GIT conditions

Question 1

Name 3 antimotility agents for diarrhoea

Answer 1

• Loperamide
• codeine
• diphenoxylate
Opioid like

Question 2

Moa antimotility agents for diarrhoea?

Answer 2

• Act on pressynaptic opioid receptors in myenteric plexus of enteric nervous system
• inhibit ach release
• increase tone and rhythmic contraction of intestine but decrease propulsion
• loperamide and codeine also antisecretory action- increase Na absorption and decrease cl secretion

Question 3

Name 2 contraindications anti-motility agents for diarrhoea

Answer 3

• Prolonged fever shigella
• toxic megacolon C diff
• acute ulcerative colitis, antibiotic - associated colitis
Not recommended for children

Question 4

Name an antidiarrhoeal agent that modify electrolyte and fluid transport by decrease fluid secretion

Answer 4

Bismuth subsalicylate

Question 5

Name 4 indications bismuth subsalicylate

Answer 5

• Traveller’s diarrhoea
• episodic diarrhoea
• acute gastroenteritis
• h pylori eradication

May cause black discoloration stool and mucous membranes

Question 6

Name 3 adsorbents for diarrhoea

Answer 6

@ Kaolin and pectin
• methylcellulose (fermented fibre)
• aioh
Chalk, charcoal.

Question 7

Moa adsorbents for diarrhoea

Answer 7

absorb toxins or microorganisms by coating and protecting intestinal mucosa, but no evidence, not very affective and interfere with absorption other drugs

Question 8

Name 4 antimuscarinics for diarrhoea

Answer 8

• Dicyclomine
• hyoscine butyl-bromide
• mebeverine
• clidinium bromide
Especially for spasms and cramping.

Question 9

Name 8 drugs that can cause constipation

Answer 9

• Ccb
• anticholinergics
• Opioids
• Aioh
• Amiodarone
• diuretics
• iron
• tricyclic antidepressants

Question 10

Name 3 bulk forming laxatives

Answer 10

• Bran
• methyl cellulose
• ispaghula

Question 11

Name 3 contraindications bulk forming laxatives

Answer 11

• Megacolon
• intestinal obstruction , fecal impaction
• dysphagia

Question 12

Name 2 osmotic laxatives

Answer 12

• Lactulose and sorbitol (nonabsorbable polysaccharides)
• saline purgative
Soften faeces within 3 days.

Question 13

Name 3 stimulant laxatives

Answer 13

• Bisacodyl (PO)
• senna
• castor oil
• low dose MgSO4
Soft/semifluid stool within 12 hours

Question 14

Name 3 anti-constipation agents that will cause watery evacuation within 6 hours

Answer 14

• magnesium citrate, hydroxide or sulphate
• rectal biscaodyl or glycerine
• peg-electrolyte combination

Question 15

Name 5 drugs with examples that can be used to resolve symptoms inflammatory bowel disease

Answer 15

• Aminosalicylates eg sulfasalazine, olsalazine, mesalazine
• glucocorticosteroids eg prednisilone, hydrocortisone, budesonide.
• immunosuppressants eg methotrexate, azathioprine, mercaptopurine, cyclosporine
• antimicrobials
• biologics that inhibit tnf-alpha eg infliximab, adalimumab