22 GI Pharmacology

Question 1

List some of the medications that exacerbate GORD.

Answer 1

1. Alpha-blockers
2. Anticholinergics
3. Benzodiazepines
4. Beta-blockers
5. Bisphosphonates
6. Calcium channel blockers
7. Corticosteroids
8. NSAIDs
9. Nitrates
10. Theophyllines
11. Tricyclic antidepressants

Question 2

The managment of GORD involves a step-up/step-down system. What steps are involved in the pathway?

Answer 2

1. Lifestyle modifications
2. PPIs/H₂RA/Antacids
3. Increase dose/frequency
4. Surgery (fundoplication)

PPIs provide rapid relief and healing in >80%

Question 3

Give 2 examples of proton pump inhibitors (on the drug list).

Answer 3

Omeprazole

Lansoprazole

Question 4

What are some of the symptoms of gastritis?

Question 5

What complication can occur as a result of gastritis?

Question 6

Give some causes of gastritis (erosive, non erosive)

Answer 6

Erosive

• NSAIDs
• Alcohol
• Bile

Non-erosive

• H.pylori

Autoimmune

Question 7

How is gastritis due to erosive causes (NSAIDs, alcohol, bile) managed?

Answer 7

1. Stop irritant
2. PPI/H2 RA

Question 8

What is involved in the therapy used to eradicate H.pylori infections?

Answer 8

• Triple therapy
  
  • PPI
  • Amoxicillin
  • Clarithromycin/Metronidazole
• Quadruple therapy
  
  • Clarithromycin/Metronidazole
  • Amoxicillin
  • PPI
  • • Bismuth (subsalicylate)
      
      • (The mechanisms of actions of bismuth on gastrointestinal pathogens including H. pylori are complex and include inhibition of protein and cell wall synthesis, membrane function and ATP synthesis. Adherence of H. pylori to surface epithelial cells is also impaired- have synergistic effects with antibiotics)

Question 9

If someone suffers from autoimmune causes of gastritis drug are they likely to be on long term?

Answer 9

Cyanobalamin

To treat vitamin B12 deficiency- synthetic form