Pharmacology

Question 1

Name three classes of alimentary drugs

Answer 1

Laxatives
Acid suppression drugs (antacids, proton pump inhibitors, H2 receptor antagonists)
Drugs affecting GI motility (anti emetics, anti muscarinics, anti spasmodics and anti motility)

Question 2

Name four drug classes used to treat IBD

Answer 2

Aminosalicylates
Corticosteroids
Immunosuppressants
Biologics

Question 3

Name an example of antacid, what it contains and what action it has

Answer 3

Maalox contains magnesium and aluminium and neutralises gastric acid

Question 4

Name an example of an alginate and what it does

Answer 4

Gaviscon

Form a viscous gel that floats on stomach contents and reduces reflux

Question 5

Name three mucosal protectors

Answer 5

Bismuth, sucralfate, misoprostol

Question 6

Name an example of a H2 receptor antagonist and what it does

Answer 6

Ranitidine
–Block histamine receptor thereby reducing acid secretion
–Indicated in GORD/Peptic ulcer disease
–Given orally or IV

Question 7

Name a proton pump inhibitor and what it does

Answer 7

Omeprezole
Block proton pump and thereby reduce acid secretion
–Indicated in GORD/peptic ulcer disease
–Oral or IV administration
–Widely used (overused?)
–Triple therapy for treatment of PU/DU associated with H pylori
–Problems with GI upset and predisposition to c. difficile infection, hypomagnesaemia, B12 deficiency

Question 8

Name two prokinetics and what they do

Answer 8

Metoclopramide, Domperidone

They increase gut motility and gastric emptying

Question 9

Name two drugs to decrease diarrhoea

Answer 9

Loperamide (Imodium) and opiods

Decrease Ach release to improve sphincter tone

Question 10

Name the four types of laxatives

Answer 10

Bulk (e.g. Isphagula)
–Osmotic (e.g. Lactulose)
–Stimulant (e.g. Senna)
–Softeners (e.g. Arachis oil)
–Work by increasing bulk or drawing fluid into gut

Question 11

Name two aminosalicylates, how they are administered and what side effects they have

Answer 11

Mesalazine, Olsalazine
Administered orally or rectally
Side effects can be renal impairment, Go upset or blood dyscrasia (imbalanced blood)

Question 12

How are corticosteroids administered and what are side effects?

Answer 12

IV, orally or rectally
Osteoporosis
Cushingoid features including weight gain, DM, HT,
Increased susceptibility to infection
Addisonian crisis with abrupt withdrawal

Question 13

Name an immunosuppressant example, how it works and what it’s side effects are

Answer 13

Azathioprine
Prevents the formation of purines required for DNA synthesis so reduces immune cell proliferation
Adverse effects mainly relate to bone marrow suppression but also azathioprine hypersensitivity and organ damage (lung, liver, pancreatitis)

Question 14

Name a biological, how it works, what it’s contraindications are and what it’s adverse effects are

Answer 14

Infliximab
Prevents action of TNFα (key cytokine in inflammatory response)
Contraindicated if Current TB or other serious infection
Multiple sclerosis
Pregnancy/breast feeding
Adverse effects include Risk of infection
Infusion reaction (fever, itch)
Anaemia, thrombocytopenia, neutropenia
Demyelination
Malignancy

Question 15

Name five biologics

Answer 15

Certolizumab
Adalimumab
Natalizumab
Golimumab
Vedolizumab

Question 16

What are the effects of Cholestyramine and it’s drug interactions?

Answer 16

Reduces bile salts by binding with them in the gut and then excreting as insoluble complex
May affect fat soluble vitamin absorption so may decrease vitamin K levels (affecting clotting and warfarin)

Question 17

How does Ursodeoxycholic Acid work and what does it do?

Answer 17

Used for gallstones and PBC
Inhibits an enzyme involved in the formation of cholesterol, altering amount in bile and slowly dissolving non-calcified stones