GIT - Medications Flashcards
1
Q
Antacids
A
- basic (alkaline) compounds that neutralise hydrochloric acid in the stomach
- aglinates contain alginic acid which creates a thick gel that prevents gastric acid rising in the stomach
- indications - gastric hyperacidity, peptic ulcer, reflux, gastritis, heartburn, indigestion, dyspepsia
- preperations - mylanta, gastrogel, alginates - gaviscon, mylanta
- A/E - constipation, diarrhoea, hypercalcaemia, abdominal distention, alkalosis, fluid retention
- considerations - antacids reduce absorption of other meds, binding with them, should not be given within 2 hours of any other medications, need to be shaken well, liquids act faster than tablets
- avoid with constiaption, heart failure, diarrhoea, kidney failure
2
Q
Antiemetics - Dopamine Agonists
A
- drugs which manage nausea & vomiting
dopamine agonists - block dopamine receptors in the chemoreceptor trigger zone and vomiting centre, decreasing vomiting, can also be prokinetic agents which increase mobility of the upper GI and increase gastric emptying
- common - metoclopramide (maxalon)
- prochlorperazine (stemetil)
- domperidone (motilium)
- A/E maxalon - restlessless, drowsiness, hypotension, tachycardia, extrapyramidal reactions, insomnia
- stemetil - constipation, dry mouth, drowsiness, extrapyramidal reactions, blurred vision
- motilium - abdominal cramping, headache, dizziness, insomnia
3
Q
Anitemetics - 5-HT3 Receptor Antagonists
A
- block 5-HT3 receptors in GIT and vomiting centres which stimulates to reduce vomiting
- indications - nausea & vomiting related to chemo, postoperative nausea & vomiting
- dolasetron (anzemet)
- ondansetron (zofran)
- tropisetron (naoban)
- A/E - headache, flushing anxiety, dizziness, drowsiness, constipation, abdominal discomfort, hypotension
4
Q
Corticosteroids
A
- have been found effective for chemotherapy induced nausea
- dexamethasone
- methylprednisolone
5
Q
Proton Pump Inhibitors
A
- weakly basic drugs that suppress gastric acid secretion by inhibiting the ATPase enzyme system blocking the final stages of acid production
- indications - gastric & duodenal ulcers (used in combination with amoxycillin & clarithromycin), oseophagitis
- esomeprazole (nexium)
- pantoprazole (somac)
- omeprazole (losec)
- A/E - headache, dizziness, abdo pain, GIT disturbance, rash
- readily absorbed from GIT, reaches peak in 3-5hrs
6
Q
Histamine H2-Receptor Antagonists
A
- block histamine release, histamine release induces H2 receptors to increase gastric acid secretion, blocking receptors decreases volume of gastric acid secretion
- indications - gastric & duodenal ulcer, reflux, oesophagitis
- cimetidine
- ranitidine
- famotidine
- A/E - headache, dizziness, tiredness, diarrhoea, constipation, musculoskeletal pain, rash, confusion
- considerations - should be taken with meals, need to continue treatment for 4-6 weeks, monitor vitals closely if given IV, may inhibit the metabolism of many other medications
7
Q
Cytoprotective Agents
A
- create a physical barrier over an ulcerated gastric surface by creating a gel for short term management of ulcers
- sucralfate
- composed of sulphated sucrose & aluminium hydroxide
- acts only in the presence of acid to form a sticky gel that creates a barrier for up to 6hrs
- A/E - constipation
- misoprostol
- prostaglandin analogue (like what the body produces naturally) that inhibits gastric acid secretion & increases gastric mucus
- A/E - diarrhoea, abdo pain, dyspepsia, nausea & vomiting, hypotension - not used in pregnant women
8
Q
Antispasmodic Drugs
A
- used to control intestinal smooth muscle spasm, as well as relax smooth muscle in other parts of the body
- antimuscarinic drugs that block muscarinic receptors and reduce contractions
- hyoscine (buscopan)
- mebeverine
9
Q
IBD - Management - Aminosalicylates
A
- management includes corticosteroids (prednisolone), immunosuppressants & aminosalicylates
- aminosalicylates - prostaglandin inhibitors used to reduce inflammation
- sulfasalazine
- mesalazine
- olsalazine
10
Q
Laxatives
A
- drugs given to increase the speed of food transit through the bowel
- bulk stimulants
- contain polysaccharide polymers that are not broken down by metabolism, stimulate peristalsis by increasing bulk of stool through water absorption
- drag water into bowel, makes fecal matter swell, increases bulk, transports through body faster
- fybrogel, metamucil, lactulose
- considerations - high oral fluid intake needed
- A/E - diarrhea, abdo cramping, electrolyte loss
- faecal softening agents
- used to treat constipation & prevent straining
- ducosate (coloxyl), liquid paraffin (agarol)
- considerations - liquid paraffin impairs absorption of fat soluble vitamins, can cause anal pruritis, chronic inflammatory reaction
11
Q
Laxatives
A
- stimulant laxatives
- promote water accumulation in the bowel & stimulate nerve endings to increase peristalsis
- bisacodyl, senna
- considerations - abdo cramping, fluid & electrolyte imbalances
- osmotic laxatives
- osmotically draw fluid into the bowel, increasing volume & accelerating transport of stools
- preperations based with glycerol, lactulose, sorbitol
12
Q
Anti-Diarrhoeal Agents
A
- reduce symptoms, reduce fluid & electrolyte loss due to diarrhoea, block stimulation of the GIT
- coat intestinal mucosa, blocking causative agents (bacteria, toxins) & allow them to be passed out
- kaomagma
- opioid anti-diarrhoeals
- activate opioid receptors in the intestinal wall & reduce secretions & peristalsis
- codeine phosphate, diphenoxylate & atropine (lomotil), loperamide (imodium)
13
Q
Bowel Surgery Preperation
A
- depends on procedure
- LWD 2 days prior, strict diet
- clear fluids on day prior
- afternoon before, bowel prep administered