Gastro-Intestinal System -Medium Flashcards

(30 cards)

1
Q

What are the 4 types of laxatives?

A
  • Osmotic
  • Stimulant
  • Bulk-forming
  • Faecal softeners
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2
Q

Name some osmotic laxatives

A

Lactulose
Macrogol

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3
Q

Name some faecal softening laxatives

A

Docusate sodium
Glycerol enemas

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4
Q

Name some stimulant laxatives

A

Senna
Bisocodyl
Docusate sodium

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5
Q

Docusate sodium acts as what kind of laxative?

A

Both stimulant and faecal softener

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6
Q

Name some bulk-forming laxatives

A

Ispaghula husk
Sterculia

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7
Q

Which laxatives are used for hepatic encephalopathy?

A

Osmotics
(lactulose/macrogol)

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8
Q

What kind of laxatives should be avoided in opioid-induced constipation?

A

Bulk-forming

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9
Q

What are the first line options for the treatment of opioid-induced constipation?

A

Stimulant + Osmotic

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10
Q

What is used to relieve opioid-induced constipation that has not responded to other laxatives?

A

Naloxegel

Methylnaltrexone bromide is also licensed for this indication

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11
Q

What kind of laxative is the first choice in pregnancy and breastfeeding?

A

Bulk-forming

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12
Q

What are some important adverse effects associated with the use of antimuscarinics such as hyoscine butylbromide?

A
  • Tachycardia
  • Dry mouth
  • Blurred vision
  • Drowsinees
  • Confusion
  • Constipation
  • Urinary retention
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13
Q

What are the first line options for the treatment of Crohn’s disease?

A

Corticosteroid
OR
Budesonide
OR
Aminosalicylates

Aminosalicylates are ;less effective but have fewer adverse effects

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14
Q

What are the possible add-on treatments for Crohn’s disease?

A

Azathioprine
Methotrexate
Infliximab

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15
Q

Which drugs can be used to maintain remission of Crohn’s disease?

A

Azathioprine (+metronidazole post-surgery)
Methotrexate (only if it was needed to induce remission)

Corticosteroids or budesonide should not be used to maintain remission

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16
Q

What are the first line options for the treatment of mild to moderate ulcerative collitis?

A

Topical amonosalicylate
Addition of oral aminosalicylate if necessary
Addition of oral or topical corticosteroid if necessary

17
Q

What are the first line options for the treatment of severe ulcerative collitis?

A

IV corticosteroids
Addition of IV ciclosporin if necessary
Infliximab if ciclosporin contraindicated

18
Q

How is remission of ulcertaive collitis maintained?

A

Using an aminosalicylate (sulfasalazine)

19
Q

Which laxative is used for bowel cleansing?

A

Citric acid with magnesium carbonate

20
Q

Is loperamide a GSL, P-med, or PoM?

A

PoM, except for Imodium orodispersible and Imodium plus

21
Q

Which drugs can cause dyspepsia?

A

Benzodiazepines
NSAIDs
Alpha-blockers
Antimuscarinics
Aspirin
Beta-blockers
Bisphosphonates
Calcium-channel blockers
Corticosteroids
Nitrates
Theophyllines
Tricyclic antidepressants

22
Q

What are the first line treatment options for dyspepsia?

A

PPIs
H2-receptor antagonists

Patients should also be tested for Helicobacter pylori

23
Q

List the most commonly used H2-receptor antagonists

A

Famotidine
Cimetidine
Ranitidine

24
Q

What is misoprostol indicated for?

A

Gastric ulcers

25
What are the H2-receptor antagonists indicated for?
1. Gastric ulceration 2. GORD and dyspepsia
26
Which drugs do H2-receptor antagonists interact with?
Cimetidine interacts with warfarin by inhibiting its metabolism
27
What is the MHRA warning associated with the use of PPIs?
Very low risk of subcute cutaneous Lupus erthematosus (September 2015)
28
What is the first line treatment for H.pylori infection?
PPI + Amoxicillin + Metronidazole (or Clarithromycin)
29
Which stimulant laxatives is indicated for the treatment of chronic constipation in palliative care?
Co-danthramer
30
Which laxative can turn the urine pink?
Co-danthramer