GI drugs

Question 1

Give 3 non- pharamacological management of GORD

Answer 1

• Lifestyle advice: dont eat before bed, sleep more upright, loose weight, stop drinking, stop NSAIDs
• check for red flags of stomach cancer (send for endoscopy if any)
• Urease breath test for H. pylori

Question 2

State 4 pharmacological management strategies of GORD

Answer 2

• Antacids
• alginates (gaviscon)
• PPIs
• H2 receptor antagonists

Question 3

Give 2 examples of H2 receptor antagonists

Answer 3

• cimetidine

- ranitidine

Question 4

Comment on the efficiency and safety of H2 receptor antagonists

Answer 4

Very safe, few side effects and interactions.

Less effective than PPIs as other ways of activating parietal cells (CCKr and M3r) still available

Question 5

Give 2 examples of PPIs

Answer 5

omeprazole, lansoprazole, esomeprazole

Question 6

Give 3 ADRs of PPIs

Answer 6

• diarrhoea
• small c diff risk so try not to give with other antibiotics
• osteoporosis with long term use as inhibits Ca2+ absorption
• delayed action (takes a couple of days to start working)

Question 7

How is H. pylori treated? (3)

Answer 7

• clarithromycin
• amoxicillin
• lansoprazole
  you need to use high doses and get diarrhoea commonly so adherence is an issue