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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
How is Lactulose effective in over failure?
Decrease transit time | Decrease acid - decrease proliferation of ammonia producing bacteria
26
What are indications for osmotic laxatives?
Constipation, faecal impaction Bowel prep for endoscopy / surgery Hepatic encephalopathy
27
What are side effects of osmotic laxatives?
Abdominal cramps and diarrhoea
28
What are specific side effects for phosphate enemas?
Local irritation and electrolyte imbalances
29
When are osmotic laxatives contraindicated?
Intestinal obstruction
30
How is an osmotic laxative administered?
PO
31
What are examples of stimulant laxatives?
Senna Bisocodyl Glycerol suppository Docusate sodium
32
What is the mechanism of stimulant laxatives?
Increase water and electrolyte secretion from colonic mucosa | Increase colonic content - stimulate peristalsis
33
What are indications for stimulant laxatives?
Constipation | Faecal impaction
34
What are side effects of stimulant laxatives?
Abdominal pain Cramping Diarrhoea
35
How do you administer stimulant laxatives?
PO Rectal for faecal impact (may be co-prescribed with opioid analgesic to prevent constipation)
36
What are examples of Dopamine D2 Receptor Antagonists? (Anti-emetics)
Domperidone | Metoclopramide
37
What is the mechanism of dopamine blockers?
Block dopamine receptor in CTZ Increase gastric motility (pro kinetic) Increase LOS, gastric emptying and duodenal peristalsis
38
What are indications for Dopamine Blockers?
Drug-induced (e.g. chemo) vomiting Vomiting in GI disorders GORD Gastroparesis
39
What are side effects of dopamine blockers?
Diarrhoea, drowsiness, physiological disturbances
40
When should dopamine blockers be avoided?
GI obstruction
41
How do you administer Dopamine blockers?
PO up to 3 times daily
42
What are examples of Muscarinic ACh Antagonists?
Hysocine Scopolamine Mebeverine
43
What is the mechanism of muscarinic ACh Blockers?
Block receptors at vomiting centre inhibit GI movement and causes GI relaxation Antispasmodic
44
What are indications for Muscarinic Ash Antagonists?
Motion sickness | IBS
45
What is an example of H1 receptor antagonist?
Cyclizine | Cinnarazine
46
What is the mechanism of a H1 Receptor Antagonist
Block H1 receptor competitively in NTS and vestibular nuclei
47
What are indications of Histamine H1 Blockers?
``` Acute labyrinthitis (inner ear infection) Motion sickness ```
48
What are side effects of histamine H1 Blockers?
Drowsiness and sedation
49
When should H1 receptor blockers be avoided?
If high-risk of hepatic encephalopathy and BPH (increase risk of urinary obstruction)
50
What are examples of 5HT3 (serotonin) receptor antagonists?
Ondansetron
51
What is the mechanism of Ondansetron?
Chemotherapy Radiotherapy Post-op induced emesis
52
What are side effects of Ondansetron?
Headaches | Constipation
53
When is Ondansetron contraindicated?
``` Obstruction Crohn's Stricture Ischaemic colitis UC Diverticulitis Toxic megacolon ```
54
What are examples of antacids?
Aluminium hydroxide | Magnesium hydroxide
55
What are antacids used for?
GORD / Dyspepsia
56
What is the mechanism of antacids?
Neutralise stomach acids
57
Why are aluminium and magnesium hydroxide used together?
Aluminium - constipation | Mag - diarrhoea
58
What are examples of mucosal strengtheners?
Sucralfate | Bismuth chelate
59
What is the mechanism of mucosal strengtheners?
Bind to ulcer base (+ve charge) to form protective mucosal barrier
60
What are side effects of mucosal strengtheners?
Constipation
61
What are indications for mucosal strengtheners?
GORD | Ulcers
62
What are examples of 5-ASAs?
Sulfasaline | Mesalazine
63
What is the mechanism of 5-ASAs?
Anti-infalmamtory | Derived from salicylic acid - though to trap free radicals
64
What are 5-ASAs used for?
Ulcerative colitis
65
What are side effects of 5-ASAs?
Diarrhoea Nausea Cramps
66
What are examples of corticosteroids used in Ulcerative Colitis, Hepatitis, Crohn's?
Prednisolone | Budenoside
67
What is Pancreatin?
Decreases pancreatic secretions
68
What is pancreatin used for?
CF and chronic pancreatitis
69
What is CREON used for?
Replace pancreatic enzymes in CF and chronic pancreatitis
70
What is thiamine?
Vitamine B1
71
What is thiamine used for and why?
Given to alcoholics because alcohol inhibits thiamine absorption
72
What is an example of a cannabinoid?
Nabilore
73
What is the mechanism of nabilore?
Decrease emesis triggers on CTZ in medulla
74
What is an indication for cannabinoids?
Patients undergoing chemo where nothing else works against CINV
75
What are side effects of cannabinoids?
Drowsiness Dry mouth Dizziness Mood changes

Year 1 Systems (JBR) (21 decks)

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