Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3rd Year Drugs > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

Name PPIs

A

Omepraziole
Lansoprazole
Pantoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indications of PPIs

A

1) Duodenal and gastric ulcers
2) Eradicating H. Pylori - in combination with antibitoics
3) Zollinger-Ellison Syndrome
4) GORD
5) Stircturing and erosive oesophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Zollinger-Ellison syndrome?

A

A rare condition in which one or more tumours forms in the pancreas or the duodenum

These tumours secrete lots of gastrin - a hormone that causes your stomach to produce too much acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Side effects of PPIs

A

Headache, diarrhoea, abdo pain (most common)

Nausea, flatulence, dry mouth (less common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Managing the adverse effects of PPIs

A

Side effecst usually mild
Analgesia for headache
Report excessive diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Action of PPIs

A

Inhibit gastric acid by blocking H+/K+ enzyme of the gastric parietal cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Contraindications of PPIs

A

Hypersensitivity
Pregnancy and lactation
Caution in older adults and patients with liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Interactions of PPIs

A

1) Omeprazole inhibits cytochrome P450
2) Lansoprazole is a weak inducer of cytochrome P450

Omeprazole and clarithromycin –> increased serum concentration of both drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name some antacids

A

Gaviscon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indications of antacids

A 
1) Hyperaciditiy problems e.g.
Heartburn
GORD
Sour Stomach
Peptic Ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 4 types of antacids

A

1) Aluminium
2) Calcium
3) Magnesium
4) Sodium Carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the additional use of aluminium antacids

A

It treats hyperphosphataemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adverse effects of each type of antacids

A

Aluminium - constipation, intestinal impaction

Calcium - rebound hyperacidity

Magneisum - severe diarrhoea

Sodium Carbonate - Systemic Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contraindication of antacids

A

Severe abdominal pain with no known cause
During lactation

Na: Patients with CV problems e.g. hypertesnion
Ca: Patients with renal calculi or hypercalcaemia
Al: Gastric outlet obstructions
Mg + Al: Decreased kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Side effecst of antacids

A

Magnesium and Sodium = diarrhoea

Aluminium and calcium = constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Interactions of antacids

A

1) They increase gastric pH - hence reduce the absorption of weakly acidic drugs
2) Absorbs/binds to drug surface - decrases the absorption of tetracycline
3) Increases urinary pH changing the rate of drug elimination
4) Decreases pharmacological effect of: corticosteroids, Iron, digoxin, chlorpromazine, ranitidine, tetracyclines, isonizaid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name H2 antagonists

A

Ranitidine/Zantac
Cimetidine/Tagamet
Nizatadine + Famotidine/ Pepcid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Indications of H2 antagonists

A

Gastric + duodenal ulcers
Gastric hypersecretion + GORD
Prevent stress related ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adverse reactions of H2 antagonists

A 
Dizziness
Somnolence
Headache
Confusions
Hallucinations
Diarrhoea
Impotence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Managing adverse reactions of H2 antagonists

A

Most are mild and transient
May requied help with walking/self care
Skin rash, fever, bleeding, hallucinations should be reported immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Actions of H2 antagonists

A

Inhibit histamine action at stomach
Reduces gastric acid secretion
Reduces total pepsion
Decreased acid allows gastric ulcers to heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Contraindications of H2 antagonists

A

Hypersensitivity
Renal/hepatic impairment
Caution in older people due to causing confusion
Caution in pregnancy and lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interactions

A

1) Antacids + metoclopramide decreases if concurrent
2) Cimetidine + digoxin: causes low digoxin levels
3) Alkylating drug or antimetabolite - causes low WBC
4) Cimetidine + morphine: Increased risk of respiratory depression
5) Increased toxicity of oral anticoagulants, phenytoin, lidocaine, quindine, theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name amino-salicylates

A

Mesalazine/Asacol
Sulfasalazine

Anti-inflammatories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Indications of amino-salicylates

A

1) Mild/moderate UC - helps prevent further episodes

2) Maintenance of remission of Crohn’s ileocolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Contraindications

A 
Allergy
Decreased kidney function
Decreased liver function
Blood clotting abnormalities
Chilren under 12
Avoid sulfasalazine in G6PD deficiency + men who want to stay fertile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Side effects

A 
Nausea
Abdo Pain
Vomiting
Diarrhoea
Dizziness
Flatulence
Headache
Rashes (including toxic dermal necrolysis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Action of amino-salicylates

