GI drugs Flashcards
Which drugs can cause constipation?
1) Opiates
2) Calcium channel blockers
3) Anticholinergic drugs (benzhexol, tricyclic antidepressants)
4) Iron
5) Lithium
What is the main treatment for constipation?
Non-pharmacological treatment is preferred.
Increase fibre in diet
Increase fluid intake
Exercise
What is the recommended amount of dietary fibre per day?
18g
What are the 4 classes of pharmacological treatment for constipation?
1) Bulk forming laxatives e.g. ispaghula husk
2) Osmotic laxatives e.g. Mg salts, lactulose
3) Stimulants e.g. Senna
4) Stool softeners e.g. arachis oil
How do we treat diarrhoea?
1) Rehydrate with oral rehydration therapy (e.g. dioralyte)
2) If volume deplete use IV fluids that will replace sodium and potassium (Saline with added K+ and dextrose).
If infective:
Treat with antibiotics: ciprofloxacin, metronidazole, vancomycin.
Loperamide is an opiate that reduces diarrhoea (but can cause constipation).
What drugs can cause diarrhoea?
Laxatives
Antibiotics
SSRIs
Orlistat (causes fat malabsorption, used in obesity)
How do we treat IBS?
If constipation- dietary fibre and laxatives
If diarrhoea- loperamide (opiate).
Psychological approach can be useful in certain cases.
Give muscle relaxants to reduce pain- have variable results:
Antimuscarinics (propantheline), direct acting relaxant (mebeverine, peppermint oil)
How do we treat IBD acutely?
Acutely: IV fluids
Specific treatment: systemic steroids, aminosalicylates (e.g. sulphazalazine, mesalazine, olsalazine).
How do we treat IBD long term?
Aminosalicylates (topically or systemically)
AVOID long term steroids
Give steroid sparing drugs (e.g. methotrexate, azathioprine in Crohns. azothioprine, ciclosporin in UC).
Infliximab may be used for both (this is an anti-TNFa)- Crohn’s for disease resistant treatment and to maintain remissions.
UC for acute exacerbations that are not settling with conventional therapy.
What drugs cause dyspepsia?
NSAIDs Corticosteroids CCBs Bisphosphonates Nitrates Theophyllines
What upper GI tract diseases are associated with H. Pylori?
Peptic ulcer disease
Chronic gastritis
Gastric adenocarcinoma
B lymphoma
Name 3 dopamine antagonist drugs (anti-emetic)?
Dom Peridone
Metoclopramide
Prochlorperazine
What kind of anti-emetic would you give for vertigo?
Anti-histamine
What kind of anti-emetic would you give for motion sickness?
Anticholinergics (e.g. hyoscine bromide)
What kind of anti-emetic would you give for nausea and vomiting SE of morphine use?
Anticholinergics
