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PRE-REG own > GI tract > Flashcards

GI tract Flashcards

1
Q

What drugs are contraindicated in an acute flare up of UC /crohns?

A

loperamide
codeine
increases risk of toxic megacolon

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2
Q

Does smoking increase the risk of relapse with crohns or UC

A

Crohns

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3
Q

What formulation should be used if UC is located:

  • extensive proximal
  • left sided distal
  • proctosigmoiditis
  • proctitis
A

Extensive proximal-whole colon=oral
left sided distal- enema
proctosigmoiditis - rectum and sigmoid colon= foams
proctitis- rectum= suppository

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4
Q

What is 1st line treatment in UC mild to moderate

A

aminosalicylate depending on location depends on form

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5
Q

What is 1st line treatment in extensive disease of UC

A

topical aminosalicylate and high dose oral aminosalicylate

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6
Q

What is treatment for severe acute UC?

A

Hospital admission for IV corticosteroids and assessment fo surgery

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7
Q

If there are 2 or more flares in 12 months that required systemic ccs then what medication is used as maintenance?

A

Aza or mercapto

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8
Q

What is used as treatment for acute flare up of crohns

A

Corticosteroid

If 2 or more flare ups in12 months then use of aza and mercapto as add on

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9
Q

What is used as maintenance of remission in crohns

A

aza/mercapto

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10
Q

What type of laxative is used if constipation is present in UC

A

after lifestyle advice, bulk forming used

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11
Q

What are key side effects of aminosalicylates to watch out for e..g mesalazine, sulfasalazine

A

blood dysgrasias and symptoms
Nephrotoxicity
Salicylate hypersensitivity-itch, hives
wear SPF

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12
Q

What is a specific side effect of mesalazine

A

pancreatitis

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13
Q

What colour does sulfasalazine turn bodily fluids

A

yellow/orange

may stain contact lenses

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14
Q

what are specific s/e of sulfasalazine

A

pancreatitis
decreased sperm production
sulfa allergy
need to increase folate dose in pregnancy

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15
Q

What is an interaction with aminosalicylates and shouldnt be used together

A

lactulose and mesalazine because lactulose lowers the stool pH in intestines so prevents sufficient release of active ingredient in EC /MR preps - designed to surpass acidic environment and be relased in intestines but pH lowered meaning drug released higher up

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16
Q

In short bowel syndrome what vitamins and electrolytes are deficient / malabsorbed?

A

Fat soluble DAKE and B12
Magnesium
Zinc, selenium

17
Q

As there is incomplete drug absorption in short bowel syndrome, what is needed?
what cannot be used

A

Increased doses of e.g. warfarin, COCs, digoxin if oral

Cant use EC/MR forms

18
Q

If a patient presents to pharmacy with lower abdominal spasms/cramps, bloating, constipation/diarrhoea, what do you suspect?
If they are >45 years old what is action?

A

Suspect IBS

refer if >45 y/o - risk cancer

19
Q

What are the licensing for antispasmodics OTC for IBS?

A

mebeverine: 18+
Alverine: 12+
Peppermint oil colpermin: 15+

20
Q

What is a counselling point for peppermint oil (colpermin IBS relief)

A

Swallow whole, irritates oesophagus and common S/e is heartburn

21
Q

What is the licensing for OTC antimuscarinics e.g. hyoscine butylbromide and dicycloverine for IBS

A

Hyoscine (buscopan) = 12+

Dicycloverinee=12+

22
Q

When would you avoid antimuscarinis for IBS?

A

Glaucoma
prostate enlargement
taking other medicines e.g. TCA, antihistamines, antipsychotics

23
Q

What are red flags for constipation

A 
>50 new onset
Anaemia
abdominal pain
unexplained weight loss 
blood in stools 
history of colon cancer
24
Q

What colour does senna turn urine/fluids?

A

Yellow brown

25
Q

When is co-danthramer used and what colour does it change urine/fluids

A

Terminally ill patients

Red

26
Q

What is 1st line trreatment for constipation?

A

Lifestyle advice!

Then bulk forming if lifestyle not effective

27
Q

How long to bulk forming laxatives take to work and counselling point

A 
72hrs ish(2-3 days)
Need to maintain adequate fluid intake, lots of water but not immediately before bed du to risk of obstruction
28
Q

What is fist line in children with constipation

A

Macrogol with diet/behaviour - diet modification alone is not recommended as 1st line
Add stimulant if inadeqeuate response

29
Q

What is the licensing for
Macrogol
Lactulose

A

macrogol 12+ (or 2-11 movicol paeds)

Lactulose 3+ months

PRE-REG own (35 decks)

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