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Drugs > Pooping > Flashcards

Pooping Flashcards

1
Q

Drugs causing diarrhoea

A

Anti virals, bacterial, fungal (capsofungin), antimalarial
Anti psychotic
Metformin

Ace inhibitors and ARB-I
Antacids
Alpha blockers

NSAIDs, cytokine blockers, ulcer healing meds

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2
Q

Use of opioids?

A

Treat diarrhoea, particularly when uncontrolled or w stoma

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3
Q

Best drug to treat diarrhoea where there is visceral pain and intestinal fluids
Avoid in whom?

A

Linaclotide guanylate Cyclase C receptor agonist

Avoid in obstruction

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4
Q

Anti motility drugs?

Avoid in dysentery

A

Loperamide

Avoid

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5
Q

What are synthetic opioids?

Careful with?

A

Atropine

Careful w dependence issues
Avoid co prescribing w MAO-I

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6
Q

Causes of constipation

A

Anti-viral, psychotics, cholinergics, epileptics
Antacids

Biphosphonates 
Beta blockers 
Opioids
NSAIDs 
Calcium channel blockers
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7
Q

Patient with hepatic encephalopathy who is constipated?

A

Osmotic laxative- lactulose

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8
Q

Constipated patient w fecal haemorrhoids, avoid what?

A

Avoid rectal prescription of fecal softener (docusate)

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9
Q

Patient with constipation and suspected bowel obstruction- avoid what?

A

Bulk forming laxatives

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10
Q

What are the simulant laxatives?

A

Bisocydol, senna

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11
Q

FODMAP=?

A

Fermentable oligosaccharides disaccharides, monosaccharides and polyols

Limit this w issues of over activity of bowel

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12
Q

Dietary recommendation to reduce diarrhoea frequency

A

Increase fibre- non fermenting fibre, psyllium e.g.

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13
Q

Smoking and IBD?

A

Bad for UC

Good for Crohns

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14
Q

What key questions would you ask in a IBD Hx?

A 
Genetics: 15% patients have first degreee relative w condition 
Anti microbial or NSAIDs can exacerbate 
Loss of intestinal flora 
Stress?
Smoking 
Infection and UC symptoms
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15
Q

Pathological feature of UC?

A 
Loss of haustra 
Depleted goblet cells
Cryptic abscesses 
Distorted atrophic glandular architecture 
Uniformly heavy lymphocytic infiltrate 
No granulomas
Thickened muscularis mucosa
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16
Q

Pathological features of crohns ?

A 
Normal goblet cells
Scanty crypt abscesses 
Preserved glandular architecture
Patchy, heavy in places,. Lymphocytic infiltrate 
Granulomas
Normal muscularis mucosae 
Lots of submucosal inflammation
17
Q

Drug therapy options for IBD?

Why is the route of administration important?

A

Aminoacylates
Immunosuppression- azathioprine
Immunomodulators-MABs
Antibiotics

Minimisé systemic absorption and maximise intestinal absorption

18
Q

Drugs be mindful to prescribe by brand?

A

Amino salicylates

19
Q

Immunosuppressants

A

Thioguanines; azothioprine; methotrexate; cyclosporate; mycophenolate

Use in those non reps nice to steroids of amino salicylates

20
Q

What are Thioguanines?

Side effects
Caution

A

Immunosuppressants - azathioprine or 6-mercaptopurine

Métabolised on the liver to the active
Inhibit purine synthesis

Hepatotoxic
Pancreatitis

immunosuppressive , so avoid active vaccines

21
Q

Methotrexate

Prescribing points

A

Induce or maintain remission esp in Crohns
Inhibits DHFR

GI related SE, hepatotoxic
Prescribe every week but not on day you co prescribe with folic acid
Avoid active vaccines

22
Q

Biological agents for IBD

A

Target B and T

iL1 and TNF

23
Q

Drug likely to be cause of Peptic ulcer

A

NSAIDs

24
Q

Treating Peptic ulcer disease (H Pyolori -)

A

Endoscopy to ID high risk patients (active bleeding,. Adhérent clôt)

Adrenaline with human thrombin and fibrin flue

Acid suppression with ppi

Check medications patient might be taking for interaction, like clopidogrel or omeprazole

25
Q

What are antacids?

A

Symptomatic relief for GORD and dyspepsia
Short term management of uncomplicated ulcers, divided into aliminium based and magnesium based. Magnesium can cause diarrhoea whereas aluminium can cause constipation

26
Q

What are H2 receptor antagonists ?

A

Compétitive inhibition of histamine receptors in gastric parietal cells

Cimedtidine, ranitidine, nizitadine
(All subject to first pass metabolism)

Rénal exertion so beware of renal impairment

27
Q

Proton pump inhibitors

A

Inhibit gastric HK ATPase channels- last step in gastric acid secretion

Different ppis bind to different sites on the pump which explains their potency differences

Métabolised in liver and exerted by kidneys

Gel ulcers

Drugs (8 decks)

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