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Victor BNF Notes > Gastro-Intestinal System Part 2 > Flashcards

Gastro-Intestinal System Part 2 Flashcards

1
Q

Food Allergy Symptoms

A

Cutaneous
- rashes, urticaria (hives)

GI
- colic (pain in abdomen), vomiting, diarrhoea

Respiratory
- breathing problems

Anaphylactic Shock

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2
Q

Food Allergy Treatment

A
  • avoid food item

Sodium Cromoglicate
Chlorphenamine

Anaphylaxis treatment = adrenaline (epipen)

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3
Q

Gastro-Intestinal Smooth Muscle Spasm Causes

A
  • Irritable Bowel syndrome
  • inflammatory bowel disease
  • bowel colic in palliative care
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4
Q

Gastro-Intestinal Smooth Muscle Spasm Treatment

A

Antispasmodics
- Hyoscine Butylbromide (buscopan)
- Mebeverine

Antimuscarinics
- Solifenacin
- Oxybutynin

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5
Q

Antimuscarinics Mode of Action

A

Reduces intestinal motility
- antagonises the muscarinic receptor, stopping digestion.

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6
Q

Antimuscarinic Side effects

A
  • blurred vision
  • urinary retention
  • constipation
  • dry mouth
  • Tachycardia
  • pupil dilation
  • drowsiness
  • angle-closure glaucoma (eye darinage gets blocked)
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7
Q

Antimuscarinic cautions

A

Diabetes
- as it an cause glaucoma as well

Hyperthyroidism
- as it can also cause tachycardia

Cardiovascular Diseases

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8
Q

Antispasmodics Mode of Action

A

Direct relaxants of intestinal smooth muscle

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9
Q

Antispasmodics and Antimuscarinics contra-indication

A

Paralytic Ileus

Bowel motor activity impaired non-mechanically

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10
Q

What are Anal Fissures?

A

A tear or ulcer in the lining of the anal canal

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11
Q

Symptoms of anal fissures

A

bleeding and or sharp pain or defecation

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12
Q

Acute Anal fissure (<6 weeks) treatment

A

Ensure soft stools or easy pass:
- Bulk forming/osmotic laxatives

Burning pain following defecation
- topical local anaesthetic

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13
Q

Chronic Anal fissure (>6 weeks) treatment

A

Glyceryl Trinitrate rectal ointment

or

Oral/topical
- Diltiazem / nifedipine

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14
Q

What are haemorrhoids?

A

Swelling of the anal mucosal cushion containing enlarged blood vessels (in or out of anus)

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15
Q

Symptoms of Haemorrhoids

A
  • Pain after defecation
  • Bleeding after defecation
  • Swellings
  • itchy sore skin around anus
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16
Q

Risk factors of haemorrhoids

A

Pregnancy
Constipation

17
Q

Lifestyle advice for Haemorrhoids

A
  • Increase fluid intake
  • perianal hygiene
18
Q

Treatment for Haemorrhoids

A

Constipation
- laxatives (bulk forming)

Pain relief
- Paracetamol or NSAID (no NSAID in rectal bleeding)
- Topical anaesthetics (max few days) Lidocaine

Inflammation
- Corticosteroid preparations (max 7 days)
Hydrocortisone, Prednisolone

19
Q

What is Reduced Exocrine Secretions (Pancreatin Insufficiency)

A

Reduced secretion of pancreatic enzymes

20
Q

Symptoms of Reduced Exocrine Secretions (Pancreatin Insufficiency)

A

Maldigestion, malnutrition, GI symptoms

21
Q

Causes of Pancreatin Insufficiency

A

Cystic fibrosis, chronic pancreatitis, Coeliac Disease (when consuming gluten, immune system attacks body), Zollinger-Ellison Syndrome

22
Q

What is Zollinger-Ellison Syndrome

A

A rare digestive disorder that results in too much gastric acid. This excess gastric acid can cause peptic ulcers in your stomach and intestine.

23
Q

Dietary advice for Reduced Exocrine Secretions

A
  • distribute food between 3 meals and 3 snacks
  • avoid difficult digesting foods (peas, beans, lentils, high fibre foods)
  • no alcohol
  • avoid reduced fat diets
24
Q

Pancreatin Supplement

A

it is used to compensate for reduced or absent pancreatic enzymes secretion. Assist with digestion

25
Q

How to take Pancreatin

A
  • Take with food

If high dose doesn’t work, (stomach acid deactivates pancreatin) so use PPI

  • Use enteric coated preparations
  • don’t mix with excessively hot food/drink (deactivated by heat)
26
Q

Side effects of Pancreatin

A
  • Diarrhoea
  • Abdominal pain/cramps
  • Nausea
  • Skin irritation
27
Q

Cautions with pancreatin

A

Can irritate the perioral skin and buccal mucosa if retained in the mouth

excessive doses can cause perianal irritation

28
Q

Contra-indications and patient counselling for pancreatin

A

Contra-indications
- Nutrizym 22
- Pancrease HL
in children aged or under with cystic fibrosis

Patient Counselling
- good hydration with high dose

Victor BNF Notes (25 decks)

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