A

Readily absorbed from the small intestine - attached to a resin to ensure release in the large bowel
Act on cells lining the small and large intestine - changes the way they release chemicals (stops UC)
Mesalazine blocks COX + inhibits prostaglandin production in action - allowed damaged intesting to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Interatcions of aminosalicylates

A

1) Indigestion remedies - can affectt ablet coating preventing mesalazine elease
2) Lactulase medication altering stool pH - prevent mesalazine wokring
3) Risk when used with azathioprine/mercaptopurine –> increased risk of side effects on blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

eliminations of aminosalicylates

A

Faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name some laxatives

A

Senokot

Movicol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the 4 different types of laxatives

A

1) Bulking agents
2) Stool softeners
3) Osmotic laxatives
4) Stimulant laxatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do bulking agent laxatives work

A

Absorb mor fluid
Bigger stools
Gives you the urge to pass stool
Works in 12-24 hours

34
Q

How do stool softener laxatives work

A

Soften the stool
Easier to pass
Only work if you drink enough water
WOrk in 24-48 hours

35
Q

How do osmotic laxatives work

A

These are things such as milk/lactulose
Holds fluid in the intestine
Draws fluid into the intesting form the tissues
Makes the stool softer and easier to pass
Works in up to 2 days

36
Q

How do stimulant laxatives work

A

E.g. Dulcolax and Senokot
SPeeds up stool through the intestine by stimulation the nerve
Regular use not recommended as this changes the tone and feeling in the large intesting and can leed to dependences

They work in 8-12 hours

37
Q

What type of laxative is movicol

A

An osmotic laxative

38
Q

Contraindication of laxatives

A

Bowel obstructoin

Crohns/UC

39
Q

Side effects of laxatives

A

1) Osteopenia - regular use changes ability to absorb vitamin D/calcium
2) Bulk forming lacatives –> can make symtpoms worse is you have severe constipation = abdo bloating and discomfort without clearing faeces that are further downt he gut

40
Q

Interactiosn of laxatives

A

Antacids containing Aluminum or magnesium

41
Q

What order should you prescribe laxatives

A

Bulk 1st line –> then osmotic –> then stimulant

Take any laxative with lots of water

42
Q

How should patient take amino-salicylates

A

Take tablets whole with lots of water

43
Q

Name some anti-diarrhoeal agents

A

Loperamide (immodium)
Atropine (Motofen)
Diphenoxylate with atropine (Lomotol)

44
Q

Indications

A

Treats diarrhoea

45
Q

Adverse reactions of anti-diarrhoead agents

A 
Unusual for loperamide but include:
Dry mouth
skin rash
Dizziness
Abdominal Discomfort
46
Q

Advesre reactins of diphenoxylate (Lomotil) anti-diarrhoea agent

A

It is a narcotic rlaeted drug
It has sedative and euphoric effects
It is commbined with atropine to discourge its abuse

47
Q

What is atropine

A

Atropine is an anti-cholinergic drug

The side effects of this mean its combined with diphenoxylate

48
Q

Managing the adverse reaction of anti-diarrhoeal agents

A

Monitor fluid intake/outtake
Replace electrolytes in severe diarrhoea
Mild soap for perianal irritaiton

49
Q

What are the actions of anti-diarrhoeal agents

A

They decrease intestinal persitalsis
Potentially antagoniszing ACh release in the intramural nuerve plexus

They are poorly absorbed and act directly on the bowel

50
Q

Contraindications of anti-diarrhoeal agents

A

Diarrhoea associated with organisms that can harm the intestinal mucosa (e.g. E. Coli, Shigella, Salmonella)

Pseudomembranous Colitis

Under 2 years age

51
Q

Caution in using anti-diarrhoeal agents

A

Pregnancy + lactation
IBD
Severe liver disease

52
Q

Interactinos of anti-diarrhoeal agents

A

Additive CNS depression with alcohol

Additive cholinergic effects when other drugs have antihcholinergic properties (e.g. antihistamine/depressants)

With monoamine oxidase inhibitors - increased hypertesive crisis

53
Q

Is vomiting a somatic or autonomic response

A

It is somatic
Dopamine excites the CTZ - the CTZ activates the vomiting centre causing = emesis

