GI II- Pancreatic & Cholestasis

Question 1

tx aim of Chronic Pancreatitis

Answer 1

• no cure
• Treatment aimed at relieving pain and malabsorption

note:
symptoms: diarrhea, weight loss , pain
causes? alcohol abuse, toxins, CF, Autoimmune disorders etc

Question 2

pain releif management in Chronic Pancreatitis

Answer 2

1) Pancreatic enzymes may also alleviate pain (May be caused by cholecystokinin-CCK normally denatured by pancreatic trypsin)
2) paracetamol, NSAIDs, opioids, TCAs
3) Surger

Question 3

Drugs that induce Pancreatitis

Answer 3

 Azathioprine
 Sulfonamides
 Tetracycline
 Valproic acid
 Didanosine
 Methyldopa
 Estrogens
 Furosemide
 6-Mercaptopurine
 5-aminosalicylic acid compounds
 Corticosteroids
 Octreotide
 GLP-1 (Glucagon-like peptide) analogues
 DPP-4 (Dipeptidylpeptidase-4) inhibitors

Question 4

What is Chloropromazine?

Answer 4

Phenothiazine

Question 5

CU of Chloropromazine

Answer 5

antipsychotic (neuroleptic)

Question 6

AE of Chlropromazine

Answer 6

1) sedation
2) moderate anti-muscarinic and
extrapyramidal side effects

Question 7

Management of Cholestasis

Answer 7

disease specific

Question 8

Tx of Pruritis caused by Cholestasis

Answer 8

1) UDCA -Ursodeoxycholic acid
2) Cholestyramine (bile acid resin)
3) Opoid anatigonists - Naltrexone
4) Phenobarbital/Rifampicin

Question 9

Drugs that induce Cholestasis

Answer 9

 Anabolic steroids
 Oral contraceptives
 Captopril
 Dicloxacillin
 Nafcillin
 Amoxicillin-clavulanate
 Erythromycin
 Chlorpromazine
 Naproxen (NSAID)
 Terbinafine

Question 10

Pathophysio of Cholestasis
* Retention of hydrophobic bile salts –> ——
* Retention of cholesterol –> Impairs membrane fxn
* Reduction of bile into intestines –> —
* Retention of damaging substances

Answer 10

• Retention of hydrophobic bile salts –> Pruritus
• Retention of cholesterol –> Impairs membrane fxn
• Reduction of bile into intestines –> Malabsorption

Question 11

management of malabsorption caused by Cholestasis

Answer 11

Dietary modifications (including vitamin
supplementation)

Question 12

pathophysio of Bilirubin excretion

Answer 12