GI/peri op drugs

Question 1

Give an example of a drug used for peri op nausea and how it works

Answer 1

Ondansetron

Selectively antagonises serotonin (5HT-3) receptors within the CNS

Question 2

What would you prescribe someone with GORD?

How does it work and what are the side effects

Answer 2

PPI- omepraxole 
Inhibits the H+/K+ ATPase, the channel responsible for pumping gastric acid into the lumen 
Headache 
N+ V 
Hypomagnesaemia

Question 3

Give an example of laxatives

Answer 3

Osmotic laxatives- lactulose

Secretory laxatives- Senna

Question 4

What is the first line treatment for 1) inducing remission 2) maintaining remission in crohns and how do these drugs work

Answer 4

To induce remission- IV hydrocortisone/ oral prednisone
Suppress the bodys normal inflammatory response

To maintain remission-
Azathioprine (thiopurines) inhibit purine synthesis, disrupting DNA synthesis and reducing T cell activation

Question 5

What are the adverse effects of azathioprine (thiopurines)

Answer 5

Bone marrow suppresion- anaemia/leukopaenia/thrombocytopenia
Hepatotoxicity- elevated LFTS
Skin- rash

Question 6

What are the drugs used to induce and maintain remission of UC?

Answer 6

Induce- Iv corticosteroids

Maintain- Aminosalicylate- mesalazine (oral/rectal)

Question 7

What will ultimately cure UC?

Answer 7

Panproctolectomy- left with permanent ileostomy or J pouch (ileo-anal anastomosis)