Lactulose/macrogel?
Stool chart
What are the indications for senna, glycerol suppositories?
Constipation
Fecal impaction
What is the mechanism of action of senna/glycerol suppositories
Increase water and electrolyte secretion from the colonic mucosa
increases the volume of colonic content and stimulates peristalsis
What are the side effects of senna/glycerol suppositories?
Flactulence
abdo cramps
When should stimulant laxatives not be used?
intestinal obstruction
haemorrhoids
what patient info should be given with senna/glycerol suppositories?
6-8 glasses of water a day
May need a few doses before the effects are seen
What is the monitoring for senna/glycerol suppositories?
Stool chart
What class of drugs are cyclizine, cinnarizine, promethazine?
Anti emetics
H2 receptor antagonists
when are cyclizine/cinnarizine indicated?
nausea and vomiting
motion sickness
vertigo
What is the mechanism of action of cyclizine/cinnarizine?
histamine and Ach receptors are mostly found in the vomiting centre of the medulla and in the communication with the vestibular system
What are the side effects of cyclizine/cinnarizine?
Drowsiness
dry throat and mouth
tachycardia
palpatations
when should you use cyclizine/cinnarizine with caution?
Hepatic encephalopathy
prostatic enlargement (may increase urinary retention)
What does cyclizine/cinnarizine interact with?
Sedative affect may be increased with benzodiazepines/opiods
What patient info should you use when using cyclizine/cinnarizine?
IV injections should be given over two mins
Advice about drowsiness (driving etc..)
What monitoring should be given for cyclizine/cinnarizine?
Symptom monitoring
