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
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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
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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
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4
Q

Corticosteroids

A
  • have been found effective for chemotherapy induced nausea
  • dexamethasone
  • methylprednisolone
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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
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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
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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
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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
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9
Q

IBD - Management - Aminosalicylates

A
  • management includes corticosteroids (prednisolone), immunosuppressants & aminosalicylates
  • aminosalicylates - prostaglandin inhibitors used to reduce inflammation
  • sulfasalazine
  • mesalazine
  • olsalazine
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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
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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
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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)
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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
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