Gastrointestinal Conditions

Question 1

Name the proton pump inhibitors

Answer 1

Omeprazole
Esomeprazole
Pantoprazole
Rabeprazole
Lansoprazole

Question 2

Name an antacid

Answer 2

Aluminium hydroxide

Question 3

Name the H2 antagonists

Answer 3

Nizatidine

Question 4

What are the drug classes of antiemetics?

Answer 4

Dopamine antagonists
5HT3 antagonists
Substance P antagonists
Antihistamines

Question 5

Name the Dopamine antagonist drugs used for gastric motility and antiemetics

Answer 5

Domperidone
Droperidol
Metoclopramide
Prochllorperazine

Question 6

Name the 5HT3 antagonist drugs used as antiemetics

Answer 6

Granisetron
Ondansetron
Palonosetron
Tropisetron

Question 7

Name the histamine receptor antagonist drugs used as antiemetics

Answer 7

Hyoscine hydrobromide
Cyclizine
Promethazine

Question 8

Name the drugs prescribed for peptic ulcer disease and why they are prescribed

Answer 8

Amoxicillin: It blocks cell wall synthesis of the H. Pylori
Clarithromycin: It blocks protein synthesis of H. Pylori and is acid resistant
Esomeprazole and Omeprazole: Reduces acid secretion into stomach thus stabilising Amoxicillin and Clarithromycin.

Question 9

Name the drugs used for constipation

Answer 9

Stool softeners: Docusate, liquid paraffin, Poloxamer
Stimulant laxatives: Bisacodyl, Senna, Sodium Picosulfate
Osmotic laxatives: Glycerol, Lactulose, Macrogol laxatives, Saline laxatives, Sorbitol
Bulk-forming laxatives: psyllium
Methylnaltrexone
Prucalopride

Question 10

Name the opioid antidiarrhoeals

Answer 10

Diphenoxylate
Loperamide

Question 11

What drugs are used for inflammatory bowel disease?

Answer 11

Corticosteroids: Budesonide, Hydrocortisone (rectal), Prednisolone (rectal)
5-Aminosalicylates: Balsalazide, Mesalazine, Olsalazine, Sulfasalazine

Question 12

What is Gastroparesis? What are the symptoms?

Answer 12

A disorder of delayed gastric emptying in the absence of physical obstruction.
Causes: idiopathic, diabetes, post-surgery, and malgnancies
Symptoms: nausea, abdominal pain, anorexia, early satiety, vomiting, post-cibal fullness, and weight loss.

Question 13

What is Dyspepsia? What are the symptoms?

Answer 13

Recurring indigestion with no obvious causes.
Associated with IBS, alcohol consumption, smoking and NSAID use.
Symptoms: post-cibal bloating, indigestion, pain, excessive belching, nausea and early fullness.

Question 14

What is Gastritis? What are the symptoms?

Answer 14

Inflammation of the stomach lining associated with H. Pylori infection, alcohol consumption, NSAID use, and smoking.
Can occur from an autoimmune condition: Crohn’s, caeliac, and Hashimotto’s diseases.
Symptoms: indigestion, vomiting, nausea, pain, excessive belching, post-cibal bloating, and early fullness.

Question 15

What is Gastroesophageal Reflux Disease? What are the symptoms?

Answer 15

Repeated acid reflux where contents of the stomach flow back up the Oesophagus. It’s caused by a loss of resting tone in the lower oesophageal sphincter. Main symptom is repeated acid reflux.

Question 16

What is Peptic Ulcer Disease? What are the symptoms?

Answer 16

Presence of open, inflamed sores in the lining of the stomach. Indigestion, heartburn and nausea are common symptoms. Caused by infection of H. Pylori bacteria.

Question 17

What is the mechanism of action of proton pump inhibitors?

Answer 17

They are non-competitive inhibitors for the H+/K+ ATPase that pumps H+ into the stomach from parietal cells. The action of inhibiting these transporters lowers the acidity of the stomach.

Question 18

What is the mechanism of action of H2 antagonists?

Answer 18

Competitively blocks H2 receptors of parietal cells, reducing gastric acid secretion.

Question 19

What is the mechanism of action of Dopamine antagonists? What are possible adverse effects?

Answer 19

Inhibition of dopaminergic D2 receptors in the postrema leads to inhibition of vomiting.
AE: akathisia, tremor, dyskinesia and drug induced Parkinsonism

akathisia=restlessness, dyskinesia=involuntary movement

Question 20

What is the mechanism of action of 5HT3 antagonists? What are possible adverse effects?

Answer 20

Blocks 5HT3 receptors in vagus nerve terminal, emetic centre, and CTZ -> blocking
AE: constipation, headache, dizziness, prolonged QT interval.

CTZ = central trigger zone

Question 21

What is the mechanism of action of histamine receptor antagonists as antiemetics? What are possible adverse effects?

Answer 21

Blocks H1 receptors in emetic areas, also antimuscarinic activity.
AE: sedation, psychomotor impairment, dizziness, confusion, blurred vision, mydriasis, dry eyes, constipation, dry mouth, and urinary retention

Question 22

What is the mechanism of action of opioid antidiarrhoeals? What are possible adverse effects?

Answer 22

activate opioid receptors in the gut wall, decreasing bowel motility, and increasing fluid absorption.
AE: abdominal pain and bloating, nausea, vomiting and constipation