Passmed Gastroenterology - Pharmacological Managements Flashcards
Acute upper GI bleed
Platelets if <50
FFP if fibrinogen/APTT deranged
Terlipressin + antibiotics
Alcoholic ketoacidosis
Infusion of saline + thiamine
Alcoholic hepatitis
Prednisolone
Ascites
Spironolactone
Prophylactic ciprofloxacin
Autoimmune hepatitis
Steroids
Bile acid malabsorption
Cholestyramine
Carcinoid tumours
Octreotide (somatostatin analogue)
H. pylori eradication
PPI + amoxicillin + clarithromycin/metronidazole (both if PA)
Prophylaxis of hepatic encephalopathy
1st - lactulose
2nd - add rifaximin
IBS symptom management
Pain - antispasmodic agents
Constipation - laxatives, avoid lactulose
Diarrhoea - loperamide
Peptic ulcer - acute bleeding
IV PPI
Primary biliary cirrhosis
Ursodeoxycholic acid
If itching = cholestyramine as well
Main adverse effects of PPIs (3)
Hyponatraemia, hypomagnesaemia
Osteoporosis
Increased risk of C. diff
Consequences of refeeding syndrome
Hypophosphataemia
Hypokalaemia
Hypomagnesaemia
How to prevent refeeding syndrome?
If haven’t eaten for >5 days, only re-feed at max 50% of requirements for the first 2 days