GI

Question 1

Antacid

Answer 1

increases gastric pH

• when gastric HCl reaches nerves in GI mucosa, signals pain to CNA
• forms a thick layer coating the stomach contents to prevent reflux

Question 2

example of antacid

Answer 2

gaviscon

Question 3

when to give antacids

Answer 3

GORD, heartburn, acid indigestion, peptic ulcers

Question 4

contra-indications for antacids

Answer 4

hypersensitivity to active substances

Question 5

side-effects of antacids

Answer 5

rare - drowsiness, dizziness, nausea, vomiting, dry mouth, diarrhoea, abdomen pain, cramps

Question 6

possible interactions of antacids

Answer 6

ACEi + Ca carbonates, digoxin - antacid decreases absorption of these

Question 7

H2 antagonists

Answer 7

reduces gastric acid secretion via blocking parietal cells -blocks histamine receptors so histamine cannot be released and this is what activates the proton pump on parietal cells

Question 8

example of H2 antagonist

Answer 8

ranitidine

Question 9

when to give H2 antagonists

Answer 9

benign gastric and duodenal ulceration, dyspepsia, GORD, prophylaxis of stress ulceration, peptic ulcer disease

Question 10

contra-indications for H2 antagonists

Answer 10

hypersensitivity, gastric cancer, renal impairment

Question 11

side effects of H2 antagonist

Answer 11

diarrhoea, GI disturbance, altered LFTs, headache, dizziness, rash, tiredness

Question 12

how are H2 antagonists eliminated?

Answer 12

renal

Question 13

proton pump inhibitor

Answer 13

suppresses gastric acid secretion by inhibiting H+/K+/ATPase parietal cell

Question 14

example of proton pump inhibitor

Answer 14

omeprazole / lanzoprazole

Question 15

when to give PPIs

Answer 15

peptic ulcers, GORD, dyspepsia, ulcerating reflux oesophagitis

Question 16

contra-indications for PPIs

Answer 16

hypersensitivity, gastric cancer, liver disease

Question 17

side effects of PPIs

Answer 17

GI disturbance (N+V, diarrhoea, flatulance, constipation), headache, agitation, impotence

Question 18

possible interactions of PPIs

Answer 18

increases plasma concentration of digoxin

decreases anti-coag effect of clopidrgral

Question 19

how are PPIs eliminated

Answer 19

hepatic

Question 20

anti-diarrhoeal agent

Answer 20

opiod agonist which acts on the u-receptors in the GI tract, decreasing peristaltic movements, decreasing motility, allowing bowel substances to spend longer time on the bowel, more time for water absorption

Question 21

examples of anti-diarrhoeal agents

Answer 21

loperamide

Question 22

when to give loperamide

Answer 22

diarrhoea

Question 23

contra-indications for loperamide

Answer 23

when peristalsis inhibition should be avoided, abdominal distension, ulcerative colitis, dysentry diarrhoea

Question 24

side effects of loperamide

Answer 24

abdo cramps, dizziness, drowsiness, skin reactions, paralytic ileum, bloating

Question 25

stimulant laxative

Answer 25

increases intestinal motility to loosen the stool (does this by increased electrolyte and water secretion, increasing the volume of colonic contents, increasing peristaltic contractions)

Question 26

example of stimulant laxative

Answer 26

senna

Question 27

when to give a senna

Answer 27

constipation

Question 28

contra-indications of stimulant laxative

Answer 28

intestinal obstruction

Question 29

side-effects of sennas

Answer 29

abdo cramps, diarrhoea, hypokalaemia (diarrhoea decreases vita absorption)

Question 30

elimination of senna

Answer 30

renal - given at night

Question 31

interactions of sennas

Answer 31

diuretics -- Senna depletes Na, | warfarin - diarrhoea decreases absorption of vitamins K and increases bleeding risk

Question 32

aminosalicyclate

Answer 32

diminishes inflammation by blocking cyclooxygenase and inhibiting prostaglandins production in the colon

Question 33

examples of aminosalicyclate

Answer 33

mesalazine

Question 34

indications for aminosalicyclate

Answer 34

ulcerative colitis

Question 35

contra-indications for aminosalicyclate

Answer 35

salicylate hypersensitivity, renal function should be monitored, blood disorders may occur

Question 36

side effects of aminosalicyclate

Answer 36

diarrhoea, nausea, vomiting, abdo pain, exacerbation of colitis symptoms, headache, hypersensitivity rash