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Year 1 Systems (JBR) > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

What is an example of a PPI?

A

Omeprazole

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2
Q

What is the mechanism of a PPI?

A

Covalent modification of gastric parietal cells H/K-ATPase (proton pumps) in the apical canalicular membranes
Prodrug that is activated in acidic environment

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3
Q

What are uses of PPIs?

A

GORD
PUD
H. pylori eradication
Zollinger-Ellison Syndrom

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4
Q

What are side effects of PPIs?

A 
Constipation
Diarrhoea
Headache 
Fatigue
Dizziness
May potentiate warfarin, disguise symptoms of gastric cancer, decrease effectiveness of Clopidogrel and increase risk of bone fracture
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5
Q

How do you administer a PPI?

A

PO, approx 40 minutes before food

IV in bleed

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6
Q

What is an example of a H2 Receptor Antagonist?

A

Ranitidine

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7
Q

What is the mechanism of Ranitidine?

A

Back action of histamine secreted from enterochromaffin cells decreasing HCl production

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8
Q

Why are H2 Receptor Antagonists not as effective as PPIs?

A

Each and gastrin can still directly stimulate parietal cells

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9
Q

What are H2 Receptor Antagonists used for?

A

Dyspepsia
Peptic ulcers
GORD

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10
Q

What are side effects of H2 Receptor Antagonists?

A 
Hypotension
Headache
Diarrhoea
Constipation
May disguise gastric cancer symptoms
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11
Q

How do you administer H2 Receptor Antagonists?

A

PO

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12
Q

What are exams of anti-motility drugs?

A

Loperamide

Codeine Phosphate

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13
Q

What is the mechanism of anti-motility drugs?

A

Opioid based - agonist of u-opioid receptors expressed by ENS
Decrease peristalsis and segmentation –> constipation
Sphincter constriction
Increased fluid absorption

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14
Q

What are anti-motility drugs used for?

A

Diarrhoea

Analgesia for acute moderate pain

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15
Q

What are contraindications for antimotility drugs?

A

Acute ulcerative colitis
Bloody diarrhoea
C. diff colitis

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16
Q

What are side effects of anti motility drugs?

A

Drowsiness
Constipation
Urinary retention

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17
Q

What are examples of bulk-forming laxatives?

A

Ispagula Husk

Methylcellulose

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18
Q

What is the mechanism of bulk-forming laxatives?

A 
Hydrophilic agents (indigestible - e.g. cellulose) 
Water attracted to stool by osmosis (adequate fluid ingestion important!)
Increase bulk and peristalsis
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19
Q

What are indications for bulk-forming laxatives?

A

Constpiation and faecal impaction
Gastritis
Mild chronic diarrhoea with diverticular disease or IBS

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20
Q

What are side effects from bulk-forming laxatives?

A

Abdominal distension and flatulence

Very rarely faecal impaction and GI obstruction

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21
Q

What are contraindications for bulk-forming laxative?

A

Risk of suffering from ileusintestinal obstruction

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22
Q

How do you administer a bulk-forming laxative?

A

PO

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23
Q

What are examples of osmotic laxatives?

A 
Lactulose
Macrogols
Citrate
Phosphate enemas
Magnesium sulphate/hydroxide
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24
Q

What is the mechanism of osmotic laxatives?

A

Osmotically active
Neither digested or absorbed
Attract water by osmosiss - water attracted to stool
Increase bulk and stimulate stimulate

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25
Q

How is Lactulose effective in over failure?

A

Decrease transit time

Decrease acid - decrease proliferation of ammonia producing bacteria

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26
Q

What are indications for osmotic laxatives?

A

Constipation, faecal impaction
Bowel prep for endoscopy / surgery
Hepatic encephalopathy

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27
Q

What are side effects of osmotic laxatives?

A

Abdominal cramps and diarrhoea

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28
Q

What are specific side effects for phosphate enemas?

A

Local irritation and electrolyte imbalances

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29
Q

When are osmotic laxatives contraindicated?

A

Intestinal obstruction

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30
Q

How is an osmotic laxative administered?

A

PO

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31
Q

What are examples of stimulant laxatives?

A

Senna
Bisocodyl
Glycerol suppository
Docusate sodium

32
Q

What is the mechanism of stimulant laxatives?

A

Increase water and electrolyte secretion from colonic mucosa

Increase colonic content - stimulate peristalsis

33
Q

What are indications for stimulant laxatives?

A

Constipation

Faecal impaction

34
Q

What are side effects of stimulant laxatives?

A

Abdominal pain
Cramping
Diarrhoea

35
Q

How do you administer stimulant laxatives?

