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Pharm Cram > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

Name an anti motility drug for treating diarrhoea

A

Loperamide (an opiate analogue)

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2
Q

What adverse effect can occur if loperamide is given in IBD

A

Toxic mega colon

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3
Q

Example of a bulk forming anti diarrhoeal drug

Why is it useful in IBS

A

Ispaghula husk

Reduces both constipation and diarrhoea. Encourages normal bowel function

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4
Q

Give an example of a fluid absorbent

Comment on clinical use

A

Kaolin

Rarely prescribed

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5
Q

Describe GI enteric nervous system
Name 2 plexuses involved
What acts as pacemaker?

A

Autonomous. Allows intrinsic control of GI motility
Auerbach’s and Meissner’s plexuses
Interstitial cells of canal act as pacemakers

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6
Q

How do faecal softeners act as laxatives?

A

Lubricate and soften stool

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7
Q

What advantage do faecal softeners offer compared to other laxatives?

A

No risk of intestinal obstruction

However although safer, not as effective

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8
Q

Example of a faecal softener

A

Docusate sodium

Arachis oil

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9
Q

Name the 3 types of osmotic laxative

A

Magnesium & sodium salts eg phosphate enema
Lactulose syrup
Macrogols (powders)

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10
Q

Which of the osmotic laxatives acts most rapidly?

A 
Phosphate enema (can be given PR for urgent relief)
Effects are quick but severe
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11
Q

How does lactulose work?

A

Not absorbed but digested by colonic to produce lactate

Lactate causes osmotic effect.

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12
Q

Explain the mechanism behind bulk laxatives

A

Insoluble, non absorbable (eg veg. fibre)

Gut distension attempts to re establish normal bowel function

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13
Q

Example bulk laxative

A

Ispaghula husk

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14
Q

ADR of -bulk laxative -irritant/stimulant laxative

A

Bulk - flatulence

Irr/Stim - Abdo. Cramps
repeated use can cause colonic atony (constipation)
Hypokalemia

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15
Q

Name 2 irritant/stimulant laxatives

A 
Senna
Glycerol suppositories ( rectal mucosal action)
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16
Q

Explain MoA of irritant/stimulant laxatives

A

Excite sensory nerve endings
Leads to electrolyte , water retention in bowel lumen
Peristalsis

17
Q

What 2 structures close during emesis?

A

Pyloric sphincter

Glottis

18
Q

What 3 structures are inv in the emetic control?

A

Vestibular apparatus

Medulla (CTZ and vomiting centre)

Postrema on floor of 4th ventricle

19
Q

Name 4 hormonal receptors blocked by anti-emetic drugs

A

Dopamine D2
Serotonin (5HT) 3
Muscarinic (ACh)
Histamine H1

20
Q

What is the mechanism of Hycoscine?

A

Muscarinic cholinergic receptor antagonist

21
Q

How does Ondansteron act?

A

5HT3 receptor antagonist

22
Q

What receptor does Domperidone act on?

A

D2 (dopamine) antagonist

23
Q

What receptor does Cyclizine act on?

A

H1 receptor antagonist

24
Q

Ondansteron use

A

CHEMO and radiation induced w CORTICOsteroids even more effective

25
Q

Ondansteron ADRs

A

Flushing Headaches

26
Q

Hycoscine use

A

Motion sickness pill or patch

27
Q

Hyosine ADRs

A

Anti cholinergic

Eg dry mouth, blurred vision

28
Q

Cyclizine use

A

Acute nausea and vomiting including motion sickness

29
Q

Cyclizine crosses the BBB. What are some ADRs?

A

Drowsiness
Sedation
!!! QT prolonged !!!!

30
Q

Domperidone can increase which hormone? What ADR will this cause?

A

Prolactin. Galactorrhoea

31
Q

Name a H2 receptor Antagonist

A

Cimetidine, ranitidine, famotidine, nizatidine

32
Q

Name H2 antagonist ADRs

Name a cimetidine specific ADR

A

(ADRs Rare) dizziness, muscle pain, rashes

Gynaecomastia

33
Q

Name some PPIs

A

Omeprazole, esomeprazole

34
Q

PPI ADRs

A

Uncommon

Headaches, rashes, diarrhoea

35
Q

The 3 anti diarrhoeal drug mechanisms/approaches

A

Anti motility
Bulk forming
Fluid absorbents

Pharm Cram (10 decks)

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