Pharmaceutical care of GI patients (THERAPEUTICS is on wordpad)

Question 1

Symptoms of Dyspepsia (7)

Answer 1

Heartburn
Fullness 
Early satiety
Upper abdominal pain/ache
Flatulence 
Hiccup coughing
Belching

Question 2

ALARM symptoms of dyspepsia

Answer 2

A - Over 55 years
L - Significant unintentional weight loss
A - Anaemia
R - Recurrent vomiting/difficulty swallowing
M - Malaena

Question 3

Pharmacological causes of dyspepsia: (5)

Answer 3

• Calcium antagonists
• Nitrates
• Theophylline
• Bisphosphonates
• NSAIDs

Question 4

Causes of dyspepsia that needs referral! (7)

4 of them are the same as ALARM symptoms

Answer 4

• Chronic GI bleed
• Progressive unintentional weightloss
• Progressive difficulty swallowing
• Persistent vomiting
• Iron deficient anaemia
• Epigastric mass
• Suspicious Barium meal

Question 5

Antacids are used to treat dyspepsia, they contain either a aluminium or magnesium salt as well as alginates

Name ONE side effect of Magnesium and ONE of Aluminium
Bonus: What is the function of the alginates

Answer 5

Magnesium- laxative effect
Aluminium- constipating

alginates form a raft, preventing acid reflux into oesophagus

Question 6

List some non-pharmacological advice a pharmacist could give to a patient with DYSPEPSIA

(7….. 4 are food/drink related)

Answer 6

DON’Ts:

1) smoking
2) alcohol
3) coffee
4) Fatty foods
5) Avoid eating late

DO’s

1) reduce weight
2) Raise head when sleeping

Question 7

What is the main therapeutic option for GORD patients? (and for how long would they be prescribed a full dose of this?)

Answer 7

PPI

1 or 2 months

Question 8

What tests can be done to diagnose Inflammatory Bowel disease (IBD)? (UC + Crohns)

Answer 8

• BLOOD test (signs: inflam, anaemia, vit/min deficiency?)
• STOOL test (c.diff inf? diarrhoea?)
• SIGMOIDOSCOPY/COLONOSCOPY (confirm)
• CT of Bowel
• LFT
• temperature

Question 9

IBS and IBD have very similar symptoms. What substance is released in excess when the intestines are inflammed?

(this helps with the differential diagnosis between the two)

Answer 9

Faecal calprotectin

Question 10

Where would these be absorbed?

Water
Iron and calcium
Folic acid
Fat and Vit B12

Answer 10

Colon- Water
Duodenum- Iron and calcium
Jejunum- Folic acid
Ileum- Fat and Vit B12

Question 11

Name which area of the GIT you would use these forms for:
suppositories
enemas
foam

Answer 11

• Suppositories: rectum (proctitis)
• Enema: Descending colon (left-sided colitis)
• Foam: Sigmoid colon (proctosigmoiditis)