GI Drugs

Question 1

What are the two classes in Gaviscon

Answer 1

Alginate

Antacid

Question 2

Name two antacids

Answer 2

Aluminium hydroxide

Magnesium carbonate

Question 3

What are the ADRs of aluminium and magnesium salts?

Answer 3

Magnesium - Diarrhoea

Aluminium - Constipation

Question 4

What are the generic ADRs for Gaviscon?

Answer 4

GI
Renal failure
Hyperglycaemia

Question 5

What class of anti-inflammatory is used in UC?

Answer 5

Aminosalicylates

Question 6

What are two drugs used in UC?

Answer 6

Sulfasalazine

Mesasalizine

Question 7

Name three ADRs of Aminosalicylates?

Answer 7

GI disturbance (N and Dyspepsia)
Leukopenia
Hypersensitivity

Question 8

What classes of antagonist work on the Vestibular Nuclei in motion sickness?

Answer 8

Muscarinic receptor
H1 receptor
D2 receptor

Question 9

Give examples of a muscarinic and three histaminergic receptor antagonists working on the vestibular nuclei.

Answer 9

M -Hyoscine hydrobromide

H - Cyclizine
Promethazine
Levomepromazine

Question 10

Name two drugs recommended for morning sickness?

Answer 10

Promathezine

Prochlorperazine

Question 11

What classes of anti-emetic works in the gut?

Answer 11

D2 Receptor antagonists

5HT-3 agonists

Question 12

What D2 receptor antagonists are indicated in
GORD:
Breast feeding:

Answer 12

D2 Receptor Antagonists

GORD: Metroclopramide
Breast feeding: Domperidone

Question 13

What are the main ADRs for gut-acting D2 antagonists?

Answer 13

Metroclopramide: Dystonia, Parkinsonism
Domperidone: Long QT, VT, Lactation

Question 14

What anti-emetic drug class acts centrally?

Answer 14

D2 antagonists

Question 15

Name 4 D2 antagonists that primarily act centrally

Answer 15

Central D2 antagonists (anti-psychotics)

Haloperidol

Chlorpromazine
Levomepromazine
Prochlorperazine

Question 16

Which two corticosteroids are indicated for emesis?

Answer 16

Dexamethasone

Meethylprednisolone

Question 17

Which anti-emetic class is an agonist of Substance P?

Answer 17

Neurokinin-1 receptor blockers

Question 18

Give three examples of neurokinin-1 receptor blockers

Answer 18

Neurokinin-1 receptor blockers:

Aprepitant
Fosaprepitant
Netupitant

Question 19

What are the first line options for Motion Sickness:

Answer 19

First line: Hyoscine hydrobromide (M antagonist)

Fewer ADRs: Cinnarizine

Question 20

Prokinetics indicated in GORD/Illeus?

Answer 20

D2 antagonists:
Domperidone
Metroclopramide

Question 21

What is the prescribing regime for Gut-related emesis?

Answer 21

1. Ondansetron (Serotonin receptor agonist)
2. Cyclizine (H1 receptor agonist- CI’d in children/elderly)
3. Dexamethasone (C. steroid)

Question 22

What drugs are indicated in Hyperemesis gravidarum?

Answer 22

1. Promethazine (H1)
   Prochlorperazine (D2)
2. Add: Metroclopramide (D2)
   Ondansetron (5HT-3)

Question 23

What anti-emetics are indicated in chemotherapy?

Answer 23

1. Low risk
   Dexamethasone
   P.r.n. Metroclopramide (D2)
2. Moderate risk
   Dexamethasone
   Ondansetron (5HT-3)
   P.r.n Metroclopramide (D2)

3. High risk
Dexamethasone
Ondansetron (5HT-3)
Aprepitant (NK1)
P.r.n Metroclopramide

Question 24

Which anti-emetics are indicated post-operatively?

Answer 24

1. Ondansetron (5HT-3)
   And/or Cyclizine (H1)
2. Add Dexamethasone

Question 25

Which three Mu receptor antagonists are indicated in diarrhoea?

Answer 25

Loperamide
Codeine
Morphine

Question 26

What are the four major classes of laxative?

Answer 26

Osmotic
Stimulant
Bulk-forming
Stool-softeners

Question 27

Name three Osmotic laxatives

Answer 27

Lactulose
Movicol
Cosmocol

Question 28

Name three stimulant laxative drugs?

Answer 28

Stimulant laxatives:

Bisacodyl (sodium picosulphate)
Senna (Codanthromer)
Glycerin (Docusate sodium)

Question 29

Name two bulk-forming laxatives

Answer 29

Medicinal fibres:

Ispaghula husk
Methylcellulose

Question 30

Which stimulant laxative also functions as a stool softener?

Answer 30

Glycerin (docusate sodium)