PP: GI QUESTIONS Flashcards
Mrs P, a 40-year-old with a BMI of 28kg/m2 is admitted to your ward with bloating and severe upper abdominal pain at night. She has a history of dyspepsia. She was referred by her GP for an endoscopy which revealed gastritis and a small peptic ulcer.
Which one of the following medicines is contraindicated in women of childbearing age unless they use effective contraceptive measures?
A. Ranitidine
B. Esomeprazole
C. Misoprostol
D. Cimetidine
E. Sucralfate
C
Misoprostol should be avoided in pregnancy as it can precipitate abortion and cause teratogenicity = tx for NSAIDs associated ulceration = potent uterine stimulant
A patient comes into the pharmacy and brings a haemorrhoid preparation to the counter and asks you what does the product contain?
Which one of the following ingredients in haemorrhoid preparations is classed as an astringent?
A. Bismuth oxide
B. Lidocaine
C. Mucopolysaccharide polysulfate
D. Benzocaine
E. Yeast cell extract
A
Bismuth oxide & hamamelis water (witch hazel) are astringents in hemorrhoids preparations
A 3-week-old baby with bouts of extreme crying during which he pulls his legs up to his chest and goes red in the face. The symptoms began yesterday but the child is otherwise well. His mother claims he is otherwise well and the pharmacist is aware of no other symptoms. Which of the following options is most appropriate?
A. Recommend a product containing ispaghula husk
B. Recommend lactulose
C. Recommend a product containing simethicone
D. Recommend Senna liquid
E. Refer urgently to a GP
C
The symptoms describe COLIC. Simethicone drops, such as Infacol, are a supplement that can be added to your baby’s bottle or breast milk before a feed. The drops are designed to help release bubbles of trapped air in your baby’s digestive system.
Mrs P is one of the patients on your oncology ward and has recently had her analgesia increased to Oxycontin (oxycodone MR) 20mg BD alongside OxyNorm (oxycodone) 5mg PRN. A few days later, upon inspecting her stool chart, you notice that she has not opened her bowels for the past 2 days. You discuss with the medical team and agree she needs a laxative.
Which of the following options would be most appropriate?
A. Lactulose 10mL BD PRN
B. Senna 15mg ON PRN
C. Lactulose 10mL BD and Senna 7.5mg-15mg ON PRN
D. Lactulose 10mL BD and Movicol (Macrogol powder) 1 sachet ON PRN
E. Mrs P should be referred for urgent bowel evacuation
C
Constipation in palliative care patients who are receiving opioids should be prevented with the regular administration of laxatives; A FAECAL SOFTENER WITH A PERISTALTIC STIMULANT (e.g. co- danthromer) or LACTULOSE SOUTION WITH A SENNA PREPARATION should be used. METHYLNALTREXONE BROMIDE is licensed for the treatment of opioid induced constipation.
Mr AS is started on Sulfasalazine 1g FOUR times a day for the initial treatment of active Crohn’s disease.
Which of the ADRs listed does Mr AS need to be counselled about?
A. Bradycardia
B. Sore throat
C. Haematuria
D. Myopathy
E. Drowsiness
B
Blood disorders – patients receiving aminosalicylates and their carers should be advised to report any UNEXPLAINED BLEEDING, BRUISING, PURPURA, SORE THROAT, FEVER OR MALAISE that occurs during treatment
What advice is incorrect when a pregnant lady is constipated?
A. A bulk-forming laxative is the first choice during pregnancy if fibre supplements fail.
B. An osmotic laxative, such as lactulose, can also be used.
C. Bisacodyl or Senna may not be suitable if a stimulant effect is necessary.
D. Docusate sodium and glycerol suppositories can also be used.
C
Bisacodyl and Senna MAY be suitable if a stimulant effect is necessary, but the use of Senna should be avoided near term or if there is a history of unstable pregnancy.
Miss P 24-years-old has recently been prescribed Co-Codamol 30mg/500mg for severe back pain, which is under investigation by the MSK team. Since starting the Co-Codamol, she has developed constipation.
Which drugs from below would be least suitable to treat Miss P’s constipation?
A. Sterculia
B. Lactulose
C. Macrogol 3350
D. Senna
A. Sterculia
Mr X has arrived to the pharmacy with a script for Omeprazole 20mg 1 OD. He has never had this medication before, and asks on how best to take the drug.
Which of the statements below described the administration of Omeprazole?
A. Take in the morning, preferable with food, with half a glass of water
B. Take in the afternoon, after your breakfast with half a glass of water
C. Take in the morning, preferably without food, with half a glass of water
D. Take whenever you get the symptoms, the medication will work imminently to relieve
them
A.
Preferably to be taken in the morning, can take with food or on an empty stomach, with half-filled water
A patient has been taking clindamycin for the past three days and has developed nausea and diarrhoea. They ask for your advice about what to do. They have been taking Clindamycin as prescribed: 450mg QDS. They still have four more days of treatment to go. What is the most appropriate advice to give the patient?
A. They should continue with the treatment as usual
B. They should go to A&E immediately
C. They should see their GP to get an alternative medication
D. They should stop taking the Clindamycin immediately and go and get an urgent
appointment with their doctor
E. They should take an over-the-counter medicine for nausea and diarrhoea
D.
With systemic use, clindamycin has been associated with antibiotic-associated colitis, which may be fatal. Patients should, therefore, discontinue treatment immediately if diarrhoea develops.
Misoprostol can be used for benign gastric ulcers, as well as prophylaxis of NSAID-induced peptic ulcers. Which of the following concerning misoprostol is false?
A. Misoprostol is a synthetic prostaglandin analogue
B. Misoprostol can be used for termination of pregnancy following mifepristone
C. Common side effects include diarrhoea and hair loss
D. Manufacturer advises patients should be cautioned on the effects on driving
C
common side effects of misoprostol are nausea, vomiting and rash
