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Pharmacology > Gastrointestinal Drugs > Flashcards

Gastrointestinal Drugs Flashcards

1
Q

Name some Proton Pump Inhibitors

A

Omeprazole, Lansoprazole, Rabeprazole, Esomeprazole and Pantoprazole

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2
Q

When are PPI’s used?

A

In treatment of GORD, PUD and Zellinger-Ellison Syndrome

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3
Q

How do PPI’s work?

A

Irreversible inhibition of H+/K+ATPase at parietal cells, decreasing secretion of acid into the stomach.

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4
Q

What are some ADRs of PPI use?

A

GI upset, headache and gastric atrophy.

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5
Q

Name some Histamine Receptor Antagonists

A

Cimetidine and Ranitidine

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6
Q

How do Histamine Receptor Antagonists work?

A

Antagonise H2 receptors, preventing amplification of parietal cell stimulation, reducing acid output into the stomach.

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7
Q

What are some ADRs of Histamine Receptor Antagonists?

A

Dizziness, fatigue, gynaecomastia and rash.

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8
Q

When are Histamine Receptor Antagonists best taken?

A

At night, as there is less food to buffer stomach acid, worsening GORD/PUD.

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9
Q

Name some Oral Bulk Laxatives

A

Ispaghula, Bran and Methylcellulose

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10
Q

When are bulk laxatives used?

A

For constipation with hard faeces

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11
Q

What are contraindications for bulk laxative use?

A

Dysphagia, intestinal obstruction or ulceration, colonic atony, faecal impaction.

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12
Q

What is the mechanism of action for bulk laxatives?

A

Increase volume of non-absorbable residue in the gut, stimulating gut wall stretch receptors, increasing peristalsis.

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13
Q

What are ADRs of bulk laxatives?

A

Flatulence, abdominal distension, and gastrointestinal obstruction.

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14
Q

Name some Faecal Softeners and how they are given?

A

Arachis Oil, as an enema, and Glycerol, given as a rectal suppository.

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15
Q

What are faecal softeners used for?

A

Haemorrhoids, constipation, faecal impaction, and anal fissures.

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16
Q

What are contraindications for faecal softener use?

A

Age below 3 years.

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17
Q

What is the mechanism of action faecal softeners?

A

Lubricate and soften stool.

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18
Q

Name some osmotic laxatives and their method of administration

A

Lactulose (oral), Magnesium and Sodium salts (rectal) and Movial (oral powder).

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19
Q

When are osmotic laxatives used?

A

For hard faecal constipation.

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20
Q

What is the mechanism of action for osmotic laxatives?

A

Increase osmosis and water movement into the bowel lumen. Specifically in Lactuloses case, lactulose is fermented by gut flora to acetic and lactic acid, having an osmotic effect.

21
Q

What are ADRs for osmotic laxatives?

A

Flatulence, cramps, abdominal discomfort and intestinal obstruction.

22
Q

When specifically are Magnesium and Sodium Salts used?

A

For rapid relief of severe constipation.

23
Q

When are irritant/stimulant Laxatives used?

A

For soft faecal clearance before operations or medical procedures.

24
Q

What are some examples of irritant/stimulant laxatives?

A

Senna, Danthron, and Bisacodyl

25
Q

What is a contraindication for irritant/stimulant laxative use?

A

Intestinal obstruction

26
Q

What is the mechanism of action for irritant/stimulant laxative use?

A

Increase GI peristalsis and water/electrolyte secretion from the mucosa.

27
Q

What are ADRs of irritant/stimulant laxatives?

A

Hypokalaemia and Colonic Atony

28
Q

Name some oral Anti-motility Antidiarrhoeals

A

Codeine and Imodium

29
Q

How do Codeine and Imodium work?

A

Act as opioid receptor agonsts, which decrease colonic motility and increase anal tone.

30
Q

What are contraindications for codeine or imodium use?

A

Toxic Megacolon (in IBD)

31
Q

What are ADRs for codeine or imodium?

A

Constipation, drowsiness and abdominal cramps.

32
Q

What is an example of a bulk forming antidiarrhoeal and when is it used?

A

Ispaghula, and used in IBS or ileostomy patients.

33
Q

What is a contraindication for bulk forming antidiarrhoeal use?

A

Intestinal obstruction

34
Q

How do bulk forming antidiarrhoeals work?

A

Absorb faecal fluid.

35
Q

When is mebeverine used and how does it work?

A

Decreases colonic hypermotility, to treat symptoms of Irritable Bowel Syndrome

36
Q

What type of drugs can be used as anti-emetics?

A

Dopamine D2 Receptor Antagonists, Serotonin Antagonists, Anti-muscarinics, Histamine H1 Receptor Antagonists, cannabinoids (nabilone) and benzodiazapines.

37
Q

Hoiw do Dopamine Antagonists work?

A

Act on the postrema of 4th ventricle floor (vomiting centre), and increase the rate of stomach emptying.

38
Q

Name some dopamine antagonists used in antiemesis

A

Domperidone, Metoclopremide

39
Q

What is an ADR of dopamine antagonist use?

A

Prolactin release, Extra-pyramidal dystonia

40
Q

What serotonin antagonists can be used for anti-emesis?

A

Ondansetron, Granisetron

41
Q

When are serotonin antagonists likely to be used?

A

For post-op, chemoptherapy and radiotherapy.

42
Q

What is the mechanism of action for serotonin antagonists?

A

Deactivate the vomiting centre, and decrease vagus nerve activity.

43
Q

What are ADRs of serotonin antagonist use?

A

Constipation, flushing and headache.

44
Q

What Anti-muscarinic (M1 antagonist) can be used, and when is it likely to be used?

A

Hyoscine, and used for motion sickness.

45
Q

What ADRs can arise from Hyoscine use?

A

Bradycardia, dry mouth, dyshydrosis

46
Q

What Histamine (H1) antagonist is likely to be used for anti-emesis?

A

Cyclizine or Phenothiazine

47
Q

What contraindication exists for cyclizine?

A

Any history of myocardial ischaemia.

48
Q

What ADRs occur from cyclizine?

A

Sedation and QT prolongation.

Pharmacology (19 decks)

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