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Pharmacology > Gastrointestinal System > Flashcards

Gastrointestinal System Flashcards

1
Q

Alginates/Antacids

Mechanism of Action

A

Antacids: buffer stomach acids
Alginate: increase viscosity of contents and create floating raft to separate acidic contents from GOJ

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2
Q

Alginates/Antacids

Indications

A

GORD, Dyspepsia

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3
Q

Alginates/Antacids

Contraindications and Side Effects

A

C/I: Thickened milk preparations can lead to bloating, caution in electrolyte imbalance and diabetics (some have Na/K, others sucrose)
Side Effects: Diarrhoea (from free Mg salts), Constipation (from free Al salts)

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4
Q

Alginates/Antacids

Interactions

A

May bind to other drugs

Antacids can reduce concentration of ACEi, Abx, bisphosphonates, digoxin, levothyroixine, PPIs

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5
Q

Alginates/Antacids

Prescription advice

A

Proprietary only (Gaviscon, Rennies), PRN, alongside lifestyle measures, suspend 2/52 before H.pylori test

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6
Q

H2-Receptor Antagonsists

Mechanism of Action

A

Reduce gastric acid secretion by inhibiting histamine from binding to parietal cells

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7
Q

H2-Receptor Antagonists

Indications

A

PUD, GORD/Dyspepsia, Zollinger-Ellison Syndrome

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8
Q

H2-Receptor Antagonists

Contraindications and Side Effects

A

C/I - renal failure, can mask symptoms of gastric cancer

S/E - bowel disturbance, headache/dizziness

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9
Q

H2-Receptor Antagonists

Interactions and Prescription advice

A 
NKDI
Rapid onset (good for pre-op/bariatrics), look out for other gastric cancer symptoms
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10
Q

Proton Pump Inhibitors

Mechanism of Action

A

Irrersible inhibition of H+/K+-ATPase pump of gastric parietal cells almost completely suppresses acid secretion

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11
Q

Proton Pump Inhibitors

Indications

A

PUD, Dyspepsia, GORD, H.pylori eradication therapy

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12
Q

Proton Pump Inhibitors

Contraindications and Side Effects

A

C/I - can disguise gastric cancers, increased risk of fracture
S/E - increased pH reduces immunity

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13
Q

Proton Pump Inhibitors

Interactions

A

Clopidogrel - reduces effectiveness (less so lansoprazole)

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14
Q

Proton Pump Inhibitors

H.pylori eradication therapy

A

1g amoxicillin + 500mg clarithromycin (or 400mg metronidazole) with PPI

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15
Q

Anti-motility (non-CNS opioid) - Loperamide

Brief details

A

MoA: Reduces propulsive contractions via u-receptors
I: Diarrhoea
C/I: acute UC exacerbation (megacolon), C.diff colitis, acute dysentery
S/E - constipation, cramping, flatulance
Interactions: risk of toxicity with other CNS active opioids
Elimination: Bile
Prescription - must have negative C.diff sceen

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16
Q

3 Different Laxative Mechanisms

A
  1. Bulk-forming - hydrophilic, attracts water and stimulates peristalsis
  2. Osmotic - holds water in stool to maintain volume and reduces ammonia absorption by acidifying stool
  3. Stimulant - increases water/electrolyte secretion to increase volume of colonic contents
17
Q

Laxatives

Indications

A

Constipation, hepatic encephalopathy (lactulose)

18
Q

Laxatives

Contraindications

A

Intestinal obstruction, ileus, dehydration, UC/Crohn’s, fluid levels, N&V, haemorrhoids, anal fissure

19
Q

Aminosalicylates
Mesalazine/Sulfasalazine
Mechansim of Action

A

Release 5-aminosalicyclic acid (5-ASA) which is anti-inflammatory against COX-2 and cytokines, breakdown product of sulfapyridine is active in RA

20
Q

Aminosalicylates

Indications

A

UC, RA

21
Q

Aminosalicylates

Contraindications

A

Aspirin hypersensitivity, folic acid deficiency (must be co-prescribed)

22
Q

Aminosalicylates

Side Effects

A

GI upset/headache

Rare - leucopenia/thrombocytopenia, irrecersible oligospermia

23
Q

Antiemetics - Dopamine receptor antagonist
Metoclopramide/Domperidone
Mechanism

A

D2 in chemoreceptor trigger zone is blocked so emetogenic substances in blood do not trigger vomiting, also pro-kinetic

24
Q

Metoclopramide

Indications

A

Prophylactic of N&V

25
Q

Metoclopramide

Contraindications

A

Extrapyramidal effects in <20, bowel obstruction/perforation

26
Q

Metoclopramide

Side effects

A

Diarrhoea, extrapyramidal syndromes, drowsiness, increased prolactin secretion

27
Q

Metoclopramide

Interactions

A

Dopaminergics - Parkinsons medications

28
Q

Alternative antiemetics

A

Cyclizine (H1r antagonist)
Hyoscine Hydrobromide (anti-muscarinic)
Ondansetron (5HT3-r antagonist - used post-op/chemo)

29
Q

Senna

Brief Description

A

MoA - bacterial activation leads to pro-motility improves transit, inhibits absorption of water and elextrolyte, increases secretions
I - constipation
C/I - obstruction, IBD, appendicitis, dehydration, <6
S/E - hypersensitivity, adbo pain/spasm, discoloured urine
Interactions - anything that lowers potassium over long term/cardiac glycosides

Pharmacology (14 decks)

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