ONLY USE ANTIEMETICS WHEN THE CAUSE OF COMITING IS KNOWN

54
Q

Several types of anti-emetics

A

1) Antichonlinergics
2) Antihistamines
3) Dopamine antagonists
4) Phenothiazine
5) Neuroinine antagonists
6) Cannabinoids
7) 5-hydroxytryptamine receptor antagonists

55
Q

What is hyoscine

A

an anticholinergic anti-emetic

56
Q

What is promethiazine

A

an antihistamine anti-emetic

57
Q

What is metoclopramine

A

a dopamine agonist anti-emetic

58
Q

what is prochlorperazine

A

a phenzothiazine anti-emetic

59
Q

What is aprepitant

A

A neurokinen antagonist anti-emetic

60
Q

What is nabilone

A

A cannabinoid anti-emetic

61
Q

What is ondansetron

A

What is 5-hydroxytryptamine receptor antagonist anti-emetic

62
Q

Indications fo anti-muscarininc anti-emetics e.g. hyoscine

A

1) Motion sickness - useful in single doses. Its side ffects make it inappropriate for long term use

it is also an alternative to anti-histaimnes and phenothiazines for the treatment of vertigo and nausea associated with Meniere’s disease

63
Q

Side effcts of anti0muscaring anti-emetic e.g. hyoscine

A

Drowsiness
Dry mouth
Blurred vision
Urinary retention

64
Q

Indications of dopamine antagonists anti-emetic e.g. metaclopramide

A

Post-op nausea
Radiationi sickness
Allows diagnostic radiology of small intestine

65
Q

Adverse effects of dopamine antagonist anti-emetics e.g. metaclopramide

A

Usually mild - but more common in women and young people

Extra-pyramidal effects (1%)
Akathisia - movement disorder
Oculogenic crises
Torticolis - a crick in the neck
Opisthontons - spasm of muscles
Parkinsonian features

Treat with benzothriopine or diazepam

66
Q

Action of dopamine antagonist anti-emetics

A

They increase ACh at post-ganglionic terminals
Central dopamine antagonist
Incrased doses block 5-HT3 receptor (serotonin receptors)

67
Q

Pharacokinetcs of dopamine antagonists anti-emetics

A

Well absorbed orally
75% excreted as metablites in urine
Half life is 4 hours

68
Q

Drug interactions of dopamine antagonists anti-emetics

A

Metacloprimade potentiates extra-pyramidal effects of phenzothiazines butryruptenes

Increase absorption of tetracyclines, aspirin, paracetamol

69
Q

How does domperidone a dopamine receptors agaonists differ from metocloparmide

A

It doesn’t cross the BBB
Seldom causes extra-pyramidal effects
It can be given with levodopa to counter their emetogenic effect

70
Q

How do phenothiazine anti-emetics work

A

Act on thte CTZ
useful against radiaiton-induced vomiting
Least effective against motion sickness
Risk of extra-pyramidal effects e.g. dyskinesia and restlessness

71
Q

How do 5HT3 receptor antagonist anti-emetics work e.g. ondansetron

A

Treat acute nausea due to chemo or post op

Their site of action is unclear

72
Q

How do cannabinoid anti-emetics e.g. nabilone work

A

Prevent vomiting due to cytotxic therapy

Acts on cortical centrea affecting descending vomiting pathways

73
Q

Adverse effects of anti-emetics

A 
Sedation
Confusion
Hypotension
Loss of coordination
Dry mouth
74
Q

Indiciations of anti-histaminic anti-emetics

A

Motion sickness
Vertigo due to labyrinthe disroders
They also have additional anticholinergic effects

75
Q

Limitations of anti-histaminic anti-emetics

A

modest efficicay and common dose related side effects

Antimuscarainic effects may be caused

76
Q

When to use cyclisine

A

oral or injection for opiate-induced vomiting

Safe in prgancny

77
Q

Which antihistamine anti-emetic is more sedative

A

Promethazine

78
Q

What antihistamine anti-emetic should we use in vertigo

A

Betahistine

Also treates Meniere’s and hearing loss

79
Q

what is Clinnazine

A

An Antihistamine and calcium antagonist anti-emetic

acts on the labyrinthe to treat motion sickness and vertigo

80
Q

Name some miscellaneous anti-emetics

A

1) Glucocorticosteroids –> anti-emetic when with cytotoxic therapy as dexamethasone improves 5HT3 antagonists
2) Benzodiazpines –> give before cytotoxic treatment to reduce vomiting

3rd Year Drugs (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions