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Pharm Y2S2 > Gastro > Flashcards

Gastro Flashcards

1
Q

What is the approximate height of villi?

A

1mm

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2
Q

What type of cells are 90% of the epithelial lining cells of the small intestine?

A

Enterocytes

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3
Q

Which enzyme breaks down sucrose and what are the products of the reaction?

A

Sucrase

Gives glucose and fructose

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4
Q

Which enzyme breaks down lactose and what are the products of the reaction?

A

Lactase

Gives glucose and galactose

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5
Q

Which enzyme breaks down maltose and what are the products of the reaction?

A

Maltase

Gives glucose and glucose

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6
Q

Which monosacccharides are transported into enterocytes by SGLT1?

A

Glucose

Galactose

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7
Q

How does the SGLT1 transporter work?

A

Sodium dependent, works via electrochemical gradient as small molecules cannot penetrate the apical layer alone

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8
Q

What transports fructose into enterocytes?

A

GLUT5

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9
Q

How do PEPT1 transporters work?

A

Proton dependent

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10
Q

How do hydrophilic drugs enter the enterocytes?

A

Absorption via uptake transporters

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11
Q

What transporters are involved in drug efflux?

A

P-glycoprotein

BCRP

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12
Q

Give examples of drug substrates for PEPT1.

A

Cephalosporins
Penicillins
Enalapril
Val-acyclovir

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13
Q

Give examples of drug substrates for OCTN2 (efflux).

A 
Quinidine
Verapamil
Imatinib
Valproic acid
Val-acyclovir
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14
Q

Give examples of drug substrates for OATP2B1.

A

Pravastatin
Rosuvastatin
Atorvastatin
Fexofenadine

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15
Q

Give examples of drug substrates for P-gp (efflux).

A 
Indinavir
Tacrolimus
Erthromycin
Digoxin
Verapamil
Quinidine
Imatinib
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16
Q

Define peptic ulcer

A

Breach in the continuity of the lining >5mm in diameter with associated inflammation

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17
Q

What are the aims of treatment of peptic ulcers?

A

Complete healing
Managing dyspepsia
Reflux symptoms
GORD

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18
Q

What is GORD?

A

Gastro-oesophageal reflux disorder

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19
Q

What are the symptoms are GORD?

A

Chronic heartburn
Pain
Nausea

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20
Q

What is GORD commonly associated with?

A

Chronic cough and laryngitis

Worsening asthma

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21
Q

What are the alarm features of GORD?

A 
Anaemia
Weight loss
Anorexia
Recurrent problems (>55 years)
Malaena
Haematemesis
Swallowing problems
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22
Q

What are alginates?

A

Foaming agent that forms a raft above gastric contents to reduce reflux and protract oesophageal mucosa

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23
Q

What the common issues with magnesium and aluminium antacids?

A

Magnesium- laxative

Aluminium- constipation

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24
Q

What is the common excipient in antacids than can cause problems?

A

Sodium bicarbonate

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25
Q

What is the common issue with antacids?

A

Can impair absorption of drugs that are basic due to increased pH

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26
Q

When are H2 antagonists used in peptic ulcers?

A

Heal ulcers at high doses, used in NSAID prophylaxis and maintenance as well as GORD

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27
Q

When are PPIs used in GORD?

A

For 1-2 months at full dose and then at lowest dose in case of recurrence

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28
Q

What is misoprostol?

A

Prostaglandin analogue with antisecretory and cytoprotective effects. Promotes ulcer healing and protects from NSAID damage.

29
Q

When should misoprostol be avoided?

A

Pregnancy

30
Q

How is GORD treated in children?

A

Usually resolves itself by 12-18 months in infancy
Can use alginates or thickeners
H2 antagonists then PPI if persistent in older children

31
Q

How is H. pylori detected?

A

Produces antibody that is detectable in serum, saliva or urine

32
Q

What is the treatment process for NSAID associated peptic ulcers?

A

Assume it is due to H. pylori and discontinue NSAID use

PPI to promote rapid healing and reduce relapse

33
Q

What bacteria is the most common cause of peptic ulcers?

A

H. pylori

34
Q

What is achlorydia?

A

Common with long term use of PPI

Low gastric acid production associated with adverse events

35
Q

What are the risks associated with long term use of PPIs?

A 
Pneumonia
Fracture risk
Osteoporosis
Reduced calcium absorption
GI infection risk
Mask GI cancer symptoms
36
Q

Define diarrhoea.

A

Abnormal passing of loose/liquid stools at increased frequency/volume
Generally >70% water

37
Q

What are the red flag symptoms of diarrhoea?

A 
Unexplained weight loss
Blood in stools
Systemic illness
Foreign travel
Symptoms lasting over 1 week
Severe pain
38
Q

What are the common pathogens causing diarrhoea?

A

E. coli
Campylobacter
Salmonella
Shigella

39
Q

What is the normal treatment for diarrhoea?

A

Oral rehydration to replace lost electrolytes

Formulated with dextrose and citrate/bicarbonate

40
Q

What does loperamide do?

A

Increases salt and water reabsorption by reducing gut motility

41
Q

What is the antidote for opioids?

A

Naloxone

42
Q

Give examples of antispasmodics.

A

Meberverine

Dicyclomine

43
Q

When is ciprofloxacin used in IBD?

A

Prophylaxis of infection from shigella/salmonella

44
Q

Give an example of a probiotic?

A

Lactobacilli

45
Q

What is racecadotril?

A

Oral enkephalinase inhibitor reducing hyper secretion of water and electrolytes into the gut lumen

46
Q

What is kaolin?

A

Very low dose morphine used to bulk out stools

47
Q

What is co-phenotrope?

A

Diphenoxylate and atropine

48
Q

When is the rotavirus vaccine given?

A

Two doses at 2 and 3 months old

49
Q

What is pseudomembranous colitis?

A

Caused by C. difficile and transmitted due to poor hygiene, often associated with antibiotic use

50
Q

How is pseudomembranous colitis treated?

A

Metronidazole 400mg tds
Oral vancomycin 125mg qds
Used for 1-2 weeks and can be used together if no resolution

51
Q

What is ulcerative colitis?

A

Inflammation of the mucosa of the rectum and colon

52
Q

What is Crohn’s disease?

A

Patchy, transmural inflammation of the entire gastrointestinal tract

53
Q

How is IBS managed?

A

Corticosteroids
Mild- enemas, suppositories
Diffuse disease- oral aminosalicylate
Severe- hospitalisation, IV corticosteroid and immunosuppressants

54
Q

What is sulphasalazine?

A

Medication used in IBS with no response to local therapy to maintain remission

55
Q

What are the side effects of sulphasalazine?

A

Headaches
Nausea
Infertility in males
Anaemia

56
Q

What is the treatment for acute relapse of IBD?

A

IV hydrocortisone/prednisolone

Immunosuppressants where above does not work (cyclosporin, methotrexate, azothioprine)

57
Q

What are cytokine modulators?

A

Tumour necrosis factor inhibitors given as a 12 month course in IBD

58
Q

Give examples of cytokine modulators.

A

Infliximab, adalimumab

59
Q

Define constipation.

A

Excessive water removal causing less frequent, hard stools

60
Q

Give examples of causes of constipation.

A

Diet and lack of fluid
Diverticulae
Paralysis
Drugs- opiates, CCBs

61
Q

What are bulking agents?

A

Stimulate peristalsis to reduce constipation

62
Q

Give examples of bulking agents.

A

Ispaghula husk

Dietary fibre

63
Q

What are osmotic laxatives?

A

Increase water content of the bowel

64
Q

Give examples of osmotic laxatives.

A

Lactulose

Macrogol

65
Q

Give examples of softening agents.

A

Docusate

Glycerol

66
Q

What is coeliacs disease?

A

Autoimmune response to gluten, causing damage to brush border of small intestine and reduced absorption

67
Q

What are common indications for prescribing ACBS?

A 
Disease related malnutrition
Intractable mal absorption
Dysphagia
Pre-operation preparation
Short bowel syndrome/bowel fistula
68
Q

What is the most common reason for a temporary stoma?

A

The divert faeces away from surgical site or obstruction

69
Q

Give some examples of problems that may occur with appliances such as stomas.

A 
Leaking
Stoma size changes
Skin problems
Dexterity
Odours

Pharm Y2S2 (26 decks)

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