GIT Flashcards

1
Q

meclizine

A

1st gen antihistamine (H1)
minimal anticholinergic an sedating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vomiting centre

A

in lateral medullary reticular formation
receptors: H1, M1, NK1, 5HT3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

5HT3 antagonists

A

ondansetron, dolasetron (long QT), palonesetron (long half life)
post op nausea and post chemo (no effect on delayed nausea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aprepitant

A

NK1 antagonist, central blockade CRTZ
chemo related vmiting in combo 5HT and steroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Steroids in post chemo

A

with 5HT3 antag to help with delayed nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CRTZ

A

outside BBB 4th vent
blood and CSF
D2 receptors and opioid receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Domperidone

A

D2 antagonist
Doesn’t cross BBB so EPSEs rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Contraindications D2 antagnists

A

e.g. metoclopromide, domperidone
phaeochromocytoma, previous EPSE, parkinsons, porphyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Loratadine

A

2nd gen antihistamine H1
high vD, does not cross BBB
inc QTc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

1st gen antihistamines

A

all sedating and anticholinergic ecept meclizine
diphenhydramine, promethazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Loperamide

A

opioid agonist doesn’t cross BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diphenoxylate

A

opioid agonist for diarrhoea
analgesic at high dose, contains atropine to stop OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bulk forming laxative

A

psyllium, methylcellulose
SE bloating and flatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Softener laxative

A

docusate, glycerin suppository, mineral oil
mineral oil - aspiration pneumonitis and de absorption ADEK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stimulant laxatives

A

aloe, senna, cascara, bisacodyl
SE colonic dilation and atony
except bisacodyl cause brown pigmentation colon (melanosis coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Osmotic laxatives

A

lactulos, magnesim hydroxicol,
high volume liquid stool
polyethylene glycol - pre endoscopy, isotonic and balanced with electrolytes

17
Q

Methylnaltrexone

A

opioid induced constipation

18
Q

Antacids

A

sodium bicarb - belching and metabolic alkalosis
calcium carbonate - less belching, milk alkali syndrome
Mg - osmotic diarrhoea
Aluminium - constipation
Mg +Al renally filtered - not for CRF

19
Q

H2 antagonist PK

A

A: F0.5 significent 1st pass
D: T1/2 1-4h, VD1L/KG, 70%PB
M: hepatic
E: glomerular filtration, tubular secretion

20
Q

Most and least potent H2 antagonists

A

cimetidine least 400mg BD
Famotidine most 20mg BD

21
Q

Effect of H2 antagonists

A

block 60-70% total acid
more effective inhibiting nocturnal acid secretion

22
Q

SE cimetidine

A

diarrhoea, headache fatigue
mental state change
gynecomastia and galactorrhoea
brady with rapid IV

23
Q

PPI drug type

A

prodrugs, irreversible H/K atpase inhibitors
pka 4-5 weak bases
lipophilic
inhibit 90-98% daily acid

24
Q

PPI bioavailability

A

bioavailability decreased by food
omeprazole 0.4-0.65
lansoprazole >0.8

25
Q

PK PPIs

A

A: PO/IV
D: Onset 05-2h, duration 1d, highly protein bound, small vD
M: p450 liver
E: renal

26
Q

SE PPIs

A

diarrhoea
interstitial nephritis
malabsorption B12, mg and Ca
hip #
risk C diff and other GI bugs + resp

27
Q

Sulfacrate

A

paste that binds GI ulcers 6h
SE constipation (contains aluminium)

28
Q

Bismuth compounds

A

coast GI ulcers
dark stool and tongue

29
Q

prostaglandin analogue GI

A

misoprostyl (PGE1)
dec H2 stimulated cAMP and therefore acid
inc mucous and bicarb

30
Q
A
31
Q

Electrolyte abnormalities sodium phosphate enema

A

Hypicalcaemia and kalaemia
Hypernatraemia
Metabolic acidosis