A

PO
Rectal for faecal impact
(may be co-prescribed with opioid analgesic to prevent constipation)

36
Q

What are examples of Dopamine D2 Receptor Antagonists? (Anti-emetics)

A

Domperidone

Metoclopramide

37
Q

What is the mechanism of dopamine blockers?

A

Block dopamine receptor in CTZ
Increase gastric motility (pro kinetic)
Increase LOS, gastric emptying and duodenal peristalsis

38
Q

What are indications for Dopamine Blockers?

A

Drug-induced (e.g. chemo) vomiting
Vomiting in GI disorders
GORD
Gastroparesis

39
Q

What are side effects of dopamine blockers?

A

Diarrhoea, drowsiness, physiological disturbances

40
Q

When should dopamine blockers be avoided?

A

GI obstruction

41
Q

How do you administer Dopamine blockers?

A

PO up to 3 times daily

42
Q

What are examples of Muscarinic ACh Antagonists?

A

Hysocine
Scopolamine
Mebeverine

43
Q

What is the mechanism of muscarinic ACh Blockers?

A

Block receptors at vomiting centre
inhibit GI movement and causes GI relaxation
Antispasmodic

44
Q

What are indications for Muscarinic Ash Antagonists?

A

Motion sickness

IBS

45
Q

What is an example of H1 receptor antagonist?

A

Cyclizine

Cinnarazine

46
Q

What is the mechanism of a H1 Receptor Antagonist

A

Block H1 receptor competitively in NTS and vestibular nuclei

47
Q

What are indications of Histamine H1 Blockers?

A 
Acute labyrinthitis (inner ear infection) 
Motion sickness
48
Q

What are side effects of histamine H1 Blockers?

A

Drowsiness and sedation

49
Q

When should H1 receptor blockers be avoided?

A

If high-risk of hepatic encephalopathy and BPH (increase risk of urinary obstruction)

50
Q

What are examples of 5HT3 (serotonin) receptor antagonists?

A

Ondansetron

51
Q

What is the mechanism of Ondansetron?

A

Chemotherapy
Radiotherapy
Post-op induced emesis

52
Q

What are side effects of Ondansetron?

A

Headaches

Constipation

53
Q

When is Ondansetron contraindicated?

A 
Obstruction
Crohn's 
Stricture
Ischaemic colitis
UC
Diverticulitis
Toxic megacolon
54
Q

What are examples of antacids?

A

Aluminium hydroxide

Magnesium hydroxide

55
Q

What are antacids used for?

A

GORD / Dyspepsia

56
Q

What is the mechanism of antacids?

A

Neutralise stomach acids

57
Q

Why are aluminium and magnesium hydroxide used together?

A

Aluminium - constipation

Mag - diarrhoea

58
Q

What are examples of mucosal strengtheners?

A

Sucralfate

Bismuth chelate

59
Q

What is the mechanism of mucosal strengtheners?

A

Bind to ulcer base (+ve charge) to form protective mucosal barrier

60
Q

What are side effects of mucosal strengtheners?

A

Constipation

61
Q

What are indications for mucosal strengtheners?

A

GORD

Ulcers

62
Q

What are examples of 5-ASAs?

A

Sulfasaline

Mesalazine

63
Q

What is the mechanism of 5-ASAs?

A

Anti-infalmamtory

Derived from salicylic acid - though to trap free radicals

64
Q

What are 5-ASAs used for?

A

Ulcerative colitis

65
Q

What are side effects of 5-ASAs?

A

Diarrhoea
Nausea
Cramps

66
Q

What are examples of corticosteroids used in Ulcerative Colitis, Hepatitis, Crohn’s?

A

Prednisolone

Budenoside

67
Q

What is Pancreatin?

A

Decreases pancreatic secretions

68
Q

What is pancreatin used for?

A

CF and chronic pancreatitis

69
Q

What is CREON used for?

A

Replace pancreatic enzymes in CF and chronic pancreatitis

70
Q

What is thiamine?

A

Vitamine B1

71
Q

What is thiamine used for and why?

A

Given to alcoholics because alcohol inhibits thiamine absorption

72
Q

What is an example of a cannabinoid?

A

Nabilore

73
Q

What is the mechanism of nabilore?

A

Decrease emesis triggers on CTZ in medulla

74
Q

What is an indication for cannabinoids?

A

Patients undergoing chemo where nothing else works against CINV

75
Q

What are side effects of cannabinoids?

A

Drowsiness
Dry mouth
Dizziness
Mood changes

Year 1 Systems (JBR) (21 decks)

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