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YEAR 3 DRUGS > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What drug class is Gaviscon?

A

Alignate and Antacid

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2
Q

What is Gaviscon indicated for?

A

GORD symptomatic relief

Dyspepsia - short term relief

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3
Q

How do antacids work?

A

Buffer stomach acids

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4
Q

How do alignates work?

A

Increase viscosity of stomach contents

React with stomach acid to form a floating raft which separates contents from gastro-oesophageal junction

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5
Q

Name an alternative to Gaviscon?

A

Peptac

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6
Q

What are the side effects of compound alignates?

A

Magnesium salts
-Diarrhoea
Aluminium salts
-Constipation

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7
Q

What are the contraindications of compound alignates?

A

Not given to infants with thickened milk preparations

Renal failure

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8
Q

Important drug interactions of compound alignates?

A

Antacids can reduce serum concentrations of many drugs e.g. ACEi, Cephalosporins, Digoxin, PPI etc
Need to take at different times to these drugs

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9
Q

What drug class is Ranitidine?

A

Histamine H2 receptor antagonists

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10
Q

What are H2 receptor antagonists indicated for?

A

Peptic Ulcer disease

GORD

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11
Q

How do H2 receptor antagonists work?

A

Reduce gastric acid secretion
Can do this as acid comes in via the proton pump
Histamine among other substances regulates the pump

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12
Q

What are the side effects of H2 receptor antagonists?

A

Few side effects

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13
Q

What are the contraindications of H2 receptor antagonists?

A

Reduce dose in renal impairment

They can disguise symptoms of gastric cancer

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14
Q

Important drug interactions of H2 receptor antagonists?

A

None

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15
Q

What drug class is Omeprazole?

A

PPI

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16
Q

What are PPIs indicated for?

A

Prevention and treatment of Peptic Ulcer Disease
Symptomatic relief of Dyspepsia and GORD
H. Pylori infection

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17
Q

How do PPIs work?

A

Irreversibly inhibit the proton pump of gastric parietal cells almost completely

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18
Q

What are the side effects of PPIs?

A

GI disturbance
Headache
Prolonged treatment hypomagnesaemia

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19
Q

What are the contraindications of PPIs?

A

Can disguise symptoms of gastric cancer

Can increase the risk of a fracture - so Osteoporosis

20
Q

Important drug interactions of PPIs?

A

Omeprazole acts on P450 and can reduce antiplatelet effect of Clopidogrel

21
Q

What drug class is Loperamide?

A

Antimotility drug

22
Q

What are Antimotility drugs indicated for?

A

Diarrhoea

23
Q

How do Antimotility drugs work?

A

Opioid - (other opiods have similar effects but loperamide has no analgesic effect)
It is an agonist of the opioid receptors in the GI tract
Reduces peristalsis
Increases non-propulsive contractions
Transit of bowel contents is slowed and anal sphincter tone is increased

24
Q

What are the side effects of Antimotility drugs?

A

GI effects

25
Q

What are the contraindications of Antimotility drugs?

A

Acute ulcerative colitis
C Dif colitis
Dysentery - risk of HUS with E. Coli O157

26
Q

Important drug interactions of Antimotility drugs?

A

None

27
Q

What drug class is Senna?

A

Stimulant Laxative

28
Q

What are the types (5) of laxatives?

A 
Bulk-forming
Stimulant
Osmotic
Lubricant
Stool-softener
29
Q

What are laxatives indicated for?

A

Constipation

As suppositories for faecal impaction

30
Q

How do stimulant laxatives work?

A

Increase water and electrolyte secretion
Increase volume of colonic content
Stimulating peristalsis

31
Q

What are the side effects of stimulant laxatives?

A

Abdominal Pain

Cramping

32
Q

What are the contraindications of stimulant laxatives?

A

Intestinal obstruction can lead to perforation
Haemorrhoids - avoid suppository
Anal fissure - avoid suppository

33
Q

Important drug interactions of stimulant laxatives?

A

None

34
Q

What drug class is Mesalazine?

A

Aminosalicylates

35
Q

What are Aminosalicylates indicated for?

A

Mesalazine - Ulcerative Colitis

Sulfasalazine - Rheumatoid Arthritis - used as DMARD

36
Q

How do Aminosalicylates work?

A

Ulcerative Colitis:

  • Release 5-aminosalicylic acid
  • anti-inflammatory and immunosuppressive effects
37
Q

What are the side effects of Aminosalicylates?

A 
GI upset
Headache
Leucopenia
Thrombocytopenia
Renal impairment
Oligospermia
38
Q

What are the contraindications of Aminosalicylates?

A

Aspirin hypersensitivity - salicylates like aspirin

39
Q

Important drug interactions of Aminosalicylates?

A

PPIs increase gastric pH, meaning coating may be broken down prematurely
Lactulose lowers stool pH prevents coating being broken down in colon

40
Q

What drug class is Metoclopramide?

A

Antiemetics (dopamine receptor antagonists)

41
Q

What are dopamine receptor antagonists indicated for?

A

Prophylaxis and treatment of nausea and vomiting

42
Q

How do dopamine receptor antagonists work?

A

There is a vomiting centre in the medulla
Receives inputs from the chemoreceptor trigger zone (CTZ)
Dopamine receptor is the main one in the CTZ
Antagonists don’t trigger this
Also have a prokinetic effect - promote gastric emptying

43
Q

What are the side effects of dopamine receptor antagonists?

A

Diarrhoea

Can induce extrapyramidal syndromes - movement abnormalities

44
Q

What are the contraindications of dopamine receptor antagonists?

A

Children
Young adults
GI obstruction due to prokinetic effect
Perforation

45
Q

Important drug interactions of dopamine receptor antagonists?

A

Antipsychotics have similar effect with extrapyramidal syndromes, so combining is bad
Not combined with dopaminergic agents in Parkinson’s

46
Q

What type of antiemetic is cyclizine?

A

Histamine

47
Q

Side effects with cyclizine?

A

Drowsiness

Dry throat and mouth due to anticholinergic effects

YEAR 3 DRUGS (8 decks)

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