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GI Flashcards

1
Q

Alginate-containing Antacid

A

Gaviscon

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2
Q

Alginate

A

Mixture of compounds extracted from brown algae. Alginate forms raft on stomach content surface reducing reflux and protects the esophageal mucosa.

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3
Q

Antacid

A

Bicarbonate, aluminium hydroxide, magnesium trisilicate

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4
Q

Indications for Antacids

A
  1. GORD
  2. Heartburn
  3. Indigestion
  4. Acid regurgitation
  5. Non-ulcerating dyspepsia (indigestion)
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5
Q

Contra-indications for Antacids

A
  1. Hypophosphatemia
  2. Renal Impairment
  3. Hepatic Impairment
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6
Q

Side-effects of Anatacids

A 
Excess abdominal distention 
Hypophosphatemia 
Renal Impairment (Mg salts)
Diarrhoea (Mg salts)
Constipation (Al salts)
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7
Q

Possible Interactions of Antacids

A
  1. May damage enteric-coated tablets
  2. Increase absorption of: ACEi, antibiotics, digoxin and Iron
  3. Increases excretion of Lithium
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8
Q

Patient info for Antacids

A

QDS (4 times a day) after meals and before bed, can be used in preganancy

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9
Q

Ranitidine

A

H2 Antagonists

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10
Q

H2 Antagonists

A

Competitive inhibitor of H2 antagonist preventing gastric secretions by parietal cells. There are 3 major gastric acid secretion pathways and the one stimulated by histamine is inhibited

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11
Q

Indications for H2 Antagonists

A
  1. Benign gastric or duodenal ulcers
  2. Chronic episodic dyspepsia
  3. GORD
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12
Q

Contra-indications for H2 Antagonists

A

Stomach cancer, porphyria, hepatic/ renal impairment

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13
Q

Side effects of H2 Antagonists

A 
DIarrhoea
GI/ LFT disturbances
Headache, dizziness or fatigue
Rash 
Rare: pancreatitis, bradycardia, AV block
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14
Q

Possible Interactions of h2 Antagonists

A

Inhibits CYP450 enzymes increasing bioavailability of oral anticoagulants, phenytoin, carbamazepine, quinidine, nifedipine, theophylline, TCAs

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15
Q

Omeprazole

A

Proton Pump Inhibitor

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16
Q

Proton Pump Inhibitor

A

Binds irreversibly to H+/K+ ATPase in parietal cells in the stomach preventing acid secretion

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17
Q

Indications for Omeprazole

A
  1. GORD
  2. Dyspepsia
  3. Oesophagitis
  4. Gastric/ Duodenal Ulcers
  5. H. Pylori
  6. Zollinger-Ellison Syndrome
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18
Q

Contraindications for Omeprazole

A
  1. GI disturbance
  2. Diarrhoea
  3. Headache
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19
Q

Possible Interactions for Omeparazole

A

Inhibits CYP450 enzymes increasing bioavailability of oral anticoagulants, phenytoin, carbamazepine

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20
Q

Elimination of Omeprazole

A

80% renal and 20% faecal

21
Q

Loperamide

A

Antidiarrheal agents

22
Q

Anti-diarrhoeal Agents

A

Binds to opioid receptors in the gut wall reducing peristalsis and colonic mass movements. Substances stay in gut longer so more water is absorbed creating firmer stools. Loperamide is an opioid butdoesn’t work as an analgesic.

23
Q

Indications for loperamide

A

Acute and chronic diarrhoea

24
Q

Contra-indications for anti-diarrhoeals

A
  1. UC

2. Antibiotic associated colitis

25
Q

Side effects of anti-diarrhoeals

A
  1. Bowel obstruction when used excessively
  2. Opioid causing Nausea and vomiting and respiratory depression
  3. Hypersensitivity -urticariaa
26
Q

Possible Interactions of Loperamide

A

Domepridone and metocolpramide prevents gastric emptying

27
Q

Patient information for Loperamide

A
  1. Should not be used chronically
  2. Should be used after bowel movement
  3. Stop drug if bloating or distension develops
28
Q

Senna

29
Q

Laxatives

A

Senna is hydrolysed in the colon to form anthracine glycoside derivatives which stimulates the mesenteric plexus promoting smooth muscle activity ande defecation

30
Q

Indications for Senna

A

Constipation

31
Q

Contraindications for Senna

A

Intestinal Obstruction

32
Q

Side effects of Lazatives

A
  1. Abdominal cramps and Diarrhoea

2. Rare: hypokalaemia

33
Q

Patient information for Senna

A

Single dose produces effect in 8 hours

34
Q

Mesalazine

A

Aminosalicylates

35
Q

Aminosalicytates

A

Releases 5-aminosalicylic acid in the bowel altering cytokine function. Used to treat Crohns to reduce inflammation

36
Q

Drugs that deliver 5-aminosalicylic acid in different ways

A
  • Mesalazine delivers to large bowel
  • Olsalazine delivers in lower bowel
  • Balsalazide = Mesalazine attached to a protein carrier
  • Sulfasalazine has different properties which deliver it to large bowel
37
Q

Ways in which aminosalicylates is given

A

Tablets for colitis
Enemas for distal colitis
Suppositories for proctitis

38
Q

Indications for Mesalazine

A
  1. Mild-moderate Ulcerative Colitis
  2. Ulcerative Colitis flare prophylaxis
  3. Sulfasalzine is DMARD for Rheumatic Arthritis
39
Q

Contraindications for Mesalazine

A
  1. Hypersensitivity

2. Renal/ hepatic impairment

40
Q

Side effects of Mesalazine

A
  1. Diarrhoea, N&V, abdominal discomfort

2. Hypersensitivity

41
Q

Possible interactions of Mesalazine

A
  1. Lactulose and other alkaline agents prevents formation of 5-aminosalycylic acid in gut
  2. Azathioprine as Mesalazine prevents azathioprine metabolism causing depression of the bone marrow
42
Q

Metoclopramide

A

Anti-emetics

43
Q

Anti-emetics

A
  1. Dopamine D2 receptor antagonist in the chemoreceptor trigger zone in the CNS prevents Nausea and vomiting
  2. It increases peristalsis of the duodenum and jejunum and relaxes pyloric sphincter
  3. Increases transport of food through the GI tract
44
Q

Indications of Anti-emetics

A

Nausea and Vomiting
Migraine
Gastroparesis (poor stomach emptying)
Lactation

45
Q

Contraindications

A
  1. Pheochromocytoma
  2. Parkinson’s disease
  3. Clinical Depression
46
Q

Side-effects of Metoclopramide

A
  1. Focal dystonia
  2. HTN
  3. Hyperprolactinaemia
47
Q

Possible interactions of Metoclopramide

A

Metoclopramide reduces effect of morphine and Levodopa

48
Q

Patient information for Metoclopramide

A

If patient experiences muscle spasms stop medicine

49
Q

Enemas

A

procedure in which liquid or gas is injected into the rectum, to expel its contents or to introduce drugs or permit X-ray imaging.

Y3 Drugs (9 decks)

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