GI SYSTEM- SPASM, LIVER DISORDER, OBESITY, ANAL FISSURES, PANCREATIC INSUFFICIENCY

Question 1

What is a food allergy?

Answer 1

Immune response to specific foods

e.g. peanuts, milk, eggs

Question 2

What is main treatment for food allergy?

Answer 2

Eliminate food from diet

Question 3

What are 4 SEs of food allergy?

Answer 3

N + V + D

Urticaria + angioedema

Dyspnoea + wheezing

Anaphylaxis

Question 4

What is given for anaphylaxis?

Answer 4

Adrenaline

Question 5

What is given for skin reactions?

Answer 5

Chlorphenamine

Question 6

What drug is given also with eliminating food giving allergy?

Answer 6

Sodium cromoglicate

Question 7

What are GI spasms?

Answer 7

Painful contractions of smooth muscle

can be due to IBS, IBD, Colic.

Question 8

What 2 drug classes are used for GI spasms?

Answer 8

Antimuscarinic

Anti-spasmodic drugs

Question 9

MOA of antimuscarinic ?

Answer 9

Reduces gut motility

Blocks muscarinic receptors to cause wide range of sympathetic effects

Question 10

What are some indications of antimuscarinics?

Answer 10

GI spasms

Asthma/COPD, motion sickness arrhythmia , Urinary incontinence, tremors.

Question 11

List 4 antimuscarinics?

Answer 11

Atropine

Dicycloverine

Propantheline

Hyoscine butylbromide

Question 11

What is a CNS SE of atropine?

Answer 11

Delirium

Question 12

What is an MHRA warning for hyoscine butylbromide?

Answer 12

Risk of serious SEs in patients with underlying cardiac disease

Question 13

What is a contra-indication of hyoscine butylbromide?

Answer 13

Tachycardia

Question 13

What is a caution of hyoscine butylbromide?

Answer 13

Cardiac disease - monitor. + resus available

Question 14

What are 6 SEs of Antimuscarinincs? (CUTe BUG)

Answer 14

Confusion, constipation, dry mouth, drowsiness
U
Tachycardia

Blurred vision
Urinary retention
Glaucoma

Question 14

What are 4 colon and bladder related contra-indications of anti-muscarinics?

Answer 14

Paralytic ileus, obstruction, toxic megacolon, urinary retention

Question 14

What is a bladder related caution of antimuscarinics?

Answer 14

Enlarged prostate

Question 15

MOA of antispasmodic?

Answer 15

Direct relaxant of intestinal smooth muscle

Question 15

Indication of antispasmodics?

Answer 15

GI spasms

IBS

Question 15

List are 3 antispasmodics?

Answer 15

Mebeverine

alverine

peppermint oil

Question 16

What antispasmodic drug can cause dizziness - careful driving?

Answer 16

Alverine

Question 16

What is patient counselling for peppermint oil capsules?

Answer 16

Swallow whole - local irritation of mouth + oesophagus

Question 16

What is a contra-indication of antispasmodics?

Answer 16

Paralytic ileus

Question 17

What is an anal fissure?

Answer 17

Tear or ulcer in anal canal

Question 17

What are 3 symptoms of anal fissure?

Answer 17

Linear split sharp pain bleeding- bright red

Question 18

What is treatment for ACUTE anal fissure?

Answer 18

Bulk forming laxative or Osmotic

Question 18

Define chronic anal fissures?

Answer 18

More than 6 weeks

Question 18

What is treatment for chronic anal fissures?

Answer 18

GTN rectal ointment

Question 18

What 2 things can be used for pain relief?

Answer 18

Simple analgesic Local anaesthetic - max a few days

Question 18

What are haemorrhoids?

Answer 18

Vascular swelling in anal canal

Question 18

What are 3 symptoms of anal fissures?

Answer 18

swellings painful + itchy Bleeding - bright red

Question 19

What is treatment for anal fissures caused by constipation?

Answer 19

Bulk forming laxatives

Question 19

What is treatment for anal fissures pain relief?

Answer 19

Simple analgesic

Question 20

What type of analgesic to avoid in rectal bleeding?

Answer 20

NSAIDs

Question 20

What 2 drugs can be used for topical treatment for anal fissures

Answer 20

Local anaesthetic Corticosteroid

Question 21

How long can steroid be used for in treatment for anal fissures?

Answer 21

max 7days

Question 22

What is pancreatic insufficiency?

Answer 22

Pancreas does not secrete enough enzymes

Question 23

What are 4 symptoms of pancreatic insufficiency?

Answer 23

Diarrhoea , abdo cramps, steatorrhea (fat in poop) Malnutrition

Question 23

What is treatment for pancreatic insufficiency?

Answer 23

Replacement therapy - vitamin supplements

Question 24

MOA of pancreatin?

Answer 24

Replaces pancreatic enzymes Help digest protein ,fat + carbohydrate

Question 25

How to take pancreatin?

Answer 25

Meals and snacks Do not mix with very hot food/drink

Question 25

What is one thing patients need to do with pancreatin?

Answer 25

Drink alot of water - if high dose given

Question 25

What dose of pancreatin to give if enteric coated?

Answer 25

Higher dose needed

Question 26

What are 3 main SEs of pancreatin ? (FIG)

Answer 26

Fibrosing colonopathy Irritation - perioral skin + buccal mucosa GI effect (common)

Question 26

What is Fibrosing colonopathy?

Answer 26

Patients with cystic fibrosis taking high dose pancreatin

Question 27

What are 4 risk factors for Fibrosing colonopathy?

Answer 27

Boys CF Laxative use high dose pancreatic enzyme (in excess of 10 000 units/kg/day lipase)

Question 28

What is a stoma?

Answer 28

Opening that puts urine/ faeces into bag

Question 28

What 4 needs should be considered for patient with stoma?

Answer 28

EC + MR preps soluble, liquids, caps GI SEs = drugs like NSAID, iron, Mg + Au antacids Electrolyte + water depletion

Question 29

Can laxatives be used in ileostomy?

Answer 29

NO

Question 29

What laxative to use if colostomy?

Answer 29

Bulk forming

Question 29

How can K+ supplements be given in stoma patients?

Answer 29

Liquid prep split doses