gi system Flashcards
what bmi is allowed to take orlistat?
what age?
over 28
over 18 yo
what are the s/e of orlistat?
oily stools and faecal incontinence
which medication can you not give alongside orlistat?
levothyroxine amiodarone ciclosporin warfarin acarbose anti-epileptics
which medication must you caution alongside orlistat
oral contraceptives
what vitamin deficiency can orlistat cause?
when must you advice pt to take vitamin supplements?
ADEK
take vitamins at night or 2 hours after orlistat dose
what are the symptoms of constipation?
small hard stools passed less frequently less than 3 times a week straining incomplete emptying abdominal cramps/bloating nausea
when would you refer someone with constipation?
blood in stools - black/tarry/blood mixed in stools
unexplained weight loss
pt over 40 yo with sudden change in bowel habit
medication adr
constipation for more than 2 weeks
what are the 1st line and 2nd line treatment for constipation?
1st line: lifestyle advice
2nd line: bulk forming, stimulant, stool softner, osmotic laxatives
which laxative colours urine yellow/brown?
senna
what are the symptoms of dyspepsia?
bloating, belching, flatulence early satiety fullness nausea and vom heart burn
when would you refer someone with dyspepsia?
ALARM
anaemia
loss of weight
anorexia
recently changes or new unexplained dyspepsia in over 55 yo
malaena [black stools]/persistant vomiting
what is the difference between gastric ulcers and duodenal ulcers?
gastric: pain aggravated by food after eating
duodenal: pain when stomach is empty and keeps pt awake at night
what otc products would you recommend for dyspepsia?
how to take these products?
antacids
alginates [form raft on top of stomach contents]
take after each meal and at bedtime or when required
which otc product is recommended first line for pregnant women suffering from gord [heart burn]
alginates eg gaviscon
what are the s/e of ppis?
abdominal pain, nausea. diarrhoea, vomiting, flatuelence, masks symptoms of gastric cancer
what can long term use of ppi cause?
hypo magnesaemia
osteoporosis
which 3 drugs does omeprazole interact with?
warfarin, phenytoin, clopidogrel
what advice would you give to someone suffering from dyspepsia?
smoking stop
avoid alcohol
raise head of bed
what are the symptoms of haemorrhoids?
swollen veins [inside anal canal = internal. or prolapses outside of anus = external] dull pain on defecation rectal bleeding itching swelling and soreness
when would you refer someone with haemorrhoids?
blood mixed in stools. dark, tarry stools abdominal pain n&v fever loss of appeite severe sharp pain on defecation symptoms more than 3 weeks unresponsive to otc for more than 1 week
what kind of otc products would you recommend for haemorrhoids?
anusol [soothing]
mild astringents
local anaesthetics eg lidocaine
products with hydrocortisone eg anusol HC
which otc haemorrhoid product is not recommended for pregnant and breastfeeding?
preparations containing hydrocortisone eg anusol hc
what is the age requirement for hydrocortisone HAEMORRHOID products??
18 and over
what are the symptoms of diarrhoea?
frequent loose watery stools
dehydration
when would you refer someone with diarrhoea? for how long must symptoms last?
for more than 3 days
when they are showing signs of dehydration
when would you refer a child under 3 months experiencing diarrhoea?
immediately
when would you refer a child under 1 years old, diabetic pt and elderly pt experiencing diarrhoea?
if symptoms more than 1 day
when would you refer a child under 3 years old experiencing diarrhoea?
more than 2 days symptoms
what symptoms would require a referral for someone experiencing diarroea?
blood/mucus in stool weight loss faecal impaction in elderly severe vomiting recent travel abroad chronic diarrhoea for more than 3 weeks
what is 1st line treatment for diarrhoea?
oral rehydration sachets
what are the reconstitution advice for oral rehydration sachets?
dissolve in 200ml water
1 or 2 sachets after each loose motion
must use boiled and cooled water for babies under 1
the solution itself should not be boiled
make immediately before use and store in fridge for 24 hours
what is 2nd line treatment for diarrhoea? what is the age requirement
how to take it and what is the max amount in a day?
12+
loperamide
2 caps after each loose motion. max 8 in a day [16mg]
what are the symptoms of IBS?
lower abdominal spasm
bloating
constipation and diarrhoea
when would you refer someone with iBS?
children over 45 yo and first time symtpoms blood in stools bowel obstruction unexplained weight loss pregnant women suspected depression
name some antispasmodics to treat IBS and the age requirements for them?
mebeverine [18+]
alverine [12+]
peppermint oil [15+]
what is a common s/e of peppermint oil?
heartburn
name some antimuscarincs that can be used to treat ibs and the age requirements of them?
hyoscine [12+ eg buscopan]
diclycloverine [12+]
